naa a22 4500 510728235 CHVBK 20180411082943.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s11748-012-0190-4 doi (NATIONALLICENCE)springer-10.1007/s11748-012-0190-4 Long-term results of bioprosthetic tricuspid valve replacement: an analysis of 25years of experience [Elektronische Daten] [Naoto Morimoto, Syunsuke Matsushima, Masaya Aoki, Soichiro Henmi, Naritomo Nishioka, Hirohisa Murakami, Tasuku Honda, Keitaro Nakagiri, Masato Yoshida, Nobuhiko Mukohara] 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±18.1years) 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±6.8years (ranging from 0 to 25.0years). 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 15years, 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. The Japanese Association for Thoracic Surgery, 2012 Tricuspid valve replacement nationallicence Right ventricular ejection fraction nationallicence Pulmonary hypertension nationallicence Morimoto Naoto Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Matsushima Syunsuke Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Aoki Masaya Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Henmi Soichiro Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Nishioka Naritomo Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Murakami Hirohisa Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Honda Tasuku Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Nakagiri Keitaro Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Yoshida Masato Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut Mukohara Nobuhiko Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/3(2013-03-01), 133-138 1863-6705 61:3<133 2013 61 11748 https://doi.org/10.1007/s11748-012-0190-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0190-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Morimoto Naoto Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Matsushima Syunsuke Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Aoki Masaya Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Henmi Soichiro Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Nishioka Naritomo Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Murakami Hirohisa Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Honda Tasuku Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Nakagiri Keitaro Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Yoshida Masato Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 700 1- Mukohara Nobuhiko Department of Cardiovascular Surgery, Himeji Cardiovascular Center, 520 Saishoko, 670-0981, Himeji, Hyogo, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/3(2013-03-01), 133-138 1863-6705 61:3<133 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer