Tricuspid Valve Replacement

Posted By Marjorie on September 21, 1998 at 13:01:51:







I have a question about the duration of a tissue valve placed in the tricuspid position. I was recently assessed at a major medical center with a specialized adult congenital heart team; but am seeking information from more than one site.
I am a 46 y/o with surgically corrected ostium prium defect (partial A/V canal) Mitral valve repaired once; then replaced with a Bjork Shiley mechanical valve 20 yr ago. Functions well with a small paravalvular leak since surgery. ASD repair x2; intact. Chronic atrial fib with 3 Bundle of His Ablations (3)  creating complete block--VVI pacer implanted x 2.
Basically, things have been going well until several months ago w the development of R sided failure and several echos show severe regur of the tricuspid valve; the leaflets don't close at all. Tricuspid replacement with a tissue valve (rather than mechanical) is recommended but my concern is the placement of a tissue valve due to my age.  These valves do not last that long and if I consent to this surgery; it means 1 or 2 more open hearts are in the future, not including the additional pacer surgeries I will have to have. I think this is an awful lot for a patient to endure.
I was told the reason for the tissue valve has to do with the pacer lead and my hx of hemorraghing due to coumadin; I was told another mechanical valve would mean an increase in the coumadin dose. Even knowing that, I do not want repeated surgeries over thru a lifetime and am wondering just how long these valves really do last -- and if mechanical valves are ever placed in the tricuspid position.  Is there a way I can find statistics on these surgical outcomes?  Thank you.  Marjorie