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Long-Term Clinical Results of Tricuspid Valve Replacement

Authors
 Byung-Chul Chang  ;  Sang-Hyun Lim  ;  Gijong Yi  ;  You Sun Hong  ;  Sak Lee  ;  Kyung-Jong Yoo  ;  Meyun Shick Kang  ;  Bum Koo Cho 
Citation
 ANNALS OF THORACIC SURGERY, Vol.81(4) : 1317-1324, 2006 
Journal Title
 ANNALS OF THORACIC SURGERY 
ISSN
 0003-4975 
Issue Date
2006
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bioprosthesis* ; Child ; Child, Preschool ; Female ; Heart Valve Prosthesis*/adverse effects ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Prosthesis Design ; Risk Factors ; Time Factors ; Treatment Outcome ; Tricuspid Valve/surgery*
Abstract
BACKGROUND: Tricuspid valve replacement (TVR) has been performed with mechanical or bioprosthetic valves. However, the relative advantages of the two types are incompletely known. METHODS: Between 1978 and 2003, we performed 138 TVR (35 bioprosthetic, 103 mechanical) in 125 patients (50 men, 75 women), with a mean age of 43.7 +/- 16.6 years. The diseases that required TVR were rheumatic (94), prosthetic valve failure (14), congenital (14), infective endocarditis(5), isolated tricuspid regurgitation (4), and miscellaneous conditions (7). The operations included the following: isolated TVR (41), double valve replacement (58), and triple valve replacement (39). The follow-up rate was 98.3%, and cumulative follow-up was 828.5 patient-years. RESULTS: There were 22 in-hospital deaths (17.6%) and 13 (10.4%) late deaths. Fourteen patients required additional operations. There were 33 postoperative valve-related events including 11 thromboembolisms and 3 bleeding episodes. Kaplan-Meier survival for the entire group at 15 years was 73.8 +/- 8.5% (bioprosthetic: 70.2 +/- 10.4%, mechanical: 66.0 +/- 19.4%). At 15 years, freedom from reoperation was 66.3 +/- 9.4% (bioprosthetic: 55.1 +/- 13.8%, mechanical: 86.0 +/- 6.2%) and freedom from valve-related events was 49.9 +/- 8.0%. The linearized incidence of valve thrombosis was 1.28%/patient-year (bioprosthetic: 0, mechanical: 1.92), anticoagulation-related bleeding was 0.37%/patient-year (mechanical: 0.54), reoperation was 1.71%/patient-year (bioprosthetic: 2.68, mechanical: 1.25), and valve-related events were 4.33%/patient-year (bioprosthetic: 3.83, mechanical: 4.6). CONCLUSIONS: Both bioprosthetic and mechanical valves revealed similar long-term outcomes. However, findings suggest that greater care is needed to prevent valve thrombosis in mechanical valves in the early postoperative period, and there is a greater chance for reoperation in bioprosthetic valves.
Full Text
http://www.sciencedirect.com/science/article/pii/S0003497505019661
DOI
10.1016/j.athoracsur.2005.11.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Meyun Shick(강면식)
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lim, Sang Hyun(임상현)
Chang, Byung Chul(장병철)
Hong, You Sun(홍유선)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109082
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