Clinical analysis of tricuspid valve mechanical prosthesis replacement

Sun Guanglong; Li Jiyong; Cao Xiangrong; Liang Lin; Chen Xinliang; Bo Ping

doi:10.3760/j.issn.1673-4777.2019.02.009

Abstract：Objective To observe the surgical outcome and survival of patients with tricuspid valve mechanical prosthesis replacement.Methods Clinical data of 36 patients receiving tricuspid mechanical valve replacement in Beijing Anzhen Hospital,Capital Medical University between January 2010 and December 2017 was retrospectively reviewed.There were 14 females and 22 males,with a mean age of (52 ± 9) years (28-64 years old).Among the patients,22 cases were in New York Heart Association(NYHA) functional class Ⅱ,12 cases were in NYHA class Ⅲ[and 2 cases were in NYHA class Ⅳ.Tricuspid valvular lesion of all patients was confirmed by echocardiography and surgical findings.There were 28 cases of rheumatic heart disease,4 cases of tricuspid valvular hypoplasia,3 cases of congenital heart disease (Ebstein's anomaly) and 1 case of tetralogy of Fallot.Mechanical valve replacement of tricuspid valve or multi-valve replacement was implemented and 45 mechanical prostheses were used.Results Three patients died of right heart insufficiency,infection and multiple organ dysfunction,the postoperative in-hospital mortality was 8.3％ (3/36).One patient was discharged 97 days after surgery;32 patients were discharged in 8-21 days after surgery.The mean follow-up interval was 3-42 months in 33 patients(91.7％).During follow-up,1 patient developed paravalvular leakage 3 months after surgery and underwent reoperation of bioprosthetic valve replacement;other patients survived without any valve-related events.Conclusions Tricuspid valve replacement has high risks of mortality and morbidity and requires rigorous indications.Patients with no indication of tricuspid valve repair or failure in repair can have valve replacement and the surgical effect is valid.