Prosthetic replacement of the tricuspid valve: biological or mechanical?

Long-Term Clinical Results of Tricuspid Valve Replacement

“…The long-term survival after TVR with mechanical valves has been reported to be similar to TVR with tissue valves [9,10]. In this series there was also no statistical difference between two types of valve prostheses in terms of long-term survival.…”

“…Reoperations took place at different times depending on prosthesis type, with reoperations in the mechanical valve group occurring within seven years, while reoperations in the bioprosthetic valve group occurred beyond 12 years, with one exception. Rizzoli and colleagues [9] reported that the risk of reoperation was 4.7 %/patient-year for bioprostheses and 2.2 %/patientyear for mechanical prostheses. They also reported that bioprosthetic valve degeneration increased at a steeper rate after seven years.…”

Mechanical Valve Replacement Versus Bioprosthetic Valve Replacement in the Tricuspid Valve Position

“…Some authors have advocated the use of bioprostheses in the tricuspid position, based on the concept that low pressure and low stress in the right heart seem to provide a higher valve durability, compared to those located in the systemic circulation. However, the use of bioprostheses in the tricuspid position leads to an increased rate of reoperation after 7–10 years . In the present study, one case of bioprosthetic valve degeneration was observed just five years after operation.…”

Triple Valve Replacement With Bileaflet Mechanical Valves

“…Rizzoli et al reported that the bioprostheses are not superior to mechanical ones in the long term because of the high rate of degeneration, particularly after 7 years. 6 Echocardiography demonstrated that 5 years post operation 35% of patients have subclinical bioprosthesis dysfunction. 12 According to Kobayashi et al, the actuarial rates of freedom from bioprosthesis stenosis and regurgitation at 10 years were as high as 46% and 51%, respectively.…”