Tricuspid Valve Replacement Using the Right Atrial Appendage Valve: Techniques and 1-Year Results.

Objectives: When tricuspid valve repair is unfeasible due to extensive damage or a complex congenital malformation, surgeons consider tricuspid valve replacement (TVR). However, it is still controversial and challenging to choose the best substitute. We aimed to introduce the innovative intraoperatively valve construction using the native right atrial appendage (RAA) tissue for TVR and investigate the short-term outcomes.

Methods: This study recruited paediatric and adult patients with unrepairable severe tricuspid regurgitation (TR) who needed TVR. The patient's RAA tissue was harvested and used to reconstruct a native bileaflet valve during surgery. Transthoracic echocardiography was conducted before operation, 6, and 12 months after surgery.

Results: The procedure was successfully executed on 3 patients with valve destruction as a result of infective endocarditis, and 3 patients who had severe TR due to congenital anomalies. There was no mortality or related morbidity. All the constructed valves had proper function with no complications after the surgery. Follow-up echocardiographic studies showed stable and satisfactory valve function with no regurgitation or significant stenosis.

Conclusions: The novel tricuspid valve operation using native RAA tissue demonstrates promising short-term results. Further studies with larger cohorts and longer follow-ups are required to confirm the technique's reliability and long-term effectiveness.