Evaluation of tricuspid valvuloplasty with mitral valve replacement in severely ill patients.

A group of twenty cases of class IV of New York Heart Association Classification is reported. They were selected among 55 cases of mitral valve replacement. Three patients died and this leaves us with a mortality rate of 15% which corresponds with that of others. Tricuspid valvuloplasty had to be carried out in seven cases. In two cases, reported in detail, two commissures and ring had to be repaired. The nature of pathology was organic and functional while in the remaining five cases it was only functional. None of the cases required tricuspid valve replacement. We believe that tricuspid valvuloplasty has an important position in heart surgery and should not be underestimated. Also, we conclude that no patient should be denied operation on the basis of the severity of his disease unless advanced coronary disease or primary myocardiac disease are also involved.