Surgery for tricuspid valve disease.

Sixty patients underwent repair or replacement of the tricuspid valve, 58 for acquired and two for congenital lesions. In 59 of the cases, the tricuspid surgery formed part of multiple valve surgery. Preoperatively, 33 patients (55%) were in New York Heart Association class IV and 25 in class III functional capacity. The tricuspid valve was replaced in 42 patients and repaired in 18. Forty-seven patients (78%) survived operation, but 10 of these died during a follow-up period of two to seven years. Thirty-four of the 37 long-term survivors show marked improvement. Operative mortality was 26% for tricuspid valve replacement and 11% for repair; late mortality was 14% and 22%, respectively. It should be stressed that the tricuspid valve replacement group consisted of patients whose preoperative condition was worse and whose valvular pathology was more severe than that of those who had tricuspid repair. In view of this, and the better long-term results of tricuspid valve replacement, it is concluded that the procedure of choice for serious organic disease of the tricuspid valve is valve replacement.