Key result
Tricuspid annuloplasty is linked to lower hospital mortality than mechanical replacement in triple valve procedures.
Why the study?
This study was conducted to analyze and summarize early and late results in patients undergoing triple valve procedures.
What are the early and late mortality outcomes and prognostic factors in patients undergoing triple valve procedures?
Cohort (n=107)
What are the early and late mortality outcomes and prognostic factors in patients undergoing triple valve procedures?
Triple valve surgery carries substantial early and late mortality, but achieves acceptable 5-year survival (53%), particularly when performed electively in patients with lower functional class and preserved right ventricular pressure.
Answers are grounded in this paper and cite their sources.
High mortality in advanced NYHA class and urgent triple valve surgery warrants careful selection; leaves open relevance to contemporary techniques and risk models.
This study summarizes the results in 107 patients with triple valve procedures (TVP) performed between 1972 and 1983. Forty-five patients underwent double valve replacement with tricuspid annuloplasty, and 62 simultaneous triple valve replacement. The hospital mortality was 19.6% (21 patients) and was influenced by: the preoperative functional class: 4.7% (1 of 22 patients) in class II, 13.7% (7 of 51) in class III and 37.2% (13 of 35) in class IV (p less than 0.05). the urgency of operation: 13.2% in elective operations (11 of 83 patients) and 41.6% for emergencies (10 of 24) (p less than 0.02) the type of tricuspid procedure: 15.5% for annuloplasty (7 of 45 patients), 21.1% for bioprosthetic replacement (11 of 52) and 30% for mechanical valve replacement (3 of 10) (p less than 0.05). Other factors such as patient age, right ventricular systolic pressure (RVSP) and type of myocardial protection had no significant influence. The late mortality was 9% per patient-year (18 patients, 9 of whom died in the first year), the majority related to cardiac causes. The 5-year survival rate was 53%. It appears that the survival rate is higher if the patient is in preoperative functional class II (55%), the right ventricular pressure is below 60 mmHg (67%), and if the operation is performed electively (57%). The findings suggest that surgery should continue to be offered to such patients.
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Kara et al. (1986) conducted a cohort in Triple valve disease requiring surgical intervention (n=107). Triple valve procedure (double valve replacement with tricuspid annuloplasty or simultaneous triple valve replacement) vs. Subgroups by preoperative functional class, urgency of operation, and type of tricuspid procedure was evaluated on Hospital mortality and 5-year survival (p=<0.05). Triple valve procedures had a 19.6% hospital mortality and 53% 5-year survival, with lower hospital mortality for tricuspid annuloplasty (15.5%) vs mechanical replacement (30%, p<0.05).
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