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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2018 Feb 08

DOI: 10.23736/S0021-9509.18.10392-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Tricuspid valve replacement: results of an orphan procedure: which is the best prosthesis?

Dominik WIEDEMANN 1 , Veronika RUPPRECHTER 1, Julia MASCHERBAUER 2, Andreas KAMMERLANDER 2, Bruno MORA 3, Kamen DIMITROV 1, Benedikt WEBER 4, Martin ANDREAS 1, Günther LAUFER 1, Alfred KOCHER 1

1 Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; 2 Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; 3 Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; 4 Department of Dermatology, Medical University of Vienna, Vienna, Austria


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BACKGROUND: Replacement of the tricuspid valve is uncommon. Prostheses specifically designed for the this position are not available. Bovine, porcine as well as mechanical valve prostheses are currently used, however, the most suitable prosthesis type has not been defined.
METHODS: We retrospectively analyzed all consecutive patients who underwent tricuspid valve replacement (TVR) at the Medical University of Vienna from 1996 to 2014. Baseline patient characteristics, prosthesis type, and postoperative outcome data were collected.
RESULTS: A total of 58 patients underwent TVR. 41 patients (71%) received biological (18 bovine, 23 porcine), and 17 patients (29%) mechanical prostheses. One year survival (70.2% vs. 76.5%, p=0.18), and freedom from reoperation at one year (86.3% vs. 94.1%, p=0.35) was not significantly different bioprostheses and mechanical valves. Freedom from reoperation rates for bovine versus porcine prostheses (one-year: 88.2% vs. 84.4%, p=0.145) were also not significantly different. However three bovine prosthesis had to be reoperated due to high-grade central regurgitation without any signs of endocarditis or structural valve degeneration.
CONCLUSIONS: There is a lack of clincial trials on tricuspid valve replacement and no specific guidelines for the choice of prosthesis. In the current study we have not identified significant differences in mortality between mechanical and biological valves. However, bovine prosthesis seem less suitable for the tricuspid position due to the high closing volume with consecutive severe postoperative regurgitation.


KEY WORDS: Tricuspid replacement - Choice of valve prostheses - Tricuspid regurgitation

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Publication History

Article first published online: February 8, 2018
Manuscript accepted: January 30, 2018
Manuscript received: December 23, 2017

Cite this article as

Wiedemann D, Rupprechter V, Mascherbauer J, Kammerlander A, Mora B, Dimitrov K, et al. Tricuspid valve replacement: results of an orphan procedure: which is the best prosthesis? J Cardiovasc Surg 2018 Feb 08. DOI: 10.23736/S0021-9509.18.10392-2

Corresponding author e-mail

dominik.wiedemann@meduniwien.ac.at