TRICUSPID-VALVE SURGERY - RECENT EXPERIENCE AT THE CHAIM-SHEBA-MEDICAL-CENTER

From 1 January 1989 to 30 June 1992, 35 patients underwent cardiac sur gery that included a tricuspid valve (TV) procedure. All had severe TV dysfunction documented by echocardiography, and were in NYHA function al class III-IV. The etiology of TV dysfunction was rheumatic-function al in 19 patients, rheumatic-organic in 13, and infective in 3. Ninete en (54%) had had at least one previous cardiac operation, and in 29 an associated procedure (MVR, AVR, DVR, DVR + CABG) had been performed. The TV was repaired in 27 patients, was replaced by a bioprosthesis in 7, and was excised in 1. There were three (8.6%) operative and two la te deaths. Except for two, all surviving patients are in NYHA function al class I-II. In two patients with organic lesions who underwent repa ir, residual moderate tricuspid regurgitation was observed. We conclud e that in these critically ill patients TV surgery can be performed wi th acceptable results. Long-term fate of a bioprosthesis in the tricus pid position is yet to be determined.