Midterm follow up after Ebstein's anomaly repair augmented with tricuspid annuloplasty ring

Abstract

BackgroundEbstein's anomaly is a malformation of the tricuspid valve and right ventricle that is characterized by a spectrum of features including; failure of delamination, apical displacement of the functional annulus, dilation of the true tricuspid annulus and an atrialized portion of the right ventricle. The aim of this study was to assess the mid-term results of Ebstein's anomaly repair reinforced with annuloplasty ring. MethodsThis retrospective Cohort study was done including 47 patients with Ebstein's anomaly who underwent complete surgical repair. After completing the repair; the neo-tricuspid annulus was reinforced using a ring either Afksendiyos Kalangos bio-ring (Kalangos' ring, Bioring®, Lonay. Switzerland) or Carpentier-Edwards Physio ring with an average diameter of 27.6 ± 3.11 mm. Resultsat time of operation, The Mean age was 18.3 ± 12.3 years (range 1–38 years) and mean body weight was 40.6 Kg ±21.4. The mean O2 Saturation was 94.04% ± 7.2% while the mean PG across TV was 22.21 ± 8.72 mmHg. Reoperation was required for two patients (4.24%). In-hospital mortality was reported in one case (2.12%) while the overall mortality was (4.24%). After a mean of 5.81 ± 2.79 years follow up there were marked improvements of the severity of tricuspid regurge (TR) and the class of NYHA. ConclusionsAugmentation of the tricuspid valve repair with annuloplasty ring can be performed with low mortality and morbidity. Early and mid-term follow-up showed clinical improvement in the majority of patients, low incidence of reoperations, and no need for tricuspid valve replacement (TVR).