| Abstract: | Background Ebstein’s anomaly of the tricuspid valve is a complex malformation. Historically, because valve replacement yielded poor results,
surgical treatment has focused on valvuloplasties with or without associated procedures. An individualised combination of
surgical procedures was practised over three years and forms the subject of this presentation.
Method Between November 1995 and September 1999, 7 patients with Ebstein’s anomaly underwent surgical repair (age 3.5 to 40 years).
Cyanosis with severe tricuspid regurgitation was present in all. Surgical repair, individualised according to the morphology
of the tricuspid valve and right ventricle to provide maximum possible symptom free survival, included, (1) Tricuspid valve:
Replacement (n=1); Repair (Carpentier type n=1, Unicuspid repair n=5), (2) Atrial septal defect: left open (n=1), closed partially
(n=1), closed compeletely (n=5), and (3) Bidirectional Cavopulmonary Shunt (BCPS)-4
Results There was no hospital death. Intraoperative transoesophageal echocardiography showed only mild tricuspid regurgitation in
all, following repair. There were no late deaths at a mean follow up of 29 months. All but one patient were in functional
Class 1 New York Heart Association(NYHA). Complications included a thrombus in the right ventricular cavity six months postoperatively
in one patient.
Conclusion Individualisation of surgical management in Ebstein’s anomaly provides optimal results. |
