Document Detail


Repair of rheumatic tricuspid valve disease: predictors of very long-term mortality and reoperation.
MedLine Citation:
PMID:  20667339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined predictors of reoperation and late mortality in patients undergoing tricuspid valve repair for rheumatic disease. METHODS: Between 1997 and 2007, 299 consecutive patients (mean age 50.8 + or - 13.7 years) underwent surgical repair of the tricuspid valve for multivalvular organic rheumatic disease. A total of 184 patients was found to have mitral and tricuspid valve disease, 108 triple valve disease, 5 isolated tricuspid lesion, and 2 aortic and tricuspid valve disease. Prosthetic ring annuloplasty was performed in 78 patients, commissurotomy and ring annuloplasty in 82, isolated commissurotomy in 10, suture annuloplasty in 105, and commissurotomy and suture annuloplasty in 24. RESULTS: Thirty-day mortality was 7.4%. Previous valve surgery and reoperation for bleeding were risk factors for early death. Late mortality was 51.2%, in the majority of patients due to cardiac causes. There was a median follow-up of 16.4 years (range, 6 months to 34 years) and cumulative follow-up of 5,432 patients per year (96.7% complete). Age, New York Heart Association functional class IV and postclamping time were predictive factors for late mortality. At 25 years, the Kaplan-Meier survival was 26.6% + or - 4.2%. A total of 106 patients required valve reoperation. Age older than 40 years was a protective factor for reoperation. At 25 years, Kaplan-Meier freedom from reoperation was 35.0% + or - 5.3%. CONCLUSIONS: Repair of the tricuspid valve in patients with rheumatic valve disease can be performed with acceptable early results, but progression of rheumatic disease is associated with a high incidence of valve dysfunction and mortality in the long term.
Authors:
J Aurelio Sarralde; José M Bernal; Javier Llorca; Alejandro Pontón; Lorena Diez-Solorzano; Juan R Giménez-Rico; José M Revuelta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  503-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, CIBER Epidemiología y Salud Pública, Hospital Universitario Valdecilla, Universidad de Cantabria, Santander, Spain.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / methods
Female
Heart Valve Diseases / mortality*,  surgery*
Humans
Male
Middle Aged
Reoperation / statistics & numerical data
Retrospective Studies
Rheumatic Heart Disease / mortality*,  surgery*
Time Factors
Tricuspid Valve*
Comments/Corrections
Comment In:
Ann Thorac Surg. 2010 Aug;90(2):509   [PMID:  20667340 ]

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


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