Reoperations on Ebstein's anomaly:Report for 17 Cases / 解放军医学杂志

ABSTRACT

Objective To summarize the experiences of reoperations on Ebstein's anomaly. Methods Clinical data of 17 cases of Ebstein's anomaly (6 males and 11 females, aged from 3 to 54 years old, averaged 23) were analyzed retrospectively. All the patients felt short breath and palpitation after exertion, and cyanosis was found in two patients. In the first operation, downwards displaced tricuspid valve leaflet was suspended and atrialized right ventricle was replicated in 14 cases, tricuspid anuloplasty and atrial septal defect were repaired in 2 cases, and tricuspid valve was replaced in 1 case. The interval time between two operations was 1-20 years in an average of 8 years. Before second operation, the cardiac function was NYHA Ⅱ in 6 cases, NYHA Ⅲ in 11 cases. Eight cases received Ebstein's anomaly anatomic correction, including transplanting downward displaced tricuspid valve and excising atrialized right ventricle. Seven cases received tricuspid valve replacement. Two cases received tricuspid valveplasty. All of operations were performed on arrested heart with moderate hypothermic cardiopulmonary bypass. The time of cardiopulmonary bypass was 70-287 (89.3?11.1)min, the time of aorta clamping was 70-287 (64.0?8.6)min. The transesophageal echocardiography was routinely performed before the operations and after the hearts rebeating. Results No case died in hospital, and all the patients were followed up for 1-3 years. Transesophageal echocardiography showed the tricuspid valve was closed well (non-reflow in 9 cases, mild reflow in 1 case) in 10 cases which received Ebstein's anatomic correction and tricuspid valveplasty. The cardiac function states of patients were significantly improved (NYHA Ⅰ-Ⅱ). Conclusion Most of patients with reoperations on Ebstein's anomaly can received anatomic correction. Tricuspid valve replacement is available if the pathology of tricuspid valve is severe.