Selective right ventricular unloading and novel technical concepts in Ebstein's anomaly

The Annals of Thoracic Surgery
Sunil P MalhotraF L Hanley

Abstract

Favorable outcomes in Ebstein's anomaly are predicated on tricuspid valve competence and right ventricular function. Successful valve repair should be aggressively pursued to avoid the morbidity of prosthetic tricuspid valve replacement. We report our experience with valve-sparing intracardiac repair, emphasizing novel concepts and techniques of valve repair supplemented by selective bidirectional Glenn (BDG). Between June 1993 and December 2008, 57 nonneonatal patients underwent Ebstein's anomaly repairs. The median age at operation was 8.1 years. All were symptomatic in New York Heart Association (NYHA) functional class II (n = 38), III (n = 17), or IV (n = 1). Preoperatively, 26 had mild or moderate cyanosis at rest. We used a number of valve reconstructive techniques that differed substantially from those currently described. BDG was performed in 31 patients (55%) who met specific criteria. No early or late deaths occurred. At the initial repair, 3 patients received a prosthetic valve. Four patients required reoperation for severe tricuspid regurgitation. Repeat repairs were successful in 2 patients. At follow-up (range, 3 months to 6 years), all patients were acyanotic and in NYHA class I. Tricuspid regurgitation was mild ...Continue Reading

References

May 6, 2008·The Journal of Thoracic and Cardiovascular Surgery·Morgan L BrownUNKNOWN Mayo Clinic Congenital Heart Center

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Citations

Oct 31, 2013·Cardiology in the Young·Lianne M Geerdink, Livia Kapusta
May 9, 2014·The Annals of Thoracic Surgery·Vijayakumar RajuPatrick W O'Leary
May 14, 2014·The Journal of Thoracic and Cardiovascular Surgery·Christopher W BairdPedro J del Nido
Sep 12, 2015·Expert Review of Cardiovascular Therapy·Joseph A DearaniPatrick W O'Leary
Dec 24, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Rüdiger LangeManfred Otto Vogt
Sep 25, 2014·Cardiology in the Young·Christopher J Knott-CraigVijaya M Joshi
Sep 14, 2011·The Journal of Thoracic and Cardiovascular Surgery·Christopher W Baird, Joseph M Forbess
Jan 10, 2020·European Heart Journal. Quality of Care & Clinical Outcomes·Filip EckerströmZacharias Mandalenakis
Mar 15, 2011·Journal of Cardiac Surgery·Srikrishna Sirivella, Isaac Gielchinsky
Jan 22, 2013·Journal of Cardiac Surgery·Ruxandra Irina NegoiCarmen Ginghina
Aug 24, 2020·The Annals of Thoracic Surgery·Elizabeth H StephensJoseph A Dearani

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