Abstract
The total experience with combined aortic, mitral, and tricuspid valve replacement in 38 patients during an eight-year period ending in December, 1974, is reviewed. The hospital mortality was 23.7% (9 patients) and was influenced by the preoperative New York Heart Association Functional Class: 18% (5 of 28 patients) in Class III and 40% (4 of 10) in Class IV. Intraoperative myocardial injury was the other important factor affecting hospital mortality. The majority of late deaths were related to cardiac causes. The five-year survival was 53% (20 patients) for the entire group and 62% (17 patients) for the Class III patients. At latest follow-up (mean, 44 months), 22 (76%) of the hospital survivors had improved by at least one functional class. It appears that surgical intervention before patients reach Class IV status should give better early and long-term results. Our current indications for tricuspid valve replacement as opposed to repair are presented.
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