Modern approaches of Ebstein’s anomaly surgical correction in adult patients
Ebstein anomaly (EA) is a rare congenital heart malformation that develops due to deviations in tricuspid valve (TV) formation during fetal period. Asymptomatic patients with EA may be diagnosed accidently during routine examinations. Evaluation of new TV reconstruction techniques results and application of new materials for replacement remain an impor-tant issue.
Objective: to analyze experience of our institution in treating Ebstein anomaly with application of modern surgical techniques .
Materials and methods. During the period from 2012 to 2016 in Ukrainian Children’s Cardiac Center 8 adult patients with Ebstein anomaly undergone TV cone reconstruction and TV replacement with handmade cylinder prosthesis. Accord-ing to our study: 4 (50%) patients had EA type “B”, 2 (25%) – type «C» and 2 (25%) – with history of previous interven-tions on the tricuspid valve with Ebstein anomaly. Cone reconstruction performed in 6 (75%) patients, handmade cylinder prosthesis implanted in 2 (25%) patients.
Results and discussion. There was no early postoperative mortality. According to echocardiographical evaluation in the early postoperative period all patients had satisfactory contractility of both ventricles and trivial TV insufficiency. Average postoperative follow-up period was 26.5±14.8 months. According to control assessment results the majority of patients maintained a small reverse flow in TV, good contractility of left and right ventricles, proving good correction result.
Conclusions. Cone reconstruction and handmade cylinder prosthesis implantation are potentially innovative methods of Ebstein anomaly surgical treatment in adult patients.
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