Cor Vasa 2010, 52(5-6):347-352 | DOI: 10.33678/cor.2010.087

Isolated tricuspid surgical procedures

Petr Němec^*, Milan Frélich, František Štětka, Jan Černý, Jiří Ondrášek, Petr Pokorný

Centrum kardiovaskulární a transplantační chirurgie, Brno, Česká republika

Aim: To evaluate outcome of surgery of the tricuspid valve only.

Patients and methods: Between 1998 and 2008, isolated tricuspid valve surgery was performed in 54 patients (8.9% of all patients undergoing combined procedures including the tricuspid valve). The group of patients consisted of 24 men and 30 women aged 20-80 years (mean, 56.5 ± 16.7 years). The majority of patients was in NYHA functional class III and IV. Twenty-seven patients had primary surgery while reoperation was undertaken in another 27 patients. The time interval between the first operation and reoperation was 16.7 ± 13.0 years (1 day-46 years).

Results: Tricuspid valve repair could be performed in 41 patients; valve replacement was carried out in 13 patients (bioprosthesis was used in 12 patients and a mechanical prosthesis in one patient). Functional class improved from 2.9 ± 0.8 before surgery to 1.7 ± 0.7 post-surgery (p < 0.05). One patient died of heart failure in the early postoperative period. Another three patients died of multiorgan failure during the initial hospital stay. Data of long-term follow-up (30.6 ± 27.7 months) were obtained in 96.4% of patients. During this period, 5 patients died from cardiac causes and 4 patients from extracardiac ones. One-, two- and five-year survival was 83%, 78% and 68%, respectively.

Conclusions: Cardiologists and cardiac surgeons have paid increasing attention to the tricuspid valve. The reason is the negative impact of tricuspid regurgitation on the long-term prognosis of patients, resulting in changing criteria for surgical treatment. Based on our results, the criteria for tricuspid valve surgery (specifically surgery for left-sided valve impairment) should be extended, given the low risk in primary surgical procedures, so as to avoid reoperations carrying a high risk.

Keywords: Tricuspid valve; Primary operation; Reoperation

Published: May 1, 2010  Show citation