Functional Tricuspid Insufficiency: Conservative or Operative Management
| Autor: | G. Kronik, J. Mlczoch, Walter Klepetko, Ch. Müller, M. Klicpera, H. Magometschnig, E. Domanig |
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| Rok vydání: | 1985 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Mitral valve replacement Hemodynamics Tricuspid insufficiency medicine.disease Prosthesis Surgery medicine.anatomical_structure medicine.artery Mitral valve Pulmonary artery medicine Vascular resistance Tricuspid Valve Regurgitation Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 33:162-172 |
| ISSN: | 1439-1902 0171-6425 |
| Popis: | Between 1978 and 1982 mitral valve replacement was performed in a total of 43 patients with mitral valve disease in the presence of functional tricuspid insufficiency (TI). The concomitant tricuspid valve regurgitation was treated conservatively in 17 patients, a Carpentier ring prosthesis was implanted in 9 patients. De Vega annuloplasty was performed in 13 patients and 4 times the valve was replaced with a Hancock bioprosthesis. The hospital mortality of 26% (11 patients) was high, due to the poor clinical condition of the patients. In a mean follow-up of 43.1 +/- 18,0 months, 20 patients could be restudied by clinical and echocardiographical investigation. Tricuspid insufficiency was found in all of the 9 patients who had been treated conservatively. Seven out of 11 patients operated showed no signs of TI, 3 had mild TI and 1 patient had severe TI. In the conservatively treated group, the preoperative mean pulmonary vascular resistance (PVR = 296 +/- 161 dynes x sex x cm-5), pulmonary artery pressure (PAP = 46.1 +/- 16.2 mmHg) and rise of right atrial V-wave (15.8 +/- 3.6 mmHg) were only slightly higher than n the operatively treated group (PVR - 274 +/- 146 dynes x sex x cm-5), PAP = 43.2 +/- 13.6 mmHg, V-wave = 18.5 +/- 6.4 mmHg) with no statistically significant difference. Preoperative hemodynamic findings in patients with and without TI a follow-up were also not significantly different. These results indicate that the recurrence of functional TI depends on the method of treatment, rather than preoperative increased PVR, PAP or V-wave rise. |
| Databáze: | OpenAIRE |
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