Subscribe to RSS
DOI: 10.1055/s-2007-1014109
Functional Tricuspid Insufficiency: Conservative or Operative Management
Publication History
1984
Publication Date:
19 March 2008 (online)
Summary
Between 1978 and 1982 mitral valve replacement was performed in a total of 43 patients with mitral valve disease in the presence of functional tricuspid insufficiency (TD. The concomitant tricuspid valve regurgitation was treated conservatively in 17 patients, a Carpentier ring prosthesis was implanted in 9 patients. De Vega annuloplasty was performed in 13 patients and 4 times the valve was replaced with a Hancock bioprosthesis. The hospital mortality of 26 % (11 patients) was high, due to the poor clinical condition of the patients. In a mean follow-up of 43.1 ± 18,0 months, 20 patients could be restudied by clinical and echocardiographical investigation. Tricuspid insufficiency was found in all of the 9 patients who had been treated conservatively. Seven out of 11 patients operated showed no signs of Tl, 3 had mild Tl and 1 patient had severe Tl. In the conservatively treated group, the preoperative mean pulmonary vascular resistance (PVR = 296 ± 161 dynes × sec × cm-5), pulmonary artery pressure (PAP = 46.1 ± 16.2 mmHg) and rise of right atrial V-wave (15.8 ± 3.6 mmHg) were only slightly higher than in the operatively treated group (PVR = 274 ± 146 dynes × sec × cm5), PAP = 43.2 ± 13.6 mmHg, V-wave = 18.5 ± 6.4 mmHg) with no statistically significant difference. Preoperative hemodynamic findings in patients with and without Tl at follow-up were also not significantly different. These results indicate that the recurrence of functional Tl depends on the method of treatment, rather than preoperative increased PVR, PAP or V-wave rise.
Key words
Functional tricuspid insufficiency - De Vega annuloplasty - Carpentier ring implantation - Reconstructive valve surgery