Tricuspid valve replacement: an analysis of risk factors and outcomes.
Thorac Cardiovasc Surg
; 56(8): 456-60, 2008 Dec.
Article
en En
| MEDLINE
| ID: mdl-19012209
ABSTRACT
BACKGROUND:
Tricuspid valve replacement (TVR) is rarely performed and is associated with a high morbidity and mortality. We report our experience with TVR and related adverse events.METHODS:
Between January 1996 and December 2007, 35 patients underwent TVR with mechanical (n = 33) or bioprosthetic (n = 2) valves. Twenty-nine patients underwent concomitant cardiac procedures.RESULTS:
All patients completed follow-up (mean 47 months). Thirty-day mortality was 20 % (n = 7). Risk factors included perioperative low arterial blood pressure ( P = 0.000), New York Heart Association (NYHA) functional class III or IV ( P = 0.001), severe pulmonary hypertension (pulmonary arterial pressure greater than 60 mmHg) ( P = 0.000), hepatic dysfunction ( P = 0.000), ascites ( P = 0.003), and reoperation ( P = 0.015). Late mortality occurred in five patients. Valve-related complications included bleeding (n = 1) and stroke (n = 1). Kaplan-Meier estimates of 1-, 5- and 10-year survival (including early mortality) and event-free survival were 77.1 %, 60 %, and 54.3 % and 91.1 %, 80.6 %, and 55.9 %, respectively. Severe pulmonary hypertension was the only predictor of late mortality ( P = 0.001). Among survivors, the mean NYHA class improved from 2.8 to 1.1 ( P = 0.000).CONCLUSIONS:
Although early outcome after TVR is suboptimal, long-term survival and functional improvement is satisfactory.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Válvula Tricúspide
/
Prótesis Valvulares Cardíacas
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Año:
2008
Tipo del documento:
Article