Plastik på trikuspidalklappen

INTRODUCTION: Tricuspid valve regurgitation (TVR) is often secondary to left-sided or congenital heart disease (CHD). Surgical correction of TVR is indicated when the primary abnormalities require operation.

MATERIAL AND METHODS: Retrospective analysis of all 50 patients (mean age: 65 years (range: 24-83), 27 males, 23 females) operated with tricuspid valve annuloplasty (TVA) in our hospital from 2000 to 2007. TVA took place concomitantly with operation for left heart disease (n = 39, 78%) or CHD (n = 11, 22%).

RESULTS: Preoperatively, TVR was severe in 40, moderate in six and mild in four cases. Thirty-four had annulus dilation > 2 cm/m(2) body surface area. Half of the patients were in New York Heart Association (NYHA) class III or IV. Postoperatively, TVR was severe in two cases, moderate in one, mild in 25 and absent in 18, and 95% of patients followed up were in NYHA I or II. There were five (10%) early and two (4%) late deaths. Temporary arrhythmias requiring medical treatment occurred in 35 cases, but eight required permanent pacemaker. No tricuspid valve reoperations were performed.

CONCLUSIONS: The combination of correction of primary heart abnormalities and TVA is associated with high perioperative mortality. In survivors, postoperative clinical improvement is common, in all probability this is mainly due to the correction of the primary disease. TVA reduces TVR, but its precise contribution to clinical improvement and prognosis remains unknown.