Long term results comparing mechanical and biological prostheses in the tricuspid valve position: which valve types are better--mechanical or biological prostheses?

Objectives: The aim of this study was to evaluate the clinical outcome of patients who underwent TVR focusing on long-term survival- and valve-related complications.

Methods: Between January 1993 and June 2011, 132 patients underwent tricuspid valve replacement in our centre. Sixty-eight bioprosthetic valves (52%) and 64 mechanical valves (48%) were implanted for tricuspid position. For 51 patients (39%) this was a first-time tricuspid valve operation.

Results: Nineteen patients died during hospitalisation, yielding a hospital mortality rate of 14%. The hospital mortality and morbidity were not statistically significantly different between the two groups. Sixteen patients (14,1%) died after discharge from the hospital. Twelve-year actuarial survival after mechanical and bioprosthetic TVR was 72,1±5,9 and 61.6±6,6%, respectively. No statistically significant difference was detected between mechanical and bioprosthetic valves in regard to event-free survival.

Conclusion: The choice between mechanical or biological prostheses in the tricuspid position should be individualised according to the clinical judgment, even though absence of any difference in the survival data supports the opinion that there is no "gold standard" for prosthetic tricuspid valve replacement.