Long-term results of tricuspid valve replacement with bioprosthetic valves
Endo, M.; Iwa, T.; Misaki, T.; Magara, T.; Yokoi, K.; IIda, S.; Saito, H.; Tsujiguchi, H.; Kawasuji, M.; Futamata, H.
Nihon Kyobu Geka Gakkai 34(9): 1676-1681
1986
ISSN/ISBN: 0369-4739 PMID: 3794433 Document Number: 285821
Observations of 15 patients having tricuspid valve replacement with bioprostheses from 1976 are described. Four patients underwent mitral valve replacement concomitantly. Two types of bioprosthetic valves were used in the tricuspid position: 11 Hancock xenografts, 4 Carpentier-Edwards bioprostheses. The operative mortality rate was 13% (2/15) and the 2 hospital deaths were due to LOS and a malignant disease. Thirteen survivors have been followed with a maximum follow-up of 8 years and the mean of 4.4 years. There were 2 late deaths due to myocardiopathy and dysarrhythmia. There was no thrombosis of the prosthetic tricuspid valve and no pulmonary embolism in all living patients. The valve dysfunctions as the ecocardiographic assessment were detected in 2 patients but their NYHA cardiac functional classifications were grade I and II and they were free from cardiogenic complaints. Many authors have reported very high incidence of thrombosis of the mechanical prosthetic valve, on the other hand in this series there was no thrombosis. It is concluded that the bioprosthetic valve has superior anti-thrombogenisity to the mechanical valve and an adequate durability in the tricuspid valve position. We have routinely combined three echocardiographic examinations, M-mode, two-dimensional (2-DE) and pulse Doppler echocardiograms (PDE). M-mode and 2-DE and 2-DE revealed morphologic abnormality of the bioprosthesis, in addition hemodynamic changes could be diagnosed by detecting the blood flow pattern through it with PDE. Echocardiographic examinations, especially combined M-mode, 2-DE and PDE, were very useful to evaluate the bioprosthetic valve function and to detect the early valve abnormality.