Clinical and morphologic observations after simultaneous replacement of the tricuspid, mitral and aortic valves

The American Journal of Cardiology
M F Sullivan, W C Roberts

Abstract

Clinical and morphologic observations are described in 12 patients who underwent simultaneous replacement of the tricuspid, mitral and aortic valves. All 12 patients had mitral stenosis, 10 aortic valve stenosis and 2 pure aortic valve regurgitation; 5 had tricuspid valve stenosis and 7 pure tricuspid valve regurgitation. Of the 10 patients who died within 60 days of triple valve replacement, 7 had the low cardiac output syndrome, which in 4, and possibly 5, of the 7 was attributed to prosthetic aortic valve stenosis. In none of the 12 patients was the ascending aorta dilated, and in the 4 (possibly 5) patients with low cardiac output, the space between the surface of the caged poppet (4 patients) or margins of the tilting disc (1 patient) in the aortic valve position and the aortic endothelium appeared inadequate to allow unobstructed flow despite small-sized prostheses in all but 1 patient. Thus, aortic valve replacement in the setting of triple valve dysfunction is hazardous or potentially so. The relative small sizes of the hearts in these patients also make valve replacement more difficult (and hazardous) compared to hearts with larger ventricles and aortas.

References

May 1, 1978·The Annals of Thoracic Surgery·Q MacmanusA Starr
Apr 1, 1977·The Annals of Thoracic Surgery·L W StephensonJ W Kirklin
Sep 1, 1985·The American Journal of Cardiology·W C Roberts
Sep 12, 1970·British Medical Journal·M V BraimbridgeD Mendel
Sep 20, 1969·British Medical Journal·M V BraimbridgeD Mendel

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Citations

Oct 26, 2006·The Annals of Thoracic Surgery·Tankut Hakki AkaySait Aslamaci
Nov 15, 1986·The American Journal of Cardiology·W C Roberts, M F Sullivan
Jul 20, 2007·Proceedings·William C Roberts, W Bruce Fye

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