Early and Midterm Results of Repair of Ebstein's Anomaly with Autologous Pericardium

Sha, Ji-ming; Zhong-ya, Yan; Zhu, Zheng-yan; Tan, Lin Hua; Li, Zheng; Shen, Yunhua; Zhong, Liang; Wu, Yi‐Jun; Sun, Yun; Guang-cun, Cheng

doi:10.1055/s-0030-1250529

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…[10][11][12] On the other hand, recent advances in surgical techniques allow for complex leaflet repair of tricuspid valve lesions. 13,14) Furthermore, modern reconstructive techniques such as 3-dimensional ring annuloplasty or implantation of artificial cordae are leading to better success rates for TV repair compared to conventional techniques. 6,15) In addition to this progress in surgical techniques, beating heart (BH) surgery for valvular disease has become attractive for many surgeons, since they expect better protection of the heart from ischemia and reperfusion injury.…”

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confidence: 99%

Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery

et al. 2015

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We analyzed the long-term results of two surgical techniques (beating versus non-beating) for isolated tricuspid valve (TV) surgery.The long-term results of 92 consecutive patients who underwent isolated TV surgery were analyzed. We compared patients with beating heart (BH) surgery (n = 48) with patients undergoing arrested heart (AH) surgery (n = 44).BH surgery was more frequently chosen in urgent/emergent operations (P = 0.029) and in redo-operations (P < 0.001). Preoperatively, the rates of renal insufficiency (P = 0.002) and EuroSCORE (P = 0.019) were higher in the BH group than in the AH group. There were no differences in perioperative outcomes and 30-day mortality between the groups. However, freedom from reoperation was significantly lower in the BH group compared to the AH group (P = 0.039). We observed a trend towards lower survival rates at 1, 5, and 10 years in the BH group (77%, 54%, and 41%) compared to those of the AH group (86%, 75%, and 72%, P = 0.062). Multivariate Cox hazard model analysis revealed preoperative heart rhythm (P = 0.014, odds ratio [OR] = 2.296) and EuroSCORE (P = 0.022, OR = 1.049) as independent risk factors for mortality after isolated TV surgery.The superiority of BH surgery over AG surgery was not proven. Surgical intervention should be considered early, since patients with elevated EuroSCORES and arrhythmia have significantly higher mortality rates.

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confidence: 99%

Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery

et al. 2015

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“…Mechanical valve at the tricuspid position in the setting of annular dilation and RV dysfunction predisposes to thrombosis. In choosing a bioprosthetic valve, a porcine valve is often favored over pericardial valve, though reasonable outcomes have been described with the later [39]. The diversity of anatomical variation and age of diagnosis dictate the surgical options.…”

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confidence: 99%

Ebstein anomaly in the adult: focus on pregnancy

Koutrolou-Sotiropoulou¹,

Lima²,

Kapur³

et al. 2015

Cardio Vasc Syst

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Ebstein anomaly (EA) is a rare cardiac congenital abnormality characterized by downward displacement of the posterior and septal leaflets of the tricuspid valve which results in atrialization of the right ventricle, enlargement of the right atrium and tricuspid regurgitation. Affected individuals experience a wide spectrum of clinical severity, ranging from heart failure in infants to asymptomatic adults and identification of the disease later in life. Other clinical presentations include cyanosis, arrhythmias and paradoxical emboli through atrial level shunts. Imaging modalities such as echocardiography and cardiac magnetic resonance are used for diagnosis. Appropriate surgical and medical management tailored to each patient's anatomy and hemodynamic status is necessary in order to ensure acceptable patient outcomes. Since most patients survive to childbearing age, understanding of the hemodynamic changes during pregnancy and careful planning of labor and delivery are paramount. The purpose of this review is to focus on Ebstein anomaly in the adult patient tailored for the adult cardiologist and to provide a systematic review of pregnancy outcomes in women with Ebstein anomaly.

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“…1 Utility of intraoperative two-dimensional echocardiography (2DE) has been reported during the surgical repair of Ebstein's anomaly. 2 Real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) has been found to provide better information than 2DE during cardiac surgery in adult patients, especially for evaluation of left ventricular function 3 and mitral valve repair. 4 However, its role in the intraoperative monitoring of congenital heart lesions is not widely popular, mainly because of unavailability of appropriate probes as well as difficult image acquisition in children who have inherently high heart rates.…”

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confidence: 99%