Background: Triple valve surgery is a complex and challenging procedure, and patients pose a high surgical risk. We reviewed our experience over 20 years in patients undergoing triple valve surgery in order to examine short and long-term outcomes.
Methods: There were 76 patients, age 65±13 years. Seventy-two (95%) were in NYHA class III-IV, 41 (54%) were in atrial fibrillation, 8 (11%) had prior stroke. Left ventricular function was reduced in 14 (18%) and 68 (89%) had mitral regurgitation of moderate or greater degree. Valvular disease included aortic stenosis in 57, aortic insufficiency in 44, mitral stenosis in 35, and mitral regurgitation in 82. Logistic EuroSCORE was 14±14. We examined long-term outcomes, and compared late survival of the subgroup undergoing triple valve surgery without coronary disease to that of patients undergoing isolated mitral or aortic valve replacement.
Results: The mitral valve was repaired in 21 (28%) and replaced in 55 (72%). Fifteen patients (20%) underwent concomitant coronary bypass. Operative mortality was 16% (n=12). We could not identify any predictors of operative mortality. Survival at 10 years was 54%. Peripheral vascular disease was the only predictor of late mortality (p=0.05). Survival at 10 years was similar to that of patients undergoing isolated mitral valve or aortic valve surgery.
Conclusions: Patients requiring triple valve surgery pose a high risk. Our results show that such patients can attain good long-term survival. For patients without coronary disease survival was similar to that of patients undergoing single mitral or aortic valve surgery.
