Tricuspid Valve Replacement: Bioprostheses are Preferable
Malcolm J. R. Dalrymple-Hay FRCS, Yvonne Leung, Sunil K. Ohri FRCS,
Marcus P. Haw FRCS, J. Keith. Ross FRCS, Steven A. Livesey FRCS,
James L. Monro FRCS

Limited data are available in patients following tricuspid valve replacement (TVR). This study analyzes results in 87 patients (52 tissue valves, 35 mechanical valves) who underwent TVR between January 1973 and September 1996. Total cumulative follow up was 707 patient-years (pt-yr) (tissue valves 393 pt-yr, mechanical valves 314 pt-yr); mean follow up was 8.1 years (range: 0 to 23.6 years). The early mortality rate was (10.3%) (n = 9; tissue 7, mechanical 2, p = 0.28). The mean (± SEM) survival rate was 68 ± 5.3% (n = 50) at 5 years, 52 ± 5.9% (n = 36) at 10 years, 35 ± 6% (n = 20) at 15 years, and 16 ± 5.3% (n = 7) at 20 years. Freedom from tricuspid valve reoperation at 5, 10 and 15 years was 93 ± 3.3% (n = 46), 83 ± 5.8% (n = 33) and 71 ± 2.8% (n = 17) respectively. Freedom from reoperation at 5, 10 and 15 years for tissue prostheses was 97 ± 2.5%, 89 ± 6.3% and 70 ± 12%, and 86 ± 7.4%, 74 ± 9.9% and 68 ± 11% for mechanical prostheses. Mechanical prostheses required reoperation earlier. We recommend the use of a bioprosthesis in the tricuspid position because of its initial durability and low reoperation rate.