Surgery for Ebstein's anomaly: the clinical and echocardiographic evaluation of a new technique

Thoraxcenter, Rotterdam, The Netherlands.

Ten consecutive patients (age range 4 to 44 years, mean 22) underwent surgical repair of Ebstein's anomaly by vertical plication of the right ventricle and reimplantation of the tricuspid valve leaflets. No patient died during or after operation. Intraoperative postbypass echocardiography documented a good result in nine patients but severe tricuspid regurgitation in one patient, who then underwent prosthetic valve replacement during a second period of cardiopulmonary bypass. Two of four patients who had had right ventricular papillary muscle dysfunction in the early postoperative period showed improved papillary muscle function with concomitant reduction of tricuspid regurgitation 6 months later. All patients were evaluated clinically and by echocardiography 2 to 23 months later. All patients showed clinical improvement, seven by one functional class and three by two classes. All were in sinus rhythm. The mean cardiothoracic ratio decreased by 6% (p less than 0.05). On bicycle ergometry performed in six patients, peak oxygen consumption exceeded 20 ml/kg per min in five. Tricuspid regurgitation diminished in eight patients (by three grades in two patients, by two grades in five and by one grade in one patient); it remained unchanged in two. Comparison of preoperative and postoperative pulsed Doppler flow velocities across the pulmonary valve showed an increase in the peak velocity of flow across the valve (mean 83 +/- 14 versus 97 +/- 11 cm/s, p less than 0.005) and a decrease in the time to peak velocity (mean 130 +/- 16 versus 91 +/- 23 ms, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				S. P. Malhotra, E. Petrossian, V. M. Reddy, M. Qiu, K. Maeda, S. Suleman, M. MacDonald, O. Reinhartz, and F. L. Hanley Selective Right Ventricular Unloading and Novel Technical Concepts in Ebstein's Anomaly Ann. Thorac. Surg., December 1, 2009; 88(6): 1975 - 1981. [Abstract] [Full Text] [PDF]

				I. Adachi, S. Y. Ho, K. P. McCarthy, and H. Uemura Coronary blood supply of the inferior wall of the right ventricle in hearts with Ebstein malformation: relevance to vertical plication. J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1437 - 1441. [Abstract] [Full Text] [PDF]

				A. Haussler and R. Pretre Surgical correction of Ebstein anomaly: the Zurich approach MMCTS, January 1, 2008; 2008(0220): mmcts.2006.002428 - mmcts.2006.002428. [Abstract] [Full Text] [PDF]

				S. Chauvaud and A. Carpentier Ebstein's anomaly: the Broussais approach MMCTS, January 1, 2008; 2008(0626): mmcts.2007.003038 - mmcts.2007.003038. [Abstract] [Full Text] [PDF]

				Q. Wu, Z. Huang, G. Pan, L. Wang, L. Li, and H. Xue Early and midterm results in anatomic repair of Ebstein anomaly. J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1438 - 1442. [Abstract] [Full Text] [PDF]

				C. J. Knott-Craig, S. P. Goldberg, E. D. Overholt, E. V. Colvin, and J. K. Kirklin Repair of Neonates and Young Infants With Ebstein's Anomaly and Related Disorders Ann. Thorac. Surg., August 1, 2007; 84(2): 587 - 593. [Abstract] [Full Text] [PDF]

				N. T. Ogus, C. Indelen, T. Yildirim, O. Selimoglu, and M. Basaran Pericardial Patch Augmentation of Both Anterior and Septal Leaflets in Ebstein's Anomaly Ann. Thorac. Surg., February 1, 2007; 83(2): 676 - 678. [Abstract] [Full Text] [PDF]

				C.-H. Lai, J.-M. Wu, and Y.-J. Yang Ebstein's Anomaly of the Tricuspid Valve in Combination of Tetralogy of Fallot: Total Correction in Infancy Ann. Thorac. Surg., January 1, 2007; 83(1): 304 - 306. [Abstract] [Full Text] [PDF]

				J. P. da Silva, J. F. Baumgratz, L. da Fonseca, S. M. Franchi, L. M. Lopes, G. M. P. Tavares, A. M. Soares, L. F. Moreira, and M. Barbero-Marcial The cone reconstruction of the tricuspid valve in Ebstein's anomaly. The operation: early and midterm results J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 215 - 223. [Abstract] [Full Text] [PDF]

				G. E. Sarris, N. M. Giannopoulos, A. J. Tsoutsinos, A. K. Chatzis, G. Kirvassilis, W. J. Brawn, J. V. Comas, A. F. Corno, D. Di Carlo, J. Fragata, et al. Results of surgery for Ebstein anomaly: A multicenter study from the European Congenital Heart Surgeons Association J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 50 - 57. [Abstract] [Full Text] [PDF]

				S. M. Chauvaud, A. C. Hernigou, E. R. Mousseaux, D. Sidi, and J.-L. Hebert Ventricular Volumes in Ebstein's Anomaly: X-Ray Multislice Computed Tomography Before and After Repair Ann. Thorac. Surg., April 1, 2006; 81(4): 1443 - 1449. [Abstract] [Full Text] [PDF]

				I. A. Russell, K. Rouine-Rapp, G. Stratmann, and W. C. Miller-Hance Congenital heart disease in the adult: a review with internet-accessible transesophageal echocardiographic images. Anesth. Analg., March 1, 2006; 102(3): 694 - 723. [Full Text] [PDF]

				M. V. Ullmann, S. Born, C. Sebening, M. Gorenflo, H. E. Ulmer, and S. Hagl Ventricularization of the atrialized chamber: A concept of Ebstein's anomaly repair Ann. Thorac. Surg., September 1, 2004; 78(3): 918 - 924. [Abstract] [Full Text] [PDF]

				J. M. Chen, R. S. Mosca, K. Altmann, B. F. Printz, K. Targoff, P. A. Mazzeo, and J. M. Quaegebeur Early and medium-term results for repair of Ebstein anomaly J. Thorac. Cardiovasc. Surg., April 1, 2004; 127(4): 990 - 999. [Abstract] [Full Text] [PDF]

				Q. Wu and Z. Huang A new procedure for Ebstein's anomaly Ann. Thorac. Surg., February 1, 2004; 77(2): 470 - 476. [Abstract] [Full Text] [PDF]

				S. Chauvaud, A. Berrebi, N. d'Attellis, E. Mousseaux, A. Hernigou, and A. Carpentier Ebstein's anomaly: repair based on functional analysis Eur J Cardiothorac Surg, April 1, 2003; 23(4): 525 - 531. [Abstract] [Full Text] [PDF]

				Q. Wu and Z. Huang Anatomic correction of Ebstein anomaly J. Thorac. Cardiovasc. Surg., December 1, 2001; 122(6): 1237 - 1238. [Full Text] [PDF]

				S. M. Chauvaud, G. Brancaccio, and A. F. Carpentier Cardiac arrhythmia in patients undergoing surgical repair of Ebstein's anomaly Ann. Thorac. Surg., May 1, 2001; 71(5): 1547 - 1552. [Abstract] [Full Text] [PDF]

				V. V. Lazorishinets, M. D. Glagola, A. S. Stychinsky, M. N. Rudenko, and G. V. Knyshov Surgical treatment of Wolf-Parkinson-White syndrome during plastic operations in patients with Ebstein's anomaly Eur J Cardiothorac Surg, October 1, 2000; 18(4): 487 - 490. [Abstract] [Full Text] [PDF]

				C. J. Knott-Craig, E. D. Overholt, K. E. Ward, and J. D. Razook Neonatal repair of Ebstein's anomaly: indications, surgical technique, and medium-term follow-up Ann. Thorac. Surg., May 1, 2000; 69(5): 1505 - 1510. [Abstract] [Full Text] [PDF]

				H. T. Kiziltan, D. A. Theodoro, C. A. Warnes, P. W. O'Leary, B. J. Anderson, and G. K. Danielson Late results of bioprosthetic tricuspid valve replacement in Ebstein's anomaly Ann. Thorac. Surg., November 1, 1998; 66(5): 1539 - 1545. [Abstract] [Full Text] [PDF]

				T. Katogi, R. Aeba, T. Ito, T. Goto, Y. Cho, T. Ueda, and S. Kawada Surgical management of isolated congenital tricuspid regurgitation Ann. Thorac. Surg., November 1, 1998; 66(5): 1571 - 1574. [Abstract] [Full Text] [PDF]

				J. A.M. van Son, P. Kinzel, and F. W. Mohr Pericardial patch augmentation of anterior tricuspid leaflet in Ebstein's anomaly Ann. Thorac. Surg., November 1, 1998; 66(5): 1831 - 1832. [Abstract] [Full Text] [PDF]

				F. J. Vargas, G. Mengo, M. A. Granja, J. A. Gentile, M. E. Rannzini, and J. C. Vazquez Tricuspid Annuloplasty and Ventricular Plication for Ebstein's Malformation Ann. Thorac. Surg., June 1, 1998; 65(6): 1755 - 1757. [Abstract] [Full Text] [PDF]

				R. Hetzer, N. Nagdyman, P. Ewert, Y. G. Weng, V. Alexi-Meskhisvili, F. Berger, M. Pasic, and P. E. Lange A modified repair technique for tricuspid incompetence in Ebstein's anomaly J. Thorac. Cardiovasc. Surg., April 1, 1998; 115(4): 857 - 868. [Abstract] [Full Text] [PDF]

				J. A. M. van Son, V. Falk, M. D. Black, G. S. Haas, and F. W. Mohr Conversion of complex neonatal Ebstein's anomaly into functional tricuspid or pulmonary atresia Eur J Cardiothorac Surg, March 1, 1998; 13(3): 280 - 285. [Abstract] [Full Text] [PDF]

				N. Augustin, P. Schmidt-Habelmann, M. Wottke, H. Meisner, and F. Sebening Results After Surgical Repair of Ebstein's Anomaly Ann. Thorac. Surg., June 1, 1997; 63(6): 1650 - 1656. [Abstract] [Full Text]

				M. P. Leung, J. Lee, R. N. S. Lo, and C. K. Mok Modified Fontan procedure for severe Ebstein's malformation with predominant tricuspid stenosis Ann. Thorac. Surg., September 1, 1992; 54(3): 523 - 527. [Abstract] [PDF]