Long-term results of triple valve repair in rheumatic heart disease

BACKGROUND: The aim of this study is to analyze the clinical outcomes of triple valve repair for rheumatic heart disease in terms of both early results and long-term benefits. METHODS: Between January 2008 and December 2016, all the patients who underwent triple valve repair for rheumatic heart disease were included in this study. RESULTS: Thirty-eight patients underwent triple valve repair procedure for rheumatic heart disease at our institute. Mean age was 33 years; 60.5% were females. Techniques used to achieve mitral valve repair were: commisurotomy (n = 26), prosthetic ring annuloplasty (n = 9), posterior teflon annuloplasty (n = 23), leaflet shaving (n = 14), implantation of neochordae (n = 5) and pericardial patch augmentation of mitral valve leaflets (n = 6). For aortic valve repair, the techniques used were: commisurotomy (n = 23), leaflet shaving (n = 16), pericardial patch augmentation (n = 3), subcommisural plication (n = 10), free margin plication (n = 2) and free margin resuspension (n = 1). Tricuspid valve repair was performed using modified Devega's technique (n = 32), commisurotomy (n = 9) and posterior annular plication (bicuspidization) (n = 5). The operative mortality was 0%. There was no primary repair failure. Estimated survival at the end of 1 year, 5 years and 10 years was 100%, 91.6% and 65.8%, respectively. Overall freedom from reintervention at 1, 5 and 10 years was 100%, 96.4% and 61.4, respectively. CONCLUSION: Triple valve repair provided satisfactory early and long-term results in this challenging subset of patients and can be considered as an acceptable option for significant triple valve disease due to the absence of anticoagulation-related events.