Temporary tricuspid valve detachment in closure of congenitalventricular septal defect

In a consecutive series of 149 patients with congenital ventricularseptal defect (VSD), temporary tricuspid valve detachment was applied in 39(detached group) to facilitate the transatrial approach for closure of thedefect. Baseline characteristics showed that, preoperatively, the detachedgroup were younger (1.3 +/− 2.3 vs. 3.5 +/− 4.1 years, P = 0.002), shorter(0.67 +/− 0.20 vs 0.87 +/− 0.34 m, P = 0.001), lighter (6.9 +/− 5.4 vs 13.5+/− 12.0 kg, P < 0.002), and had a higher mean right atrial pressure (6+/− 2 vs 4+/− 3 mm Hg, P < 0.003), mean end-diastolic right ventricularpressure (10 +/− 3 vs 8 +/− 3 mm Hg, P <; 0.01) and mean pulmonaryvascular resistance (267+/− 202 vs 170 +/− 131 dyn s cm-5, P < 0.02) oncardiac catheterization. At surgery the aortic cross-clamp time was longer(48 +/−17 vs 39 +/− 15 min, P = 0.003). Seven patients died (2 detached, 5not-detached), from causes not related to either tricuspid detachment orVSD closure. Follow-up was complete with a mean duration of 2.0 years(range 0.1- 5.5). All 142 survivors were investigated by echocardiography, which showed normal tricuspid valve function in all but 29 patients who hadtrivial regurgitation (6 detached, 23 not-detached). There was no tricuspidstenosis. In 30 patients (8 detached, 22 not-detached) a trivial residualVSD could be detected. One reoperation (not-detached) was performed 12.5months after the initial surgery for recurrent VSD.(ABSTRACT TRUNCATED AT250 WORDS).