Surgical Pathology of the Tricuspid Valve: A Study of 363 Cases Spanning 25 Years
Section snippets
Study Group.
From the tissue registry at our institution, 363 tricuspid valves that had been excised surgically during the 25 years between January 1963 and December 1987 were examined. For gross examination of the valves, we used the methods described by Davies16 and by Roberts.17 Patients in this study may also have had replacement or surgical repair of additional cardiac valves. Excluded from this study, however, were patients who underwent repair, rather than excision and replacement, of tricuspid
Functional Classification.
Of the 363 tricuspid valves reviewed (Table 1), 269 (74%) were purely insufficient, 84 (23%) were both insufficient and stenotic, 8 (2%) were purely stenotic, and 2 (0.6%) were neither insufficient nor stenotic (Table 2). Two functionally normal valves were removed, one during repair of a double-outlet left ventricle because of straddling chordae tendineae and the other to allow septation during correction of a double-inlet left ventricle.
Morphologic Classification.
Postinflammatory changes were the most common cause of
Postinflammatory Disease.
In patients who have undergone a tricuspid valve surgical procedure, tricuspid valve dysfunction is most commonly caused by postinflammatory disease, which is presumably a manifestation of chronic rheumatic disease in most instances. It accounted for 39 of 41 cases (95%) of valve replacement or repair reported by Kratz and associates,9 for 194 of 363 valve replacements (53%) in the current study, and for 9 of 21 valve replacements (43%) reported by Waller.19 A striking female preponderance has
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Current address: University of Louisville, Louisville, Kentucky.