[Triple-valve prosthesis (old problems, new prospects)].

The article analyses 30 operations for prosthetics of the mitral, aortic, and tricuspid valves in patients with trivalve rheumatic heart disease. Twenty-nine patients had a marked organic tricuspid valvular disease. Various models of prostheses (ball, semispherical, biological, disk) were used for replacement of the valves. Techniques which allowed the subvalvular structures of the tricuspid valve to be preserved partly or completely were applied in 18 patients. The hospital mortality was 16.7%, long-term mortality 4%. Improvement by two functional classes and more occurred in 86% of patients. It is concluded that surgeons are no longer compelled to resort to prosthetics of the tricuspid valve, which has now become an alternative operation, particularly in the category of extremely grave patients with organic affection of 3 valves when the prognosis of the result is needed in view of the patient's severe condition. The techniques for preserving the valvular apparatus provides optimum conditions for functioning of the right ventricle in replacement of the tricuspid valve.