Surgical management of double-orifice tricuspid valve

Double-orifice tricuspid valve (DOTV) is a very rare cardiac malformation. We sought to describe our experience with surgical management of this defect in three cases.

Between September 2008 and October 2010, three patients (one male, two females) with DOTV were treated at our institute. They were 62, 20, and 32 years of age, respectively. The diagnosis of DOTV was made during the operation for other congenital cardiac malformations including partial atrioventricular septum defect, tetralogy of Fallot, and Ebstein's anomaly. The DOTV was regurgitant in all (moderate in one case and mild in two cases) without stenosis. Surgical management included tricuspid valve annuloplasty in two cases and suture of the accessory orifice in one case. Associated malformations were simultaneously corrected.

Echocardiography after the surgery revealed good coaptation of the tricuspid valve with trivial regurgitation and no tricuspid stenosis. No operative complication or late deaths occurred. All three patients were asymptomatic on follow-up.

The occurrence of the DOTV is extremely rare and it is difficult to diagnose by echocardiography. It is always associated with other congenital cardiac malformations that determine patient outcome.