Key result
Triple-valve surgery yields ~71% 10-year cumulative survival despite high early mortality.
Why the study?
Triple-valve procedures are associated with high early and late mortality, prompting a review of long-term outcomes.
What are the long-term survival and re-operation outcomes of combined mitral and aortic valve replacement with tricuspid valve repair or replacement?
Cohort (n=25)
No
What are the long-term survival and re-operation outcomes of combined mitral and aortic valve replacement with tricuspid valve repair or replacement?
Despite a 20% perioperative mortality rate, double-valve replacement with tricuspid annuloplasty provides satisfactory 10-year cumulative survival (71%) and low re-operation rates.
Answers are grounded in this paper and cite their sources.
High mortality risk warrants selective use and shared decisions; leaves open whether contemporary techniques have improved triple-valve outcomes.
Triple-valve procedures are associated with high early and late mortality. We reviewed our experience in 25 patients who underwent combined mitral and aortic valve replacement with tricuspid valve repair or replacement between 1979 and 2004. The mean follow-up was 7.8 years (range, 10 days to 24.5 years). The mean age at operation was 52 years (range, 31 to 72 years). Four patients underwent triple-valve replacement and 21 had double-valve replacement and tricuspid annuloplasty. Perioperative mortality was 20% and late mortality was 24%. Cumulative survival, calculated taking perioperative mortality into account, was 71% +/- 10% at 10 years and 36% +/- 15% at 15 years after surgery. Only 1 of 20 perioperative survivors required re-operation for prosthetic valve dysfunction. Double-valve replacement with tricuspid annuloplasty offers satisfactory long-term survival with freedom from thromboembolism and re-operation.
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Sakamoto et al. (2006) conducted a cohort in Triple-valve heart disease (n=25). Combined mitral and aortic valve replacement with tricuspid valve repair or replacement was evaluated on Cumulative survival at 10 years. Triple-valve surgery yielded 20% perioperative mortality, 24% late mortality, and cumulative survival of 71% at 10 years and 36% at 15 years.
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