Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 2001 August;42(4) > The Journal of Cardiovascular Surgery 2001 August;42(4):443-9

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi PROMO
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Estratti
Permessi

 

ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2001 August;42(4):443-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Tricuspid valve involvement in combined mitral and aortic valve surgery

Mueller X. M., Tevaearai H. T., Stumpe F., Fischer A. P., Hurni M., Ruchat P., von Segesser L. K.

From the Clinic for Cardiovascular Surgery CHUV (Centre Hospitalier Universitaire Vaudois) Lausanne, Switzerland


PDF


Background. Combined ­mitral ­and aor­tic ­valve dis­ease requir­ing sur­gery ­may ­involve ­the tri­cus­pid ­valve as ­well. Our treat­ment pol­i­cy is con­ser­va­tive espe­cial­ly ­for tri­cus­pid regur­gi­ta­tion ­which is oper­at­ed on ­when ­severe ­only.
Methods. A ret­ro­spec­tive ­study ­was per­formed at a ter­tiary ­and sec­on­dary refer­ral cen­ter ­for car­di­o­vas­cu­lar dis­ease. Over a 15-­year peri­od, 65 con­sec­u­tive ­patients under­went aor­tic ­and ­mitral sur­gery ­with con­com­i­tant tri­cus­pid regur­gi­ta­tion ­and/or sten­o­sis. Fifty-five/65 (85%) ­patients ­were in ­NYHA ­class ­III-IV. Fifty-eight/65 (89%) ­patients ­had tri­cus­pid regur­gi­ta­tion sec­on­dary to ­right cham­ber dil­a­ta­tion ­and 7/65 (11%) ­had tri­cus­pid sten­o­sis ­and/or regur­gi­ta­tion ­because of pre­vi­ous endo­car­ditis. Twenty-two/65 (34%) tri­cus­pid ­valves ­were oper­at­ed on: 18/22 (82%) de Vega annu­lo­plas­ty, 2/22 (9%) com­mis­su­rot­o­mies ­and 2/22 (9%) pros­thet­ic ­valves. Mortality ­and com­pli­ca­tions ­were record­ed dur­ing a ­mean fol­low-up of 5.3 ­yrs (­range, 6 ­months-15.3 ­yrs). Event-­free sur­vi­vals ­were deter­mined ­using ­the Kaplan-Meier meth­od.
Results. Hospital mor­tal­ity ­was 6.2% (4/65) ­and ­the com­pli­ca­tion ­rate ­was 18.5% (12/65). The free­dom ­from ­late ­valve relat­ed mor­tal­ity ­and mor­bid­ity at 5, 10 ­and 15 ­years ­was 86±5.5%, 81.9±6.8%, ­and 81.9±6.8% respec­tive­ly. One ­valve relat­ed com­pli­ca­tion ­was ­due to ­the tri­cus­pid ­valve. At ­last fol­low-up, 87% (47/54) of ­the sur­vi­vors ­were in ­NYHA ­class I-II.
Conclusions. With a con­ser­va­tive pol­i­cy of tri­cus­pid ­valve inter­ven­tion, func­tion­al ­results of ­this ­patient pop­u­la­tion are ­good ­and ­long-­term ­valve relat­ed mor­bid­ity ­and mor­tal­ity ­are main­ly relat­ed to ­the ­mitral ­and aor­tic ­valve pro­ce­dures.

inizio pagina