NDLI: Tricuspid valve replacement: an analysis of risk factors and outcomes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Civelek, A. Ak, K. Akgün, S. Isbir, S. C. Arsan, S.
Description	Country affiliation: Turkey Author Affiliation: Civelek A ( Department o Cardiovascular Surgery, Marmara University School of Medicine, Istanbul, Turkey. alicivelek@tnn.net)
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.
File Format	HTM / HTML
ISSN	01716425
Issue Number	8
Volume Number	56
e-ISSN	14391902
Journal	The Thoracic and Cardiovascular Surgeon
Language	English
Publisher	Thieme
Publisher Date	2008-12-01
Publisher Place	Germany
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline General Surgery Discipline Cardiology Discipline Vascular Diseases Discipline Pulmonary Medicine Heart Valve Prosthesis Tricuspid Valve Ascites Complications Bioprosthesis Blood Pressure Female Follow-up Studies Heart Valve Prosthesis Implantation Mortality Humans Hypertension, Pulmonary Liver Diseases Male Reoperation Risk Factors Journal Article
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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