Document Detail


Tricuspid valvulectomy without replacement. Twenty years' experience.
MedLine Citation:
PMID:  1960998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A Arbulu; R J Holmes; I Asfaw
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
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:
Created Date:  1992-01-09     Completed Date:  1992-01-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  917-22     Citation Subset:  AIM; IM    
Affiliation:
Wayne State University, School of Medicine, Detroit, Mich.
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MeSH Terms
Descriptor/Qualifier:
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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