PMID- 7495588
OWN - NLM
STAT- MEDLINE
DCOM- 19960117
LR  - 20190512
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 9
IP  - 8
DP  - 1995
TI  - The valve choice in tricuspid valve replacement: 25 years of experience.
PG  - 441-6; discussion 446-7
AB  - This study reviews 146 consecutive patients who underwent tricuspid valve 
      replacement (TVR) with 69 bioprostheses (porcine and bovine pericardial) and 77 
      mechanical ball, disc or bileaflet valves between 1967 and 1987. The mean age was 
      51.4 +/- 12.1 years. Preoperatively, 97% were in New York Heart Association 
      (NYHA) functional class III or more and over 40% had undergone previous cardiac 
      surgery. Hospital mortality was high (16.1%). Incremental risk factors for 
      hospital death were preoperative icterus (P < 0.01), hepatomegaly (P = 0.02), 
      NYHA functional class IV (P = 0.02) and male sex (P = 0.04) (univariate 
      analysis). Ninety-eight percent of the hospital survivors were followed up for a 
      mean of 92 months. Cumulative follow-up added up to 955 patient-years. There were 
      70 late deaths. The actuarial survival rate was 74% at 60 months and less than 
      25% at 14 years. Incremental risk factors for late death indicated by univariate 
      analysis were the type of tricuspid prosthesis (Smel-off-Cutter and Kay-Shiley 
      prostheses) (P = 0.04), the type of operative myocardial protection (normothermia 
      and coronary perfusion) (P = 0.05) and preoperative NYHA functional class IV (P = 
      0.05). We conclude that TVR carries a high operative risk and poor long-term 
      survival, both influenced by preoperative and perioperative variables. Bearing in 
      mind the poor prognosis for TVR, we prefer a large-sized bioprosthesis, in view 
      of its initial good durability and low risk of valve-related events. However, in 
      patients with good life expectancy, a bileaflet mechanical prosthesis may be an 
      acceptable alternative.
FAU - Van Nooten, G J
AU  - Van Nooten GJ
AD  - Department of Cardiac Surgery, University Hospital of Gent, Belgium.
FAU - Caes, F L
AU  - Caes FL
FAU - Francois, K J
AU  - Francois KJ
FAU - Taeymans, Y
AU  - Taeymans Y
FAU - Primo, G
AU  - Primo G
FAU - Wellens, F
AU  - Wellens F
FAU - Leclerq, J L
AU  - Leclerq JL
FAU - Deuvaert, F E
AU  - Deuvaert FE
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Actuarial Analysis
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Animals
MH  - *Bioprosthesis
MH  - Cattle
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/etiology/mortality
MH  - Prosthesis Design
MH  - Prosthesis Failure
MH  - Reoperation
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Swine
MH  - Tricuspid Valve Insufficiency/mortality/*surgery
MH  - Tricuspid Valve Stenosis/mortality/*surgery
EDAT- 1995/01/01 00:00
MHDA- 1995/01/01 00:01
CRDT- 1995/01/01 00:00
PHST- 1995/01/01 00:00 [pubmed]
PHST- 1995/01/01 00:01 [medline]
PHST- 1995/01/01 00:00 [entrez]
AID - 10.1016/s1010-7940(05)80080-6 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 1995;9(8):441-6; discussion 446-7. doi: 
      10.1016/s1010-7940(05)80080-6.