Trendsand Resultsin TricuspidValve Surgery

Forty-six tricuspid valve operations were performed over 12 years. Operations were conservative (two valvotomies, eight DeVega annuloplasties, seven Carpentier rings) in 17 and valve replacement (17 mechanicals, 12 tissues) in 29. Operative mortality rate was improved with better preoperative functional class, use of cardioplegia, or use of annuloplasty. Heart block occurred less with annuloplasty (6 vs 24 percent). Long-term survival was similar with annuloplasty or S urgical treatment of the adult patient with tricuspid valve disease continues to present the cardiac surgeon with a difficult challenge. The presence of tricuspid insufficiency in patients with other valve lesions usually signifies advanced valvular disease. The relative importance of the tricuspid component of the patient’s disease process is frequently difficult to assess accurately. Once ajudgment is made that correction of the tricuspid component is essential, the surgical choices include valve replacement with a tissue or mechanical valve, or repair of the valve by one of several annuloplasty techniques. Grondin and co-workers’ indicated that the issue was essentially settled because of their favorable experience with annuloplasty by either the DeVega or Carpentier technique. Our impression that involvement of the tricuspid valve continues to present some unresolved questions prompted this review of patients undergoing tricuspid valve surgery at the Medical University of South Carolina over the past 12 years.