| Tricuspid valvulectomy without replacement. Twenty years' experience. | |
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MedLine Citation:
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PMID: 1960998 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Since September 1970, we have operated on 55 patients with intractable right-sided endocarditis. All patients were addicted to heroin. Fifty-three underwent tricuspid valvulectomy without replacement and in addition two had pulmonic valve excision. Twenty-four patients (49%) returned to their drug addiction. Six patients (11%) required prosthetic heart valve insertion 2 days to 13 years later for medically refractory right-sided heart failure, and four of these died. Overall, 16 patients (29%) died, six (11%) within 45 days after the tricuspid valvulectomy. One (2%) of these deaths was related to the operation and five were due to uncontrollable infection. Ten (18%) deaths occurred 9 months to 13 years after the tricuspid valvulectomy. Nine were due to drug addiction and one to progressive right ventricular failure 2 months after prosthetic heart valve insertion and 10 years after the initial valve removal. Of the 39 patients who are alive, 37 (67%) have not required prosthetic heart valve insertion. From our observations we reached the following conclusions: (1) Drug addiction is a recurrent and lethal disease. Among these patients, tricuspid valvulectomy without replacement is the operation of choice for the management of intractable right-sided endocarditis; (2) after tricuspid valvulectomy without replacement, only six of 55 patients (11%) had required prosthetic heart valve insertion to control medically refractory right-sided heart failure; (3) in a small percentage of patients the absence of the tricuspid valve may lead to severe and permanent impairment of right ventricular function. |
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Authors:
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A Arbulu; R J Holmes; I Asfaw |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 102 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1991 Dec |
Date Detail:
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Created Date: 1992-01-09 Completed Date: 1992-01-09 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 917-22 Citation Subset: AIM; IM |
Affiliation:
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Wayne State University, School of Medicine, Detroit, Mich. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Actuarial Analysis Adult Endocarditis, Bacterial / mortality, surgery* Female Heart Valve Prosthesis Heroin Dependence / complications*, mortality Humans Liver Function Tests Male Middle Aged Pseudomonas Infections / mortality, surgery* Pseudomonas aeruginosa Tricuspid Valve / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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