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Ann Thorac Surg 1999;68:2158-2163
© 1999 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Outcome of previous tricuspid valve operation and arrhythmias in adult patients with congenital heart disease

^a Departments of Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
^b Surgery, Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada

Address reprint requests to Dr Harris, Toronto General Hospital, Gerrard Wing, 3-562, 150 Gerrard St W, Toronto, ON M5G 2C4, Canada;
e-mail: lharris{at}torhosp.toronto.on.ca

Background. Tricuspid valve operation or replacement has been associated with high perioperative mortality and poor long-term results. The prevalence of atrial arrhythmias before and after operation in these patients is undefined.

Methods. We retrospectively examined the outcome and frequency of atrial arrhythmias in 85 adult patients (46% men) with congenital heart defects who underwent tricuspid valve operation between 1961 and 1995.

Results. The majority had either Ebstein’s anomaly (22%), congenitally corrected transposition (19%), tetralogy of Fallot (15%), atrial (13%), or ventricular (11%) septal defects. Forty-two (49%) patients had sustained arrhythmias within 1 year before operation. After tricuspid valve operation, 21 patients (50%) had recurrence of atrial arrhythmias, and 7 in preoperative sinus rhythm developed late rhythm disturbances. Multivariate analysis identified age at operation and preoperative arrhythmias as independent predictors of late arrhythmias. Perioperative mortality was 5%, and there were seven late deaths. Survival was 91% at 5 years, and 83% at 10 years.

Conclusions. Surgical intervention does not prevent recurrence of atrial arrhythmias. Tricuspid valve operation in patients with congenital heart disease can be performed with a low risk of perioperative mortality and good long-term outcome.

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