SERIAL DOPPLER-ECHOCARDIOGRAPHIC EVALUATION OF BIOPROSTHETIC VALVES IN THE TRICUSPID POSITION

Objectives. This study sought to evaluate bioprosthetic valve dysfunct ion in the tricuspid position by serial Doppler echocardiography. Back ground. Few reports on the long-term results of tricuspid valve replac ement with bioprosthetic valves are evaluated by serial Doppler echoca rdiography. Methods. Between September 1979 and December 1993, 95 pati ents underwent tricuspid valve replacement with bioprosthetic valves a t our facility. Sixty patients who underwent serial Doppler echocardio graphic examination at intervals of at least 2 years after operation w ere included in the final analysis. These patients were followed up fr om 1.5 to 13.0 years (mean 5.8 +/- 2.5). Results. The actuarial rates of freedom from bioprosthetic valve stenosis and regurgitation at 10 y ears were 46% and 51%, respectively. The prevalence of bioprosthetic v alve stenosis and regurgitation increased progressively in a linear ma nner beginning 1 or 2 years after tricuspid valve replacement. Right h eart failure developed during follow up in 20 of the 25 patients with bioprosthetic valve dysfunction. Conclusions. The long-term durability of bioprosthetic valves in the tricuspid position was substantially l ower in our study than that reported in previous studies. Tricuspid bi oprosthetic valve dysfunction increased progressively in a linear mann er beginning 1 to 2 years after tricuspid valve replacement.