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

Background. Tricuspid valve operation or replacement has been associated wi th high perioperative mortality and poor long-term results. The prevalence of atrial arrhythmias before and after operation in these patients is undef ined. Methods. We retrospectively examined the outcome and frequency of atrial ar rhythmias 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 corr ected transposition (19%), tetralogy of Fallot (15%), atrial (13%), or vent ricular (11%) septal defects. Forty-two (49%) patients had sustained arrhyt hmias within 1 year before operation. After tricus- pid valve operation, 21 patients (50%) had recurrence of atrial arrhythmias, and 7 in preoperative sinus rhythm developed late rhythm disturbances. Multivariate analysis ide ntified age at operation and preoperative arrhythmias as independent predic tors of late arrhythmias. Perioperative mortality was 5%, and there were se ven late deaths. Survival was 91% at 5 years, and 83% at 10 years. Conclusions. Surgical intervention does not prevent recurrence of atrial ar rhythmias. Tricuspid valve operation in patients with congenital heart dise ase can be performed with a low risk of perioperative mortality and good lo ng-term outcome. (C) 1999 by The Society of Thoracic Surgeons.