LONG TERM RESULTS OF THE TRICUSPID VALVE REPLACEMENT

Murat Mert, *Alev Arat Özkan, Ahmet Özkara, Gürkan Çetin, İhsan Bakır, Serdar Küçükoğlu, **Atıf Akçevin, İlhan Günay

İstanbul Üniversitesi Kardiyoloji Enstitüsü, Kalp Damar Cerrahisi Kliniği, İstanbul
*İstanbul Üniversitesi Kardiyoloji Enstitüsü, Kardiyoloji Kliniği, İstanbul
**VKV Amerikan Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul

Interventions on the tricuspid valve are not in the same amount as the aortic and/or mitral valves in cardiac surgery and valvular plasty procedures consists the majority of these interventions. Because of its poor long-term results, Tricuspid valve replacement (TVR) is reserved for the patients who have not other therapeutic means. We present in the current manuscript the follow-up results of the patients who have undergone TVR.

Between the years 1990 and 2003, 33 patients (22 female, 11 male) underwent TVR procedure in our clinic. The mean age of the patients at the time of operation was 36.2 (± 18.2). Of these patients, 9 had congenital cardiac pathologies and 6 had already undergone tricuspid valve plasty procedures. Isolated TVR was accomplished in 14 patients whereas concomittant cardiac procedures were added to TVR in 19 patients. The type of the prosthesis was mechanic in 26 and biologic in 7 patients.

Six patients died during the early post-operative period (18.2%) and 27 patients were discharged from the hospital. Of the discharged patients, 3 were lost to follow-up. The remaining 24 patients ( 88.9% of the discharged patients) were followed for a mean period of 70.6 months (± 54 months). Seven patients died during the follow-up period and thrombosis on the tricuspid prosthesis was detected in 2 patients. The remaining 15 patients (45.4%) are still alive without any need for a re-intervention on the tricuspid valve. In statistical analysis, we could not detect any factor related directly to mortality following TVR.

The results of the TVR are still far from ideal and carry a significant mortality. As the disease is generally a result of advanced aortic and/or mitral valve disease, the most effective prevention is to intervene in aortic and/or mitral valve diseases at the most suitable time point before it causes an irreversible tricuspid pathology. In cases where TVR is mandatory, the tendency of our clinic is to use bioprosthesis

Keywords : Tricuspid valve, valve replacement, mechanical prosthesis, bioprosthesis

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