Aguirre-Baca GG, Careaga RG, Argüero SR

Language: Spanish
References: 17
Page: 119-126
PDF size: 161.65 Kb.

ABSTRACT

Introduction: Actually exists controversy for the approach and the good moment to carry out the surgical treatment for the tricuspid valve disease. Objective: The objective of this work was to identify the clinical, echocardiographic and surgical findings to carry out a reconstruction procedure or replacement of the tricuspid valve. Material and methods: A retrospective, observational, longitudinal study was realized. We reviewed and recorded demographic and clinical data, signs and clinical symptoms, echocardiographic and surgical findings, surgical procedure, morbidity or mortality of the patients surgically treated of the tricuspid valve, between January 1, 2000 and December 31, 2004. Results: We collected information of 52 patients. The mean age was 53.35 ± 11.8 years, 71% was female, 55.7% had rheumatic fever antecedent, 57.7% had already been previously operated, 89% had atrial fibrillation. The 56% had moderate lung arterial hypertension and was severe in 21%. The tricuspid ring was smaller than 5 cm in 89% of cases. Functional class NYHA was reported as II in 65%. The surgical procedure was De Vega’s plastic procedure for minimally tricuspid regurgitation and lower pulmonary hypertension, the valve replacement was the main procedure for cases with moderate or severe regurgitation, with moderate and severe pulmonary artery hypertension. There were five deaths, 4 had preoperative functional class IV (p ‹ 0.001), 4 severe pulmonary artery hypertension (p = 0.02), 4 had severe tricuspid regurgitation (p = 0.02), and/or dilation of the tricuspid ring (p = 0.02). All 5 have ejection fraction ‹ 50% (p = 0.002). Conclusion: The patients with worse functional class to the moment of the surgery have worse presage for what should be strictly evaluated for the risk-benefit of surgery.

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