title: Outcome of previous tricuspid valve operation and arrhythmias in adult patients with congenital heart disease.
abstract: 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.
authors.affiliation: Department of Medicine and Surgery, Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, University of Toronto, Ontario, Canada.
authors.forename: C B
authors.initials: CB
authors.lastname: Overgaard
authors.forename: D A
authors.initials: DA
authors.lastname: Harrison
authors.forename: S C
authors.initials: SC
authors.lastname: Siu
authors.forename: W G
authors.initials: WG
authors.lastname: Williams
authors.forename: G D
authors.initials: GD
authors.lastname: Webb
authors.forename: L
authors.initials: L
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications*; D006348:Cardiac Surgical Procedures / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D014261:Tricuspid Valve / Q000601:surgery*