[Observation of the right atrial wall suture line after tricuspid valve supra-annular implantation]

Strength of the right atrial wall suture line after tricuspid valve supra-annular implantation (TVSI) is controversial. We observed the right atrial supra-annular position of a 63-year-old male during his third mitral operation who underwent mitral valve replacement (MVR) and TVSI 15 years ago. Eight years later, he received the second MVR and removal of the bioprosthetic valve from the tricuspid position due to primary tissue failures. The annular size of the tricuspid valve had decreased enough to be fixed by tricuspid annuloplasty (TAP) and re-TVSI was not needed at that time. In this operation, 7 years following bioprosthetic valve removal, the circularly bulging atrial wall still remained and seemed to have enough strength for holding the prosthetic valve. This finding may support the conclusion that the right atrial wall has enouth strength for holding a prosthetic valve in position.