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Ann Thorac Surg 1977;23:327-332
© 1977 The Society of Thoracic Surgeons
Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Alabama Medical Center, and Birmingham Veterans Administration Hospital, Birmingham, AL.
Accepted for publication September 15, 1976.
* Address reprint requests to Dr. Kouchoukos, Department of Surgery, University of Alabama Medical Center, University Station, Birmingham, AL 35294.
The total experience with combined aortic, mitral, and tricuspid valve replacement in 38 patients during an eight-year period ending in December, 1974, is reviewed. The hospital mortality was 23.7% (9 patients) and was influenced by the preoperative New York Heart Association Functional Class: 18% (5 of 28 patients) in Class III and 40% (4 of 10) in Class IV. Intraoperative myocardial injury was the other important factor affecting hospital mortality. The majority of late deaths were related to cardiac causes. The five-year survival was 53% (20 patients) for the entire group and 62% (17 patients) for the Class III patients. At latest follow-up (mean, 44 months), 22 (76%) of the hospital survivors had improved by at least one functional class. It appears that surgical intervention before patients reach Class IV status should give better early and long-term results. Our current indications for tricuspid valve replacement as opposed to repair are presented.
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