Surgical treatment of children with Ebstein's anomaly in 31 cases

Abstract

Objective To study the surgical treatment for Ebstein's anomaly in children.Methods From August 1992 to August 2010,there were 31 cases of Ebstein's anomaly in children underwent surgical repair,including thirteen males and eighteen females,aged from 6 months to fifteen years[mean(6.9±1.6) years] and the weight was from 5.5 to 53.5 kg[mean(19.6±4.7)kg].Eight patients underwent Danielson repair of tricuspid valve,among these 2 patients were added bidirectional Glenn operation;23 patients underwent Carpentier repair of tricuspid valve,among these 5 patients were added bidirectional Glenn operation.The results of 31 cases of Ebstein's anomaly in children were retrospectively analyzed.Results There was no postoperative death with Carpentier repair of tricuspid valve.All survivals were in New York Heart Association class Ⅰ.Postoperative tricuspid regurgitation was markedly improved,echocardiography showed disappearance of tricuspid incompetence in 9 patients,mild incompetence in 13 and moderate incompetence in 1.There was one postoperative death with Danielson repair of tricuspid valve,and main causes of death were tachyarrhythmia and continuance hypoxia.All survivals were in New York Heart Association class Ⅰ.Postoperative echocardiaography showed disappearance of tricuspid incompetence in 3 patients,mild competence in 3 and moderate mild competence in 2. No reoperation for residual or recurrent tricuspid incompetence was required in all survivals. Conclusions In spite of the variable degree of Ebstein's anomaly present,the majority of patients can undergo a surgical repair.Tricuspid reconstruction should be the first choice of surgical procedures whenever possible in children.Carpentier repair of tricuspid valve is the best procedure at present.The bidirectional Glenn could be adopted according to the function of tricuspid valve and right ventricle. Key words: Ebstein's anomaly; Cardiac surgical procedures