TRICUSPID-VALVE REPLACEMENT - LONG-TERM C LINICAL AND ECHOCARDIOGRAPHIC FOLLOW-UP

Long term results of tricuspid valve replacement, were evaluated by ec hocardiographic and clinical means retrospectively on 55 patients hosp italized at the Montreal Heart Institute between 1969 and 1993. Twenty seven percent were male and 73 % female. Taking into account differen ces in means of myocardial protection the whole population was divided in 2 groups. Group 1: 19 patients from 1969 to 1980. Group 2: 36 pati ents - from 1981 to 1994. Forty seven patients (85 %) received a biopr osthesis and 8 (15 %) a mechanical valve. Forty one (74 %) had another surgical procedure and 60 % (33 patients) - were re-operations. Morta lity at 30 days is 23 % (13 patients) 15 % group 1 and 27 % group 2. T wenty six patients (72 %) of group 2 were re-operations compared with 7 (36 %) for group 1 (p = 0.026). Risk factors of operative mortality were: high systolic pulmonary pressure (0.051), bypass time (0.012) an d abnormal ejection fraction (0.025). Mean time of follow up is 113.8 months completed at 95 %. Six patients were re-operated; 4 for failure of bioprosthesis 11.5 years (mean) after initial surgery. Forty three percent of patients presented with an amelioration of NYHA class, 26% in class I and 50% in class II. Mean gradient across the tricuspid va lve was 4.1 +/- 1 mm Hg. Twenty two over 42 patients (50 %) died durin g follow up; 75 months after surgery.