A review of surgery for acquired tricuspid valve disease, including an assessment of the stented semilunar homograft valve, and the results of operation for multivalvular heart disease.

B. G. Barratt-Boyes, J. D. Rutherford, R. M. Whitlock, J. R. Pemberton

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A total of 246 operations were performed in 230 patients for correction of acquired tricuspid valve disease. All but three of the patients had multivalvular heart disease. There was an 11% hospital mortality which fell to 7% in the later era (1973-82). Mortality was similar for tricuspid annuloplasty and tricuspid replacement and for double and triple valve surgery. On multivariate analysis the incremental risk factors for hospital death were extreme functional disability (Class V), being of Caucasian race, and having a high cardiothoracic ratio (CTR). Actuarial survival was 58% at 9 years postoperative. The incremental risk factors for late death were prior cardiac surgery, age at operation greater than or equal to 55 years, and advanced functional disability (Classes IV, V). The actuarial incidence of significant tricuspid incompetence following annuloplasty was 12% at 3 years, and following stented homograft semilunar valve replacement was 6% at 3 years and 24% at 8 years. Severe homograft valve incompetence was always associated with recurrent left-sided valve lesions or residual pulmonary hypertension. It is concluded that a homograft valve is a superior form of tricuspid valve replacement.

Original languageEnglish (US)
Pages (from-to)23-34
Number of pages12
JournalAustralian and New Zealand Journal of Surgery
Volume58
Issue number1
StatePublished - Jan 1988

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Tricuspid Valve
Allografts
Heart Diseases
Tricuspid Valve Insufficiency
Hospital Mortality
Pulmonary Hypertension
Thoracic Surgery
Multivariate Analysis
Survival
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "A review of surgery for acquired tricuspid valve disease, including an assessment of the stented semilunar homograft valve, and the results of operation for multivalvular heart disease.",
abstract = "A total of 246 operations were performed in 230 patients for correction of acquired tricuspid valve disease. All but three of the patients had multivalvular heart disease. There was an 11{\%} hospital mortality which fell to 7{\%} in the later era (1973-82). Mortality was similar for tricuspid annuloplasty and tricuspid replacement and for double and triple valve surgery. On multivariate analysis the incremental risk factors for hospital death were extreme functional disability (Class V), being of Caucasian race, and having a high cardiothoracic ratio (CTR). Actuarial survival was 58{\%} at 9 years postoperative. The incremental risk factors for late death were prior cardiac surgery, age at operation greater than or equal to 55 years, and advanced functional disability (Classes IV, V). The actuarial incidence of significant tricuspid incompetence following annuloplasty was 12{\%} at 3 years, and following stented homograft semilunar valve replacement was 6{\%} at 3 years and 24{\%} at 8 years. Severe homograft valve incompetence was always associated with recurrent left-sided valve lesions or residual pulmonary hypertension. It is concluded that a homograft valve is a superior form of tricuspid valve replacement.",
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AU - Whitlock, R. M.

AU - Pemberton, J. R.

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N2 - A total of 246 operations were performed in 230 patients for correction of acquired tricuspid valve disease. All but three of the patients had multivalvular heart disease. There was an 11% hospital mortality which fell to 7% in the later era (1973-82). Mortality was similar for tricuspid annuloplasty and tricuspid replacement and for double and triple valve surgery. On multivariate analysis the incremental risk factors for hospital death were extreme functional disability (Class V), being of Caucasian race, and having a high cardiothoracic ratio (CTR). Actuarial survival was 58% at 9 years postoperative. The incremental risk factors for late death were prior cardiac surgery, age at operation greater than or equal to 55 years, and advanced functional disability (Classes IV, V). The actuarial incidence of significant tricuspid incompetence following annuloplasty was 12% at 3 years, and following stented homograft semilunar valve replacement was 6% at 3 years and 24% at 8 years. Severe homograft valve incompetence was always associated with recurrent left-sided valve lesions or residual pulmonary hypertension. It is concluded that a homograft valve is a superior form of tricuspid valve replacement.

AB - A total of 246 operations were performed in 230 patients for correction of acquired tricuspid valve disease. All but three of the patients had multivalvular heart disease. There was an 11% hospital mortality which fell to 7% in the later era (1973-82). Mortality was similar for tricuspid annuloplasty and tricuspid replacement and for double and triple valve surgery. On multivariate analysis the incremental risk factors for hospital death were extreme functional disability (Class V), being of Caucasian race, and having a high cardiothoracic ratio (CTR). Actuarial survival was 58% at 9 years postoperative. The incremental risk factors for late death were prior cardiac surgery, age at operation greater than or equal to 55 years, and advanced functional disability (Classes IV, V). The actuarial incidence of significant tricuspid incompetence following annuloplasty was 12% at 3 years, and following stented homograft semilunar valve replacement was 6% at 3 years and 24% at 8 years. Severe homograft valve incompetence was always associated with recurrent left-sided valve lesions or residual pulmonary hypertension. It is concluded that a homograft valve is a superior form of tricuspid valve replacement.

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