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Ann Thorac Surg 2003;75:47-50
© 2003 The Society of Thoracic Surgeons

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Original article: cardiovascular

Tricuspid valve replacement: an analysis of 25 years of experience at a single center

^a Department of Surgery, The Montreal Heart Institute and the University of Montreal, Montreal, Quebec, Canada
^b Department of Medicine, The Montreal Heart Institute and the University of Montreal, Montreal, Quebec, Canada

Accepted for publication August 1, 2002.

* Address reprint requests to Dr Carrier, Department of Surgery, Montreal Heart Institute, 5000 Belanger St E, Montreal, Quebec H1T 1C8, Canada
e-mail: carrier{at}icm.umontreal.ca

BACKGROUND: Tricuspid valve replacement is seldom used in clinical practice, but the choice between mechanical and biologic prostheses remains controversial.

METHODS: Between 1977 and 2002, 97 patients underwent tricuspid valve replacement and were followed at the Montreal Heart Institute Valve Clinic. Patients underwent replacement with bioprostheses (n = 82) and mechanical valves (n = 15).

RESULTS: Patients with bioprosthetic tricuspid replacements averaged 53 ± 13 years of age compared with 48 ± 11 years in those with tricuspid mechanical valve replacements (p = 0.2). Isolated tricuspid valve replacement was performed in 11 patients (73%) in the mechanical valve group compared with 31 patients (38%. p = 0.01) in the bioprosthetic replacement group. In patients undergoing bioprosthetic tricuspid replacement, 51 (62%) underwent multiple associated valve replacements. The 5-year survival after tricuspid replacement averaged 60% ± 13% in the mechanical valve group and 56% ± 6% in the biologic replacement group (p = 0.8). The 5-year freedom rate from tricuspid valve reoperation averaged 91% ± 9% in patients with mechanical valves and 97% ± 3% in those with biologic valves (p = 0.2).

CONCLUSIONS: Patient survival after tricuspid valve replacement is suboptimal but related to the clinical condition at operation. The use of biologic prostheses for tricuspid valve replacement remains a good option in young patients because of limited life expectancy unrelated to the type of tricuspid prostheses at long-term follow-up.

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