Eleven cases underwent tricuspid valve replacement with bioprosthetic heart valve between 1981 and 1990. Mean age was 51±12 years old and mean follow up period was 40±40 months. Mitral valve replacement in ten cases and aortic valve replacement in one underwent simultaneously. Warfarin and dipyridamole were prescribed for post-operative anti-coagulant therapy. Post-operative early death within 30 days was seen in two cases and late death was in two cases. Five years survival rate including early death was 70±14% and nine years survival rate was 54±18%. All seven cases excluding demised cases were III°or IV°in NYHA classification preoperatively but six were I°or II°at postoperative period. Preoperative functional status of all fatal cases were IV°. Cardio-thoracic ratio was 76.2±12.8% pre-operatively, 67.7±9.0 one year after operation, 66.3±7.8% three years after operation and 68.9±9.3 five years after operation. In conclusion post-operative cardiac function ameliorated, but could not return to fairly satisfactory state.

Fifty-two year-old woman was operated for type A acute dissection of the aorta superimposed on pre-existing post-stenotic dilatation dut to congenital aortic valve stenosis. The left main coronary artery was discontinued by dissection. Aortic valve replacement, replacement of ascending aorta by woven-Dacron graft and saphenous vein graft between the left anterior discending artery and the prosthetic graft. Compression gauze around the site of the anastomoses and the prosthetic graft was useful to control of intractable bleeding. The gauze could be extracted twenty-eight hours after the operation by platelet and plasma transfusion. She was well eleven months after the operation.