Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience
Background Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series. Methods We retrospectively studied the early and late results of 32 consecutive patients (7 male and 25 female; mean age 60.2 ± 18.1 years) und...
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| Veröffentlicht in: | General thoracic and cardiovascular surgery 2013-03, Vol.61 (3), p.133-138 |
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| creator | Morimoto, Naoto Matsushima, Syunsuke Aoki, Masaya Henmi, Soichiro Nishioka, Naritomo Murakami, Hirohisa Honda, Tasuku Nakagiri, Keitaro Yoshida, Masato Mukohara, Nobuhiko |
| description | Background
Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series.
Methods
We retrospectively studied the early and late results of 32 consecutive patients (7 male and 25 female; mean age 60.2 ± 18.1 years) undergoing bioprosthetic tricuspid valve replacement between 1985 and 2010. The etiology is rheumatic in 38 %, congenital in 3 %, endocarditis in 9 %, and functional in 50 %. Patients underwent isolated valve replacement. The remaining underwent combined aortic and tricuspid (
n
= 5, 16 %), mitral tricuspid (
n
= 15, 47 %), and aortic, mitral, and tricuspid (
n
= 1, 3 %) valve replacement. Preoperative liver dysfunction was evaluated using Model for End-stage Liver Disease (MELD) score. Mean follow-up was 5.6 ± 6.8 years (ranging from 0 to 25.0 years).
Results
Hospital mortality was 19 %. On univariate logistic regression analysis, NYHA class IV (
p
= 0.039, odds ratio 11.3, 95 % confidence interval 1.2–112.5), MELD score (>10) (
p
= 0.011, odds ratio 21.0, 95 % confidence interval 12.0–222.0) and congestive liver (
p
= 0.05, odds ratio 9.4, 95 % confidence interval 1.0–93.5) were incremental risk factors for hospital death. The 15- and 25-year actuarial survival were 56.5 ± 10.3 % and 45 ± 13.0 %, respectively. Multivariate analysis using Cox proportional hazard model showed MELD score (
p
= 0.024, hazard ratio 7.0, 95 % confidence interval 2.1–23.9) and postoperative pulmonary hypertension (
p
= 0.012, hazard ratio 4.4, 95 % confidence interval 1.4–14.1) were significantly associated with decreased survival. At 15 years, freedom rates from tricuspid valve reoperation, anticoagulation-related bleeding, and valve related events were 85.7 ± 13.2 %,95.7 ± 4.3 % and 81.8 ± 13.2 %, respectively. The linearized incidence of structural valve deterioration was 0.50 %/patient-year, anticoagulation-related bleeding was 0.94 %/patient-year, and valve-related events were 1.52 %/patient-year.
Conclusion
Preoperative hepatic congestion and liver dysfunction which were indicated by the MELD score >10 were associated with poor outcome for patients undergoing tricuspid valve replacement. The MELD score is useful to predict the morality among these patients. |
| doi_str_mv | 10.1007/s11748-012-0190-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1315134246</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1315134246</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-e9b9701f0a2fa2262f91893ba6676cde7f564dd66ec8b62effb8b8d3a7fdf33f3</originalsourceid><addsrcrecordid>eNp1kclKBDEQhoMozrg8gBdp8OKlNUt3Ou1NBjcY8KLnkE5Xxgy9mXQPztv4LD6ZmcURBCEhFfL9Van6EToj-IpgnF17QrJExJjQsHMcJ3toTARnMc8I29_FOB2hI-_nGKdckPQQjSijNOEiHSMzbZtZ3IOrIwd-qHoftSYqbNu51vdv0Fsd9c7qwXe2jBaqWkAAu0ppqKHpbyLVhKWqpbdrJU2_Ppeg3PoCHx04C42GE3RgVOXhdHseo9f7u5fJYzx9fnia3E5jnXDax5AXeYaJwYoaRSmnJiciZ4XiPOO6hMykPClLzkGLglMwphCFKJnKTGkYM-wYXW7yhu-_D-B7WVuvoapUA-3gJWEkJSwJzQf04g86bwcXWvGShqoZExgngSIbSod5eAdGds7Wyi0lwXJlgtyYIIMJcmWCXGnOt5mHooZyp_iZegDoBvDhqZmB-y39f9Zva56TtQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2918738004</pqid></control><display><type>article</type><title>Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience</title><source>MEDLINE</source><source>ProQuest Central (Alumni Edition)</source><source>ProQuest Central UK/Ireland</source><source>SpringerLink Journals - AutoHoldings</source><source>ProQuest Central</source><creator>Morimoto, Naoto ; Matsushima, Syunsuke ; Aoki, Masaya ; Henmi, Soichiro ; Nishioka, Naritomo ; Murakami, Hirohisa ; Honda, Tasuku ; Nakagiri, Keitaro ; Yoshida, Masato ; Mukohara, Nobuhiko</creator><creatorcontrib>Morimoto, Naoto ; Matsushima, Syunsuke ; Aoki, Masaya ; Henmi, Soichiro ; Nishioka, Naritomo ; Murakami, Hirohisa ; Honda, Tasuku ; Nakagiri, Keitaro ; Yoshida, Masato ; Mukohara, Nobuhiko</creatorcontrib><description>Background
Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series.
Methods
We retrospectively studied the early and late results of 32 consecutive patients (7 male and 25 female; mean age 60.2 ± 18.1 years) undergoing bioprosthetic tricuspid valve replacement between 1985 and 2010. The etiology is rheumatic in 38 %, congenital in 3 %, endocarditis in 9 %, and functional in 50 %. Patients underwent isolated valve replacement. The remaining underwent combined aortic and tricuspid (
n
= 5, 16 %), mitral tricuspid (
n
= 15, 47 %), and aortic, mitral, and tricuspid (
n
= 1, 3 %) valve replacement. Preoperative liver dysfunction was evaluated using Model for End-stage Liver Disease (MELD) score. Mean follow-up was 5.6 ± 6.8 years (ranging from 0 to 25.0 years).
Results
Hospital mortality was 19 %. On univariate logistic regression analysis, NYHA class IV (
p
= 0.039, odds ratio 11.3, 95 % confidence interval 1.2–112.5), MELD score (>10) (
p
= 0.011, odds ratio 21.0, 95 % confidence interval 12.0–222.0) and congestive liver (
p
= 0.05, odds ratio 9.4, 95 % confidence interval 1.0–93.5) were incremental risk factors for hospital death. The 15- and 25-year actuarial survival were 56.5 ± 10.3 % and 45 ± 13.0 %, respectively. Multivariate analysis using Cox proportional hazard model showed MELD score (
p
= 0.024, hazard ratio 7.0, 95 % confidence interval 2.1–23.9) and postoperative pulmonary hypertension (
p
= 0.012, hazard ratio 4.4, 95 % confidence interval 1.4–14.1) were significantly associated with decreased survival. At 15 years, freedom rates from tricuspid valve reoperation, anticoagulation-related bleeding, and valve related events were 85.7 ± 13.2 %,95.7 ± 4.3 % and 81.8 ± 13.2 %, respectively. The linearized incidence of structural valve deterioration was 0.50 %/patient-year, anticoagulation-related bleeding was 0.94 %/patient-year, and valve-related events were 1.52 %/patient-year.
Conclusion
Preoperative hepatic congestion and liver dysfunction which were indicated by the MELD score >10 were associated with poor outcome for patients undergoing tricuspid valve replacement. The MELD score is useful to predict the morality among these patients.</description><identifier>ISSN: 1863-6705</identifier><identifier>EISSN: 1863-6713</identifier><identifier>DOI: 10.1007/s11748-012-0190-4</identifier><identifier>PMID: 23224685</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Adult ; Aged ; Bioprosthesis - adverse effects ; Cardiac Surgery ; Cardiology ; Confidence intervals ; Congenital diseases ; Creatinine ; Ejection fraction ; Female ; Heart failure ; Heart Valve Prosthesis - adverse effects ; Hemodynamics ; Hospitals ; Humans ; Hypertension, Pulmonary ; Liver diseases ; Liver Diseases - classification ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Original Article ; Pacemakers ; Patients ; Proportional Hazards Models ; Pulmonary arteries ; Regression analysis ; Reoperation - statistics & numerical data ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Surgeons ; Surgical Oncology ; Survival Analysis ; Thoracic Surgery ; Tricuspid Valve - surgery</subject><ispartof>General thoracic and cardiovascular surgery, 2013-03, Vol.61 (3), p.133-138</ispartof><rights>The Japanese Association for Thoracic Surgery 2012</rights><rights>The Japanese Association for Thoracic Surgery 2012.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-e9b9701f0a2fa2262f91893ba6676cde7f564dd66ec8b62effb8b8d3a7fdf33f3</citedby><cites>FETCH-LOGICAL-c462t-e9b9701f0a2fa2262f91893ba6676cde7f564dd66ec8b62effb8b8d3a7fdf33f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11748-012-0190-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918738004?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,21369,21370,27905,27906,33511,33512,33725,33726,41469,42538,43640,43786,51300,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23224685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morimoto, Naoto</creatorcontrib><creatorcontrib>Matsushima, Syunsuke</creatorcontrib><creatorcontrib>Aoki, Masaya</creatorcontrib><creatorcontrib>Henmi, Soichiro</creatorcontrib><creatorcontrib>Nishioka, Naritomo</creatorcontrib><creatorcontrib>Murakami, Hirohisa</creatorcontrib><creatorcontrib>Honda, Tasuku</creatorcontrib><creatorcontrib>Nakagiri, Keitaro</creatorcontrib><creatorcontrib>Yoshida, Masato</creatorcontrib><creatorcontrib>Mukohara, Nobuhiko</creatorcontrib><title>Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience</title><title>General thoracic and cardiovascular surgery</title><addtitle>Gen Thorac Cardiovasc Surg</addtitle><addtitle>Gen Thorac Cardiovasc Surg</addtitle><description>Background
Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series.
Methods
We retrospectively studied the early and late results of 32 consecutive patients (7 male and 25 female; mean age 60.2 ± 18.1 years) undergoing bioprosthetic tricuspid valve replacement between 1985 and 2010. The etiology is rheumatic in 38 %, congenital in 3 %, endocarditis in 9 %, and functional in 50 %. Patients underwent isolated valve replacement. The remaining underwent combined aortic and tricuspid (
n
= 5, 16 %), mitral tricuspid (
n
= 15, 47 %), and aortic, mitral, and tricuspid (
n
= 1, 3 %) valve replacement. Preoperative liver dysfunction was evaluated using Model for End-stage Liver Disease (MELD) score. Mean follow-up was 5.6 ± 6.8 years (ranging from 0 to 25.0 years).
Results
Hospital mortality was 19 %. On univariate logistic regression analysis, NYHA class IV (
p
= 0.039, odds ratio 11.3, 95 % confidence interval 1.2–112.5), MELD score (>10) (
p
= 0.011, odds ratio 21.0, 95 % confidence interval 12.0–222.0) and congestive liver (
p
= 0.05, odds ratio 9.4, 95 % confidence interval 1.0–93.5) were incremental risk factors for hospital death. The 15- and 25-year actuarial survival were 56.5 ± 10.3 % and 45 ± 13.0 %, respectively. Multivariate analysis using Cox proportional hazard model showed MELD score (
p
= 0.024, hazard ratio 7.0, 95 % confidence interval 2.1–23.9) and postoperative pulmonary hypertension (
p
= 0.012, hazard ratio 4.4, 95 % confidence interval 1.4–14.1) were significantly associated with decreased survival. At 15 years, freedom rates from tricuspid valve reoperation, anticoagulation-related bleeding, and valve related events were 85.7 ± 13.2 %,95.7 ± 4.3 % and 81.8 ± 13.2 %, respectively. The linearized incidence of structural valve deterioration was 0.50 %/patient-year, anticoagulation-related bleeding was 0.94 %/patient-year, and valve-related events were 1.52 %/patient-year.
Conclusion
Preoperative hepatic congestion and liver dysfunction which were indicated by the MELD score >10 were associated with poor outcome for patients undergoing tricuspid valve replacement. The MELD score is useful to predict the morality among these patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Bioprosthesis - adverse effects</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Confidence intervals</subject><subject>Congenital diseases</subject><subject>Creatinine</subject><subject>Ejection fraction</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Valve Prosthesis - adverse effects</subject><subject>Hemodynamics</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension, Pulmonary</subject><subject>Liver diseases</subject><subject>Liver Diseases - classification</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Original Article</subject><subject>Pacemakers</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Pulmonary arteries</subject><subject>Regression analysis</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Surgeons</subject><subject>Surgical Oncology</subject><subject>Survival Analysis</subject><subject>Thoracic Surgery</subject><subject>Tricuspid Valve - surgery</subject><issn>1863-6705</issn><issn>1863-6713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kclKBDEQhoMozrg8gBdp8OKlNUt3Ou1NBjcY8KLnkE5Xxgy9mXQPztv4LD6ZmcURBCEhFfL9Van6EToj-IpgnF17QrJExJjQsHMcJ3toTARnMc8I29_FOB2hI-_nGKdckPQQjSijNOEiHSMzbZtZ3IOrIwd-qHoftSYqbNu51vdv0Fsd9c7qwXe2jBaqWkAAu0ppqKHpbyLVhKWqpbdrJU2_Ppeg3PoCHx04C42GE3RgVOXhdHseo9f7u5fJYzx9fnia3E5jnXDax5AXeYaJwYoaRSmnJiciZ4XiPOO6hMykPClLzkGLglMwphCFKJnKTGkYM-wYXW7yhu-_D-B7WVuvoapUA-3gJWEkJSwJzQf04g86bwcXWvGShqoZExgngSIbSod5eAdGds7Wyi0lwXJlgtyYIIMJcmWCXGnOt5mHooZyp_iZegDoBvDhqZmB-y39f9Zva56TtQ</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Morimoto, Naoto</creator><creator>Matsushima, Syunsuke</creator><creator>Aoki, Masaya</creator><creator>Henmi, Soichiro</creator><creator>Nishioka, Naritomo</creator><creator>Murakami, Hirohisa</creator><creator>Honda, Tasuku</creator><creator>Nakagiri, Keitaro</creator><creator>Yoshida, Masato</creator><creator>Mukohara, Nobuhiko</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience</title><author>Morimoto, Naoto ; Matsushima, Syunsuke ; Aoki, Masaya ; Henmi, Soichiro ; Nishioka, Naritomo ; Murakami, Hirohisa ; Honda, Tasuku ; Nakagiri, Keitaro ; Yoshida, Masato ; Mukohara, Nobuhiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-e9b9701f0a2fa2262f91893ba6676cde7f564dd66ec8b62effb8b8d3a7fdf33f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bioprosthesis - adverse effects</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Confidence intervals</topic><topic>Congenital diseases</topic><topic>Creatinine</topic><topic>Ejection fraction</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Valve Prosthesis - adverse effects</topic><topic>Hemodynamics</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension, Pulmonary</topic><topic>Liver diseases</topic><topic>Liver Diseases - classification</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Original Article</topic><topic>Pacemakers</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Pulmonary arteries</topic><topic>Regression analysis</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Surgeons</topic><topic>Surgical Oncology</topic><topic>Survival Analysis</topic><topic>Thoracic Surgery</topic><topic>Tricuspid Valve - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morimoto, Naoto</creatorcontrib><creatorcontrib>Matsushima, Syunsuke</creatorcontrib><creatorcontrib>Aoki, Masaya</creatorcontrib><creatorcontrib>Henmi, Soichiro</creatorcontrib><creatorcontrib>Nishioka, Naritomo</creatorcontrib><creatorcontrib>Murakami, Hirohisa</creatorcontrib><creatorcontrib>Honda, Tasuku</creatorcontrib><creatorcontrib>Nakagiri, Keitaro</creatorcontrib><creatorcontrib>Yoshida, Masato</creatorcontrib><creatorcontrib>Mukohara, Nobuhiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>General thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morimoto, Naoto</au><au>Matsushima, Syunsuke</au><au>Aoki, Masaya</au><au>Henmi, Soichiro</au><au>Nishioka, Naritomo</au><au>Murakami, Hirohisa</au><au>Honda, Tasuku</au><au>Nakagiri, Keitaro</au><au>Yoshida, Masato</au><au>Mukohara, Nobuhiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience</atitle><jtitle>General thoracic and cardiovascular surgery</jtitle><stitle>Gen Thorac Cardiovasc Surg</stitle><addtitle>Gen Thorac Cardiovasc Surg</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>61</volume><issue>3</issue><spage>133</spage><epage>138</epage><pages>133-138</pages><issn>1863-6705</issn><eissn>1863-6713</eissn><abstract>Background
Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series.
Methods
We retrospectively studied the early and late results of 32 consecutive patients (7 male and 25 female; mean age 60.2 ± 18.1 years) undergoing bioprosthetic tricuspid valve replacement between 1985 and 2010. The etiology is rheumatic in 38 %, congenital in 3 %, endocarditis in 9 %, and functional in 50 %. Patients underwent isolated valve replacement. The remaining underwent combined aortic and tricuspid (
n
= 5, 16 %), mitral tricuspid (
n
= 15, 47 %), and aortic, mitral, and tricuspid (
n
= 1, 3 %) valve replacement. Preoperative liver dysfunction was evaluated using Model for End-stage Liver Disease (MELD) score. Mean follow-up was 5.6 ± 6.8 years (ranging from 0 to 25.0 years).
Results
Hospital mortality was 19 %. On univariate logistic regression analysis, NYHA class IV (
p
= 0.039, odds ratio 11.3, 95 % confidence interval 1.2–112.5), MELD score (>10) (
p
= 0.011, odds ratio 21.0, 95 % confidence interval 12.0–222.0) and congestive liver (
p
= 0.05, odds ratio 9.4, 95 % confidence interval 1.0–93.5) were incremental risk factors for hospital death. The 15- and 25-year actuarial survival were 56.5 ± 10.3 % and 45 ± 13.0 %, respectively. Multivariate analysis using Cox proportional hazard model showed MELD score (
p
= 0.024, hazard ratio 7.0, 95 % confidence interval 2.1–23.9) and postoperative pulmonary hypertension (
p
= 0.012, hazard ratio 4.4, 95 % confidence interval 1.4–14.1) were significantly associated with decreased survival. At 15 years, freedom rates from tricuspid valve reoperation, anticoagulation-related bleeding, and valve related events were 85.7 ± 13.2 %,95.7 ± 4.3 % and 81.8 ± 13.2 %, respectively. The linearized incidence of structural valve deterioration was 0.50 %/patient-year, anticoagulation-related bleeding was 0.94 %/patient-year, and valve-related events were 1.52 %/patient-year.
Conclusion
Preoperative hepatic congestion and liver dysfunction which were indicated by the MELD score >10 were associated with poor outcome for patients undergoing tricuspid valve replacement. The MELD score is useful to predict the morality among these patients.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>23224685</pmid><doi>10.1007/s11748-012-0190-4</doi><tpages>6</tpages></addata></record> |
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| ispartof | General thoracic and cardiovascular surgery, 2013-03, Vol.61 (3), p.133-138 |
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| source | MEDLINE; ProQuest Central (Alumni Edition); ProQuest Central UK/Ireland; SpringerLink Journals - AutoHoldings; ProQuest Central |
| subjects | Adult Aged Bioprosthesis - adverse effects Cardiac Surgery Cardiology Confidence intervals Congenital diseases Creatinine Ejection fraction Female Heart failure Heart Valve Prosthesis - adverse effects Hemodynamics Hospitals Humans Hypertension, Pulmonary Liver diseases Liver Diseases - classification Male Medicine Medicine & Public Health Middle Aged Mortality Original Article Pacemakers Patients Proportional Hazards Models Pulmonary arteries Regression analysis Reoperation - statistics & numerical data Retrospective Studies Risk Factors Severity of Illness Index Surgeons Surgical Oncology Survival Analysis Thoracic Surgery Tricuspid Valve - surgery |
| title | Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25 years of experience |
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