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Revista chilena de cardiología

versión On-line ISSN 0718-8560

Resumen

MUNOZ, Cecilia et al. Tricuspide valve replacement: comparison of biological versus mechanical valve: a descriptive observational study. Rev Chil Cardiol [online]. 2020, vol.39, n.1, pp.16-23.  Epub 01-Abr-2020. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602020000100016.

Background:

Tricuspid valve replacement (TVR) is an uncommon surgical procedure, associated with high mortality and morbidity. The use of biological or mechanical prostheses in TVR has advantages and disadvantages and, therefore, there persists a debate regarding the choice of one or other type of prostheses.

Aim:

To analyze our operative and long-term surgical results, comparing both types of prosthetic valves.

Methods:

The Data Base of the Cardiovascular Surgery Service was reviewed for the period between January 1991 and December 2017. 83 patients with TVR were identified, the operative notes and echocardiogram reports were analyzed. Survival was obtained from the Chilean Civil Identification Service.

Results:

83 patients (76% women) had TVR. They represented 0.7% of the total cases operated on with extracorporeal circulation and 2.1% of all valve disease cases, for the study period. Mean age was 49±16.5 years. 49 cases (59%) were reoperations and another 49 had an associated procedure. In 40 patients (48%) a mechanical prosthesis was used and in 43 (52%) a biological one was implanted. Operative mortality rate was 9.6% (8 patients, had a mechanical valve and the other 8, a biological one). Follow-up was 100% completed, with an average of 7.1 years. 28 patients died during follow-up; the main cause of death was heart failure. Five-year survival rate was 70.3 ± 5.3% and at 10 years it was 58 ± 6.3%, without significant difference the type of prostheses. Seven patients were re-operated during follow-up (5 cases corresponded to a biological prostheses and 2 to a mechanical one).

Conclusion:

TVR is still an infrequent surgical procedure, more commonly performed in women, on the fifth decade of life. Most patients presented comorbidities and had a previous cardiovascular surgical operation. Half of them received a mechanical prosthesis and half a biological one. There was no significant difference between both types of prostheses related to surgical mortality, long-term survival or reoperation.

Palabras clave : Tricuspid valve; Tricuspid valve replacement; Tricuspid insufficiency.

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