Copyright © 1987 by the European Society of Cardiology.
© 1987 The European Society of Cardiology
Combined aortic, mitral and tricuspid surgery: Results in 78 patients
Service de Cardiologie, Hôpital Tenon, 4 rue de la Chine 75020 Paris, France
Received 10 July 1986; revised 27 October 1986; .
Abstract
Between 1968 and 1984, 78 patients (mean age 43, range 14 to 65 years) underwent combined aortic, mitral and tricuspid surgery (22 triple valve replacements, 56 aortic valve replacements with tricuspid conservative surgery and mitral valve replacement (N=48), or commissuroplasty (N=8).
Pre-operative consequences of valvular disease (mainly mixed valve disease) were severe as assessed by functional class (72 pts in III or IV NYHA), cardiomegaly (CTR: 62±6%), increase of mean pulmonary arterial and wedge pressures (respectively 30±12 and 19±6mmHg) decrease in cardiac index (2.1±0.5 lmin–1 m–2), LV dilatation (LVend diastolic volume: 184±86ml m–2) and impairment of LV systolic function (LV ejection fraction: 50±12%). Operative mortality rate was 11.5%. The 69 survivors were all followed up, for a mean of 56 months (2 to 207). 16 late deaths occurred. Actuarial survival rate at 10 years was 58.4%, and greatly influenced by pre-operative NYHA class. Linearized rates of thromboembolic events, valve thrombosis and haemorrhage were respectively 6.4, 1.5 and 1.2% pt–1 yr–1. Those of infective endocarditis, periprosthetic leak, reoperation and valve failure were 0.6, 3.3 and 4.9% pt–1 yr–1 respectively.
At 9 years, 42% of the patients were in NYHA class I or II and free from complications
Key Words: Multivalvular disease • triple valve surgery • triple valve replacement
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