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Appraisal of Long-Term Outcomes of Tricuspid Valve Replacement in the Current Perspective.
- Source :
-
The Annals of thoracic surgery [Ann Thorac Surg] 2016 Mar; Vol. 101 (3), pp. 863-71. Date of Electronic Publication: 2015 Dec 08. - Publication Year :
- 2016
-
Abstract
- Background: We address the differential long-term results of tricuspid valve replacement and late valve-related events among bioprostheses versus mechanical prostheses.<br />Methods: In a single-institution investigation, we reviewed the patients' prospectively collected data and performed a clinical follow-up. Both the Kaplan-Meier (actuarial) and the competing risks (actual) methodologies were used.<br />Results: Overall, 188 tricuspid valve replacements were performed during 1971 to 2012. In this complex population (reoperations, 48.1%; associated procedures in 71.3%), operative mortality was 27.6% (significantly declining in recent years). A bioprosthesis was used in 82.4%. Follow-up was 10.2 ± 9.1 years (as long as 37.3 years, or 1,270 patient-years; 91.2% complete). At 15 years, freedom from structural valve deterioration was 93.3% ± 6.4% (competing risks 94.7 ± 5.1%) in the mechanical group and 85.2% ± 5.4% (competing risks 92% ± 2.9%) in the bioprostheses group (p = 0.19). Freedom from any valve-related adverse events was lower among mechanical valves versus bioprostheses (although not statistically significant). Mechanical valves showed significantly lower freedom from thromboembolic events (actuarial 62.3% ± 14.3% versus 97.7% ± 1.6%; competing risks 74.1% ± 10% versus 98% ± 1.4%; p < 0.001) and earlier adverse events (4.9 ± 4.5 versus 11.1 ± 9.4 years) than bioprostheses. There were 11 reoperations for bioprosthetic structural valve deterioration (89.8% and 94.3% actuarial and actual freedom, respectively).<br />Conclusions: Bioprostheses for tricuspid valve replacement have a very good long-term durability. Mechanical valves display earlier and more severe morbidity at follow-up.<br /> (Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Bioprosthesis
Female
France epidemiology
Heart Valve Diseases mortality
Humans
Incidence
Male
Middle Aged
Prosthesis Design
Retrospective Studies
Survival Rate trends
Treatment Outcome
Forecasting
Heart Valve Diseases surgery
Heart Valve Prosthesis
Postoperative Complications epidemiology
Tricuspid Valve surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1552-6259
- Volume :
- 101
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Annals of thoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26675557
- Full Text :
- https://doi.org/10.1016/j.athoracsur.2015.09.081