Clinical and pathological features of accessory valve tissue

Background. Accessory valve tissue is a rare congenital cardiac malformatio n causing a variety of clinical features. We describe our experience with t he surgical treatment of accessory valve tissue to clarify clinical and pat hological features of this anomaly. Methods. Between December 1990 and February 1999, 11 children underwent res ection of accessory Valve tissue together with repair of coexisting intraca rdiac malformations. Eight patients had accessory tricuspid valve, while 3 had accessory mitral valve tissue. Associated intracardiac malformations in cluded tetralogy of Fallot in 6 patients, transposition of the great arteri es in 3, coarctation complex in 1, and ventricular septal defect in 1. Results. Accessory valve tissue was completely resected in all but 1 patien t with accessory mitral valve and transposition of the great arteries. As t otal resection of the accessory valve tissue through the pulmonary artery w as unsuccessful, partial resection and bidirectional Glenn shunt operation was performed instead of arterial switch operation in this patient. Conclusions. The clinical signs and symptoms of accessory valve tissue vary according to its location and coexisting cardiac malformations. Congenital heart surgeons should be familiar with the clinical and pathological featu res of accessory valve tissue, so as not to overlook it during operation. ( C) 2000 by The Society of Thoracic Surgeons.