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P.L. MICHEL, E. HOUDART, G. GHANEM, G. BADAOUI, A. HAGE, J. ACAR, Combined aortic, mitral and tricuspid surgery: Results in 78 patients, European Heart Journal, Volume 8, Issue 5, May 1987, Pages 457–463, https://doi.org/10.1093/oxfordjournals.eurheartj.a062305
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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
- aorta
- cardiomegaly
- bacterial endocarditis
- thrombosis
- hemorrhage
- lung
- aortic valve replacement
- mitral valve replacement surgery
- brachial plexus neuritis
- diastole
- repeat surgery
- surgical procedures, operative
- survival rate
- survivors
- systole
- pressure-physical agent
- surgery specialty
- cardiac index
- thromboembolic event
- ejection fraction
- left ventricular dilatation
- new york heart association classification
- surgical mortality
- tricuspid valve operation