Exercise Capacity After Repair of Ebstein Anomaly in Adults.

Repair of Ebstein anomaly has evolved over the last decade, and timing of repair remains variable. There have been no studies of exercise or functional capacity in patients who have had tricuspid valve surgery for Ebstein anomaly in adulthood. We aimed to compare exercise capacity before and after tricuspid valve repair or replacement for Ebstein anomaly in adults at Mayo Clinic. We performed a retrospective chart review of all patients with Ebstein anomaly who underwent tricuspid valve surgery at Mayo Clinic between June 2007 and January 2015. We compared pre- and postoperative echocardiograms, exercise tests, and clinic visits. Tricuspid valve surgery was done for 322 patients, and 32 patients met criteria of native tricuspid valve repair or replacement at age 18 or older and had maximal pre- and postoperative exercise tests. Nineteen patients had valve repair, and 13 had valve replacement. Surgery for Ebstein anomaly resulted in significant reduction in tricuspid regurgitation and right ventricular size. There was a significant improvement in NYHA functional class after surgery; however, there was no significant improvement in functional aerobic capacity (FAC), metabolic equivalents (METs), exercise time, or [Formula: see text] after surgery. Patients who had an atrial shunt closed during surgery had improved minimum blood oxygen saturations during exercise, though no improvement in exercise capacity. In our cohort, patients who had tricuspid valve repair or replacement for Ebstein anomaly reported an improvement in functional capacity; however, this did not reflect improvement in measured exercise capacity, despite excellent surgical results by echocardiography.

Diagnostico ecocardiografico de la enfermedad de Ebstein / Ultrasonographic diagnosis of Ebstein disease

Se analizaron los hallazgos Eccocardiograficos en siete pacientes con diagnostico clinico, Radiologico y Electrocardiografico de Enfermedad de Ebstein, tres de estos pacientes fueron sometidos a Cateterismo Cardiaco y Cineangiocardiografia. Las alteraciones Ecocardiograficas encontradas e interpretadas como criterios diagnosticos de Enfermedad de Ebstein en vigencia del examen clinico, fueron: 1) Retraso del cierre de la Valvula Tricuspide respecto a laValvula Mitral, mayor a 50 miliseg. b) Registro simultaneo de la Valvula Mitral Tricuspide desde posiciones alejadas del borde esternal izq. c) Amplitud incrementada del movimiento diatolico de la valva anterior de la Tricuspide, d) Morfologia alterada de la valva anterior de la Tricuspide, e) incremento aparente de las dimensiones de Ventriculo derecho, f) Movimiento anormal del Neptum Intraventricular. Se concluye que la Ecocardiografia incrementa las posibilidades diagnosticas de esta Cardiopatia compleja, asimismo se llama la atencion sobre la elevada incidneica de la Enfermedad de Ebstein en nuestra casuistica.