1. Surgery for Ebstein’s Anomaly:
A Single Centre Experience
Dr Vishva A. Wijesekera, Dr Dorothy J. Radford, Dr Peter Pohlner
Adult Congenital Heart Disease Service, Cardiology Program, The Prince Charles Hospital, Brisbane
BACKGROUND
First described by Wilhelm Ebstein in 1866, the condition was managed conservatively for many years.
With improvements in surgery, tricuspid valve repair began to be undertaken and techniques evolved.
We evaluated the results of surgical intervention at our institution.
RESULTS
Records for 22 patients were reviewed. Ages ranged from 2 to 74 years and 59% were female.
52% of patients had less than NYHA class III dyspnoea.
Two patients had clinical signs of right heart failure
95% had at least Grade 3/4 tricuspid regurgitation prior to surgery.
42% (8 patients) had RV dysfunction preoperatively. RV dilatation was present in most and 9 were classified as severe.
At early follow-up 89% had improvement in dyspnoea by at least one NYHA class.
Nine patients required redo-TV surgery for TR or TS. There were no deaths.
METHOD
Available records of patients who had surgery for Ebstein’s Anomaly between January 1990 and January 2010 were analysed.
ASSOCIATED CONDITIONS
RV hypoplasia + Pulmonary Stenosis
TRICUSPID REGURGITATION
(1)
PDA (1)
ASD (9)
SVT (9)
No of patients
TYPE OF
SURGERY
TV Replacement
PRE-OP
POST-OP
CONCLUSIONS
Surgery for Ebstein’s anomaly of the tricuspid valve results in improvement of dyspnoea and in the degree of tricuspid regurgitation.
There is a high rate of redo surgery.
TV Repair with Ring
TV Repair
Adult Congenital Heart Disease Unit
The Prince Charles Hospital
IMPROVEMENT IN DYSPNOEA
PRE-OP
SIX MONTH FOLLOW-UP (POST OP) I I
NYHA Class
NYHA Class II II
III IV
No of patients
No of patients