Original article: cardiovascularTricuspid valve replacement: an analysis of 25 years of experience at a single center
Section snippets
Material and methods
Ninety-seven patients who underwent isolated, reoperative, or combined tricuspid valve replacement with an associated mitral or aortic replacement between 1977 and 2002 were reviewed. All patients were prospectively followed at the Montreal Heart Institute Valve Clinic with annual follow-up visits. The follow-up was complete in all except 3 patients (3%). The follow-up duration averaged 4 ± 5 years, ranging from 0 to 21 years. During the same period, 463 patients underwent a conservative
Characteristics of patients
Sixty-one women (74%) and 21 men (26%) with a mean age of 53 ± 13 years underwent tricuspid valve replacement with a bioprosthesis (group 1, n = 82), and 10 women (66%) and 5 men (33%) with a mean age of 48 ± 11 years underwent tricuspid valve replacement with a mechanical valve (group 2, n = 15). Congestive heart failure and prosthetic valve dysfunction were the two indications for operation in both groups (Table 1). Significant tricuspid regurgitation was the most common indication for
Comment
Tricuspid valve replacement remains the second and the last choice of treatment in patients with tricuspid regurgitation and in the rare occurrence of tricuspid stenosis in which repair is not feasible or has already failed. In the present study, most patients had previous left-sided valve replacements. Mechanical valves were most often used in patients undergoing isolated and reoperative tricuspid valve replacement as opposed to those undergoing combined tricuspid and left-sided valve
References (14)
- et al.
Guidelines for reporting morbidity and mortality after cardiac valvular operations
Ann Thorac Surg
(1996) - et al.
Tricuspid valve replacement. Fifteen years of experience with mechanical prostheses and bioprostheses
J Thorac Cardiovasc Surg
(1995) - et al.
Tricuspid valve replacement with bioprostheseslong-term results and causes of valve dysfunction
Ann Thorac Surg
(2001) - et al.
In-hospital, and long-term outcome after porcine tricuspid valve replacement
J Thorac Cardiovasc Surg
(1995) - et al.
Tricuspid valve operations in 530 patients. Twenty-five year assessment of early and late phase events
J Thorac Cardiovasc Surg
(1990) - et al.
Tricuspid valve replacementUK Heart Valve Registry mid-term results comparing mechanical and biological prostheses
Ann Thorac Surg
(1998) - et al.
Prosthetic replacement of the tricuspid valvebiological or mechanical?
Ann Thorac Surg
(1998)
Cited by (89)
Early and long-term outcomes of bioprosthetic versus mechanical tricuspid valve replacement: A nationwide population-based study
2023, Journal of Thoracic and Cardiovascular SurgeryOutcomes After Tricuspid Valve Operations in Patients With Drug-Use Infective Endocarditis
2022, American Journal of CardiologyTricuspid valve replacement: The old and the new
2022, Progress in Cardiovascular DiseasesCitation Excerpt :It has been shown than porcine bioprostheses (such as the Hancock valve and the Carpentier-Edwards bioprostheses) in the TV position yield significantly better long-term results than those in the mitral position when the same bioprostheses were implanted in both mitral and TV positions in the same patient.15 Differences in pressure and velocity at the two valve locations with a lower pressure in the right side of the heart and a greater mechanical stress on the cusps at the mitral position are a more likely explanation for a longer durability of bioprosthetic valves and a lower rate of reoperation in the TV position.16 First studies published in the nineties reported a durability of bioprostheses in the TV position between 7 and 9 years, with a steeper increased rate of bioprosthetic valve degeneration after 7 years.17
Mechanical Versus Bioprosthetic Valve Replacement in the Tricuspid Valve Position: A Systematic Review and Meta-Analysis
2021, Heart Lung and CirculationFifteen-Year Outcomes After Bioprosthetic and Mechanical Tricuspid Valve Replacement
2020, Annals of Thoracic Surgery