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Tricuspid Valve Replacement In Patient With Congenital Heart Disease
Sungkyu Cho, Yong Jin Kim, Eun Seok Choi, Woong-Han Kim, Jeong Ryul Lee.
Seoul National University Hospital, Seoul, Korea, Republic of.

OBJECTIVE: Tricuspid valve replacement in patient with congenital heart disease is not commonly performed. We reviewed to evaluate the long term outcomes of TVR in patients with congenital heart disease.
METHODS: From April, 1981 to September, 2012 tricuspid valve replacement was performed in 15 patients (9 female) with congenital heart disease at our institution (total of 24 prostheses).The most frequent diagnosis was Ebstein anomaly in 8 patients.
RESULTS: Median age was 12.8 years (from 2.0 to 25.2 years) at the time of initial tricuspid valve replacement. 8 patients (median age: 9.1, from 2.0 to 17.0 years) underwent replacement with mechanical valves and 7 patients (median age 14.9: from 5.6 to 25.2 years) underwent replacement with tissue valves (p=0.95). One patient died early postoperatively due to acute myocardial failure. During a median follow up of 15.3 years (from 1.4 to 32.0 years), 50% of patients needed a re-replacement because of valve related complications (valve thrombosis or valve degeneration). The re-replacement rate by Kaplan-Meier log rank was higher in patients who underwent tricuspid valve replacement under 12 years old (p=0.01), but no significant re-replacement rate between mechanical valves and tissue valves (p=0.40).
CONCLUSIONS: Tricuspid valve replacement in patients with congenital heart disease showed high incidence of re-replacement that might be unrelated to prosthesis material. The patients of young age at operation could be a risk factor for re-replacement of tricuspid valve replacement in this series.

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