Short- and Long-Term Results of Triple Valve Surgery: A Single Center Experience.
10.3346/jkms.2009.24.5.818
- Author:
Sung Ho SHINN
1
;
Sam Sae OH
;
Chan Young NA
;
Chang Ha LEE
;
Hong Gook LIM
;
Jae Hyun KIM
;
Kil Soo YIE
;
Man Jong BAEK
;
Dong Seop SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, College of Medicine, University of Hanyang, Guri, Korea.
- Publication Type:Original Article
- Keywords:
Triple valve surgery;
Renal Failure;
Stroke
- MeSH:
Adult;
Aged;
Anticoagulants/adverse effects/therapeutic use;
Aortic Valve/*surgery;
Female;
Heart Valve Diseases/complications/mortality/*surgery;
Heart Valve Prosthesis Implantation/*methods;
Hemorrhage/chemically induced/epidemiology;
Humans;
Intraoperative Complications/mortality;
Kidney Failure/etiology;
Male;
Middle Aged;
Mitral Valve/*surgery;
Postoperative Complications/mortality;
Reoperation;
Risk Factors;
Severity of Illness Index;
Stroke/etiology;
Survival Analysis;
Thromboembolism/epidemiology;
Tricuspid Valve/*surgery
- From:Journal of Korean Medical Science
2009;24(5):818-823
- CountryRepublic of Korea
- Language:English
-
Abstract:
Triple valve surgery is usually complex and carries a reported operative mortality of 13% and 10-yr survival of 61%. We examined surgical results based on our hospital's experience. A total of 160 consecutive patients underwent triple valve surgery from 1990 to 2006. The most common aortic and mitral valve disease was rheumatic disease (82%). The most common tricuspid valve disease was functional regurgitation (80%). Seventy-four percent of the patients were in New York Heart Association (NYHA) class III and IV. Univariate and multivariable analyses were performed to identify predictors of early and late survival. Operative mortality was 6.9% (n=11). Univariate factors associated with mortality included old age, preoperative renal failure, postoperative renal failure, pulmonary complications, and stroke. Of them, postoperative renal failure and stroke were associated with mortality on multivariable analysis. Otherwise, neither tricuspid valve replacement nor reoperation were statistically associated with late mortality. Survival at 5 and 10 yr was 87% and 84%, respectively. Ninety-two percent of the patients were in NYHA class I and II at their most recent follow-up. Ten-year freedom from prosthetic valve endocarditis was 97%; from anticoagulation-related hemorrhage, 82%; from thromboembolism, 89%; and from reoperation, 84%. Postoperative renal failure and stroke were significantly related with operative mortality. Triple valve surgery, regardless of reoperation and tricuspid valve replacement, results in acceptable long-term survival.
