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Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.
RESUMEN
Objective To evaluate the efficacy of surgical treatment of Ebstein's anomaly with modified Carpentier's repair technique. Methods ⑴Enlarging the anterior leaflet with a pericardium patch; ⑵The edge of posterior leaflet was sewed to the edge of anterior leaflet or septal leaflet in favor of enlarging the area of leaflet; ⑶Annulus was reinforced with the terylene ring covered with pericardium; ⑷Adjustable Devega's procedure. Results 31 patients with Ebstein's anomaly underwent modified Carpentier's repair operation from Jan 1992 to May 2003 in our institution. There was one patient died after operation because of a fatal cardiac dysfunction, and no late deaths. During the followed-up period of 6～94 months, all surviving patients had a marked improvement of heart function, and 6 cases were in class I, 21 in class II and 3 in class III. There were no postoperative rhythm disturbances. Conclusion The modified Carpentier's repair technique is feasible and possesses a good outcome.