10-YEAR EXPERIENCE WITH THE CARPENTIER-EDWARDS PERICARDIAL XENOGRAFT IN THE TRICUSPID POSITION

We reviewed the cases of 66 patients who underwent 67 tricuspid valve replacements with Carpentier-Edwards pericardial xenografts between Ap ril 1985 and January 1994. Average patient age at time of operation wa s 52 years (range 8 to 71 years), Concomitant mitral or aortic valve r eplacements were performed in 46 patients, There were 10 operative dea ths and 6 late deaths, Actuarial survival at 9 years was 75.4% +/- 5.7 %, Prosthetic valve endocarditis occurred twice in one patient, Reoper ations for tricuspid regurgitation and for concomitant procedures (maz e operation and repair for leak of the mitral prosthesis) were perform ed in two patients. In both cases, examination of the explanted prosth eses showed that the tricuspid regurgitation was the result of nonstru ctural dysfunction caused by fibrous pannus formation on the cusps of the ventricular side. Among the survivors, 47 patients (92%) were in f unctional class I or II, Prosthetic valve function was studied by colo r Doppler echocardiography, Among 38 patients, tricuspid regurgitation more than grade 3/4 or transprosthetic gradient more than 5 mm Hg was found in 11. One patient had right heart failure and the others had n o symptoms. In 10 years of experience with the Carpentier-Edwards peri cardial xenograft, mortality and morbidity after tricuspid valve repla cement were satisfactory, Echocardiographic examination revealed subcl inical prosthetic dysfunction in 35% of patients who were followed up for longer than 5 years, however, and we believe that these patients s hould receive careful follow-up.