Follow-up assessment of St. Jude Medical prosthetic valve in the tricuspid position: clinical and hemodynamic results.
Seven patients underwent postoperative right heart catheterization implantation of the St. Jude Medical prosthetic valve in the tricuspid position. Six patients were in atrial fibrillation at catheterization, and 1 was in normal sinus rhythm. At postoperative catheterization, the mean right atrial pressure ranged between 4 and 16 mm Hg (mean, 9.7 mm Hg); right ventricular systolic pressure was normal in 1 patient, mildly elevated (less than 50 mm Hg) in 4 patients, and moderately elevated (65 and 70 mm Hg) in 2. The cardiac output ranged between 3.0 and 7.0 L/min (mean, 4.2 L/min). There was no end-diastolic gradient across the St. Jude Medical prosthesis in 6 patients. The other patient had a gradient of 2 mm Hg across the valve when cardiac output was 7.0 L/min. On fluoroscopy, both discs demonstrated full excursion in all patients. These data demonstrate that a normally functioning St. Jude Medical valve in the tricuspid position does not create obstruction to forward flow, and they support use of this prosthesis in patients with tricuspid valve disease.