Abstract
The management of mild tricuspid valve disease associated with left-sided valve lesions remains controversial. Between January 1985 and September 1995, 87 patients underwent combined double (aortic and mitral) valve replacement and tricuspid valve repair at the Shanghai Chest Hospital. The early mortality was 16.1%. Predictors of early mortality were found to be New York Heart Association functional class IV and right ventricular systolic pressure of 65 mm Hg or more, by multivariable regression analysis. The mean follow-up was 4.6 years. Cumulative 3-year and 5-year survival rates in patients discharged from hospital were 80% ± 4% and 63% ± 7%. Late mortality was due to sudden death (18.7%), myocardial infarction (6.5%), and cerebral embolism or hemorrhage (31.2%). Of 48 patients still alive, 45 are in New York Heart Association functional class I or II. None of them has mild or moderate tricuspid regurgitation. Based on these results, we recommend early surgical treatment prior to the appearance of severe hemodynamic deterioration and we propose a policy of liberal indication for tricuspid annuloplasty for mild functional tricuspid insufficiency at the initial double valve replacement.
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