Document Detail


Mid-term follow up of triple valve surgery in a western community: predictors of survival.
MedLine Citation:
PMID:  21053745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Triple valve surgery remains a challenge, although with an improved survival rate compared to historical data. Aws assessment was made as to whether the type of valve surgery, underlying valve lesion and pathology were independent predictors of outcome. The patient characteristics were also described according to the type of surgery performed.
METHODS: A total of 166 consecutive patients underwent triple valve surgery and were followed up between October 1972 and June 2006. The clinical and operative variables were obtained retrospectively by physicians. The median follow up was 6.11 years (interquartile range 2.13-10.43).
RESULTS: The overall 30-day mortality was 10%, five-year survival 70%, and 10-year survival 60%. In patients with three mechanical valves, survival at five years was 90%, and 85% at 10 years, compared to 40% at five years and 30% at 10 years in patients with three bioprostheses. Among all patients with a mechanical valve in the aortic and mitral positions, those with a tricuspid bioprosthesis were compared to patients with tricuspid repair. The survival rate at 10 years was 60%, and similar between groups. The survival rate of patients with aortic and mitral bioprostheses and tricuspid repair was comparable to that in patients with three bioprostheses. Multivariable analyses showed that the type of tricuspid surgery, age, and NYHA functional class were each significant and independent predictors of survival, with a tricuspid mechanical prosthesis favoring survival. According to the type of surgery, the patient groups differed in their cardiovascular and non-cardiovascular risk profiles.
CONCLUSION: Triple-valve surgery is a difficult procedure, with greatly improved survival rates compared to historically reported data. The decision of prosthetic valve type and repair should be tailored to the individual patient, as both patient characteristics and chosen surgery appear to determine survival and morbidity. In young patients, a mechanical prosthesis should also be considered in the tricuspid position.
Authors:
Hadewich Hermans; Markus Tjahjono; Dirk Faes; Ann Belmans; Bart Meuris; Paul Herijgers; Willem Flameng; Marie-Christine Herregods
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  19     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  644-51; discussion 652     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospitals Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aortic Valve / surgery
Bioprosthesis*
Cohort Studies
Female
Follow-Up Studies
Heart Valve Diseases / mortality*,  surgery*
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / instrumentation,  methods*
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mitral Valve / surgery
Predictive Value of Tests
Retrospective Studies
Survival Rate
Tricuspid Valve / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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