J Korean Med Sci.
2009 Oct;24(5):818-823. 10.3346/jkms.2009.24.5.818.
Short- and Long-Term Results of Triple Valve Surgery: A Single Center Experience
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, College of Medicine, University of Hanyang, Guri, Korea.
- 2Department of Cardiovascular Surgery, Sejong General Hospital, Bucheon, Korea. ssoh97@sejongh.co.kr
- 3Department of Thoracic and Cardiovascular Surgery, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea.
- 4Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, College of Medicine, University of Korea, Seoul, Korea.
- 5Department of Thoracic and Cardiovascular Surgery, Sanbon Medical Center, College of Medicine, University of Wonkwang, Gunpo, Korea.
- KMID: 1782000
- DOI: http://doi.org/10.3346/jkms.2009.24.5.818
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.
Keyword
MeSH Terms
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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
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