Triple Valve Replacement With Bileaflet Mechanical Valves

Abstract

ecause the outcome of tricuspid valve replacement (TVR) is relatively poor, most tricuspid valve surgery is repair procedures. As a result, the experience of prosthetic valve replacement in the tricuspid position is limited and the optimal choice of replacement valve is still controversial. Generally, bioprostheses have excellent antithrombogenic characteristics with relatively greater durability, and many recommend this choice for TVR. 1-3 On the other hand, satisfactory results with the newly developed bileaflet mechanical valve have been demonstrated, 4-7 though higher levels of anticoagulation were required. In particular, when a patient already has mechanical prostheses in the aortic and/or mitral position, a more durable mechanical valve may be a better choice than a bioprosthesis, because such patients will require anticoagulation regardless of the kind of prosthesis used in the tricuspid position. Additionally, the patient often has had multiple previous valve surgeries, so any future potential surgery should be avoided because of the high surgical risk.The mechanical bileaflet valve was our first choice for the tricuspid position in patients undergoing triple valve replacement (aortic, mitral and tricuspid positions). Here we review our experience of triple valve replacement with mechanical valves and assess the optimal valve selection, particularly for the tricuspid position.

A case of stuck mechanical Tricuspid Valve

“… 12 Kawano and his colleagues published a retrospective study and reported that after TVR six out of nineteen SJM valves have been detected with thrombosis of valve (2.9%/patient-years), and they reported the tricuspid valve position vulnerable to thrombosis. 13 …”

“…12 Kawano and his colleagues published a retrospective study and reported that after TVR six out of nineteen SJM valves have been detected with thrombosis of valve (2.9%/patient-years), and they reported the tricuspid valve position vulnerable to thrombosis. 13 Better bio prostheses are a good choice for lowpressure chamber (as right sided is low pressure area|) than the high pressure chamber (left sided in the mitral and aortic position). 14 Stenosis, dysfunction and late valve calcification are the complications of bio prostheses.…”