HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Charles S. Roberts Julie A. Swain Richard E. Clark Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by S. Brown, P. Articles by Clark, R. E. Search for Related Content PubMed PubMed Citation Articles by S. Brown, P. Articles by Clark, R. E.

Ann Thorac Surg 1993;55:502-508
© 1993 The Society of Thoracic Surgeons

---

Articles

Late results after triple-valve replacement with various substitute valves

Surgery Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland USA

Accepted for publication June 12, 1992.

^_* Address reprints requests to Dr Clark, Cardiovascular and Pulmonary Research Center, Allegheny-Singer Research Institute, 320 East North Ave, Pittsburgh, PA 15212.

The purpose of this study was to determine what influence various combinations of mechanical and bioprosthetic valves in the aortic, mitral, and tricuspid positions had on late morbidity and mortality of 40 hospital survivors of triple-valve replacement. At operation the patients ranged in age from 27 to 69 years; 73% were women. The mean postoperative follow-up interval was 8.3 years, with a total follow-up of 331 years (100% complete). At 12 months after operation, functional class decreased from 3.3 to 1.6 (p < 0.05), cardiac index increased from 2.0 to 2.6 L · min^–1 · m^–2 (p < 0.05), and pulmonary artery pressures decreased from 59/27 to 40/17 mm Hg (p < 0.05). There were no differences in preoperative variables between groups. Actuarial survival for the 40 patients (exclusive of 30-day or in-hospital mortality, which was 31%) was 78% and 74% at 5 and 10 years. At the same milestones, freedom from reoperation was 96% and 54%, freedom from combined thromboembolism and anticoagulant-related hemorrhage was 68% and 56%, and freedom from all late valve-related morbidity and mortality was 64% and 25%. Comparison of the patients with two or more mechanical prostheses with the patients having two or more bioprostheses indicated no significant differences in actuarial freedom from late death, thromboembolic events, or anticoagulant-related hemorrhage. However the actuarial freedom from reoperation in the groups with two or more mechanical valves was lower than that of the groups with two or more bioprosthetic valves (0/10 versus 13/30; p < 0.05). Among 13 patients having reoperation, reoperation in 12 was prompted by degeneration of one or more bioprosthetic valves. Six of the patients who underwent reoperation died in the hospital, and 4 others died between 2 and 8 years after operation. These results support the view that mechanical prostheses provide better long-term results for triple-valve replacement than those produced using bioprostheses, primarily by reducing need for reoperation and its attendant complications.

This article has been cited by other articles:

				H. V. Schaff and R. M. Suri Multiple Valve Disease Card. Surg. Adult, January 1, 2008; 3(2008): 1129 - 1158. [Full Text]

				Q.-Q. Han, Z.-Y. Xu, B.-R. Zhang, L.-J. Zou, J.-H. Hao, and S.-D. Huang Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases Eur J Cardiothorac Surg, May 1, 2007; 31(5): 845 - 850. [Abstract] [Full Text] [PDF]

				T. H. Akay, B. Gultekin, S. Ozkan, E. Aslim, B. Saritas, A. Sezgin, and S. Aslamaci Triple-Valve Procedures: Impact of Risk Factors on Midterm in a Rheumatic Population Ann. Thorac. Surg., November 1, 2006; 82(5): 1729 - 1734. [Abstract] [Full Text] [PDF]

				B. Alsoufi, V. Rao, M. A. Borger, M. Maganti, S. Armstrong, C. M. Feindel, H. E. Scully, and T. E. David Short- and Long-Term Results of Triple Valve Surgery in the Modern Era Ann. Thorac. Surg., June 1, 2006; 81(6): 2172 - 2178. [Abstract] [Full Text] [PDF]

				Y. Sakamoto, K. Hashimoto, H. Okuyama, S. Ishii, T. Inoue, and K. Kinouchi Long-Term Results of Triple-Valve Procedure Asian Cardiovasc Thorac Ann, February 1, 2006; 14(1): 47 - 50. [Abstract] [Full Text] [PDF]

				S. Guhathakurta and K. M Cherian Triple Valve Replacement with Carpentier-Edwards Bioprostheses Asian Cardiovasc Thorac Ann, December 1, 2004; 12(4): 369 - 371. [Abstract] [Full Text] [PDF]

				H. V. Schaff and D. H. Marsh Multiple Valve Disease Card. Surg. Adult, January 1, 2003; 2(2003): 1017 - 1045. [Full Text]

				M. Carrier, M. Pellerin, D. Bouchard, L. P. Perrault, R. Cartier, Y. Hebert, A. Basmadjian, P. Page, and N. C. Poirier Long-term results with triple valve surgery Ann. Thorac. Surg., January 1, 2002; 73(1): 44 - 47. [Abstract] [Full Text] [PDF]

				A. Ian Munro, W. R. Eric Jamieson, L. H. Burr, H. Ling, R. T. Miyagishima, and E. Germann Comparison of porcine bioprostheses and mechanical prostheses in multiple valve replacement operations Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S459 - S463. [Abstract] [PDF]