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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 846-851, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
C Minale, H Lambertz, S Nikol, N Gerich and BJ Messmer
Between July 1986 and March 1989, 48 patients whose ages averaged 60 +/- 6
years were subjected to a new technique for tricuspid valve annuloplasty.
The preoperative New York Heart Association functional class averaged 3.7.
There were 32 mitral-tricuspid procedures, 13 aortic-mitral-tricuspid
procedures, and three repeat tricuspid annuloplasties. The hospital
mortality rate was 6.3% with three deaths resulting from cardiac or
respiratory failure, or both. Follow-up averaged 14 +/- 8 months. One
patient (2.2%) died suddenly, 7 months postoperatively. All patients whose
follow-up period lasted 6 months or more improved to class I or II.
Twenty-six patients were reinvestigated by catheter or echocardiographic
methods, or both. The gradient over the tricuspid valve averaged 1.4 +/-
0.6 mm Hg, and a moderate regurgitant murmur (2/3) was detected in four
cases. The diameter of the tricuspidal anulus in the apical four-chamber
view decreased from 23.7 +/- 3.9 mm/m2 body surface area preoperatively to
15.7 +/- 1.9 mm/m2 body surface area at late follow-up examination. The
present technique allows an anatomic and functional reconstruction of the
tricuspid valve with a good compromise between stenosis and regurgitation.
The overall mortality rate is low and functional improvement is striking.
ARTICLES
Selective annuloplasty of the tricuspid valve. Two-year experience
Department of Thoracic and Cardiovascular Surgery, University Hospital of R.W.T.H., Aachen, Federal Republic of Germany.
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