Twenty-five year outcomes of tricuspid valve replacement comparing mechanical and biologic prostheses

Andrea Garatti, Giovanni Nano, Giuseppe Bruschi, Alberto Canziani, Tiziano Colombo, Alessandro Frigiola, Luigi Martinelli, Lorenzo Menicanti

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Tricuspid valve replacement (TVR) has historically been associated with high mortality and morbidity, and current knowledge of long-term results of TVR is limited. This study reviewed our experience from a consecutive series at 2 institutions. Methods: Ninety patients (65 women [72%]; mean age, 53.8 ± 14.2 years; mean body surface area, 1.6 ± 0.2 m 2) underwent TVR between January 1980 and December 2005. The etiology was secondary to left-heart valve disease in 56 patients (62%), degenerative disease in 16 (18%), Ebstein anomaly in 7 (8%), and endocarditis in 11 (12%). Seventy patients (78%) were in New York Heart Association class III or IV. Sixty patients (67%) underwent redo procedures. TVR was with a mechanical valve in 46 patients (51%) and a biologic prosthesis in 44 (49%). Results: The overall operative mortality was 17.7% (16 patients). During follow-up, 16 of the 74 survivors died. Kaplan-Meier survival at 5, 10, and 15 years was, respectively, 72%, 65%, and 63%. During follow-up, 16 patients (21.6%) underwent reoperation; among them, 8 with a mechanical valve underwent reoperation for tricuspid valve thrombosis and 6 with a biologic prosthesis for tricuspid valve deterioration. However, freedom from reoperation at 5 and 10 years was similar between mechanical (86% and 76%) and bioprostheses (97% and 83%). All 16 patients survived the reoperation. Conclusions: The present experience suggests that the type of implanted prosthesis in the tricuspid position does not affect early and long-term outcomes or the reoperation rate. Timely referral before end-stage cardiac impairment develops could determine further outcomes improvement.

Original languageEnglish
Pages (from-to)1146-1153
Number of pages8
JournalAnnals of Thoracic Surgery
Volume93
Issue number4
DOIs
Publication statusPublished - Apr 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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