[Results of tricuspid valve replacement using xenograft bioprostheses].

Thirty-two cases of tricuspid valve replacement were done with bioprostheses during the period from 1979 to 1986 at our institution. In these cases there were 19 cases of acquired valvular diseases, 10 cases of congenital types of heart diseases and other 2 cases were another genesis. Seven different kinds of bioprostheses were utilized: 30 were bovine pericardial xenografts and 2 were porcine xenografts. In postoperative hemodynamic study, right ventricular end-diastolic pressure and right atrial pressure significantly decreased after tricuspid valve replacement. RV ejection fraction were reduced but there was no statistic significance when compared to the preoperative data. There were 5 patients who showed postoperative atrio-ventricular block and two of them needed permanent pacemaker implantation. Six patients died in postoperative period and other 3 died in late follow-up period. However, these was no mortality directly related to prosthetic valvular failure. In follow-up study, there was no episode of valve thrombosis nor pulmonary embolism. Prosthetic endocarditis was not encountered during this observation period. One patient showed mild degree of tricuspid regurgitation who had severe pulmonary hypertension even after the operation. Based on our experience, we concluded that the bovine pericardial xenograft may be the best choice for the TVR because of its anti-thrombogenicity. However, mechanical valve will be better choice for the patients who are complicated with severe pulmonary hypertension.