Long-Term Outcomes of Tricuspid Valve Replacement in the Current Era

摘要: Background Regardless of the indication, tricuspid valve replacement (TVR) has historically been associated with high mortality and morbidity. We report results our experience in a high-risk patient population an emphasis on operative mortality, long-term survival, related events according to type prosthesis. Methods Between 1985 1999 TVR was performed 81 patients (isolated n=25, combined surgery n=44, CABG or other n=12). The mean age 61 years old (range 19–83 old). Risk factors included New York Heart Association functional class III/IV (n = 73, 90%), reoperation 58, 72%), urgent/emergent indication 62, 76%), hepatic dysfunction 13, 16%). Mean pulmonary artery pressure 34 mmHg. Etiology regurgitation classified as 18, 22%) organic 52, 64%), failed previous 11, 14%). Results Tricuspid either bioprosthetic 34, 42%) mechanical 47, 58%). overall 22% 18). for status, greater than 50 old, etiology, elevated pressure. Of 60 survivors, 26 (43%) died during follow up. After univariate analysis, etiology only predictor late death ( p 0.01). Kaplan-Meier survival at 2.5, 5, 10 80%, 60%, 45% bioprosthetic, 84%, 69%, 59% valves, respectively. Conclusions Patients requiring are typically high-percentage reoperations, concomitant cardiac procedures, end-stage class. Operative remains high. failure predominant cause early deaths, emphasizing importance timely referral before development impairment.