Mechanical valve replacement versus bioprosthetic valve replacement in the tricuspid valve position

Abstract

Background: The purpose of this study was to evaluate the clinical outcomes and risk of tricuspid valve replacements and to compare bioprosthetic versus mechanical valves. Methods: Between 1991 and 2009, 104 consecutive patients (71 women; mean age, 57 ± 10.8 years) with tricuspid valvular disease underwent mechanical TVR (mechanical group; n = 59) or bioprosthetic TVR (bioprosthesis group; n = 45). Follow-up was complete in 97.1% (n = 101) with a median duration of 49.9 months (range 0-230 months). Results: Hospital mortality after mechanical TVR and bioprosthetic TVR was not different on adjusted analysis by propensity score. Ten-year actuarial survival after mechanical and bioprosthetic TVR was 83.9 ± 7.6% and 61.4 ± 9.1%, respectively (p = 0.004). However, there was also no significant difference in terms of adjusted analysis by propensity score (p = 0.084). No statistically significant difference was detected between mechanical and bioprosthetic valves in regard to event-free survival. Conclusions: Mechanical TVR is not inferior to bioprosthetic TVR in terms of occurrence of valve-related events, especially anticoagulation-related complications. © 2013 Wiley Periodicals, Inc.