Early timing of surgical intervention in patients with Ebstein's anomaly predicts superior long-term outcome☆

Badiu, Catalin Constantin; Schreiber, Christian; Hörer, Jürgen; Ruzicka, Daniel J.; Wottke, Michael; Cleuziou, Julie; Krane, Markus; Lange, Rüdiger

doi:10.1016/j.ejcts.2009.06.052

Cited by 51 publications

(40 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean time between initial surgery and redo in our series was 13.4 ± 10.6 years. Re-operation rates of 9 and 20% were reported by Chauvaud [5] and Badiu et al [8], respectively. Long-term follow-up in operated patients with Ebstein’s anomaly is mandatory, as redo surgery in adulthood is not rare.…”

Section: Discussionmentioning

confidence: 71%

“…The reoperation rate in this series was 9% [5]. Today, early mortality rates as low as 1.6% have been reported [8]. The majority of patients in our study underwent valve repair.…”

Section: Discussionmentioning

confidence: 88%

“…There was no significant difference in survival between the group with valve repair and the group with valve replacement. It is unclear whether tricuspid valve repair or valve replacement is superior in the long-term outcome [3,8,9]. However, Chauvaud [5] suggests a superiority of tricuspid valvuloplasty associated with a longitudinal right ventricular plication over valve replacement.…”

Section: Discussionmentioning

confidence: 99%

“…As our study consisted of a relatively low number of patients (n = 49), we presume it is underpowered to detect predictors of surgery. However, other series showed that the need for surgery is an individual matter, primarily based on functional status [5,8,9]. There is a benefit from early surgical therapy regarding survival and freedom from redo surgery in the long term [8].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Behavior of Ebstein’s Anomaly: Single-Center Experience and Midterm Follow-Up

Legius

Bruaene²,

Deyk³

et al. 2010

Cardiology

View full text Add to dashboard Cite

Objectives: Ebstein’s anomaly, characterized by an apical displacement of the tricuspid valve into the right ventricle, occurs in approximately 1/200,000 live births. Because long-term follow-up data of adults with Ebstein’s anomaly are scarce, we evaluated the outcome of our Ebstein’s anomaly patients. Methods: All patients >16 years and registered in the congenital heart disease database of our hospital with isolated Ebstein’s anomaly were selected for the study. Records were reviewed for outcome. Results: Forty-nine patients (21 males, mean age at diagnosis 29.1 ± 20.7 years) were followed for a mean time of 11.4 years (range 1.1–32.4). Twenty-five patients (51%) underwent tricuspid valve surgery (16 valvuloplasty and 9 valve replacement). Eight patients (32%) required redo tricuspid valve surgery. Twenty-six patients (52.1%) exhibited supraventricular arrhythmia, and the typical Wolff-Parkinson-White syndrome occurred in 15 patients (31.2%). Seventeen patients (34.7%) underwent ablation therapy and 5 patients (10.4%) required pacemaker implantation. Conclusions: Half of the patients with Ebstein’s anomaly needed tricuspid valve surgery and redo surgery was not uncommon. Supraventricular arrhythmia occurred frequently and ablation therapy was often indicated. Careful follow-up is obligate, as some complications occur for the first time in adulthood.

show abstract

Section: Discussionmentioning

confidence: 71%

“…The reoperation rate in this series was 9% [5]. Today, early mortality rates as low as 1.6% have been reported [8]. The majority of patients in our study underwent valve repair.…”

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Behavior of Ebstein’s Anomaly: Single-Center Experience and Midterm Follow-Up

Legius

Bruaene²,

Deyk³

et al. 2010

Cardiology

View full text Add to dashboard Cite

show abstract

“…Patients who had surgery at institutions other than the present one, and for whom data on the surgery, or echocardiography or clinical records were ity. 8 They suggested that, even in an asymptomatic or minimally symptomatic patient, early surgery must be performed before cardiomegaly develops and functional class worsens. In contrast, other authors consider that surgery should be delayed until symptoms appear, cyanosis becomes evident or paradoxical embolism occurs.…”

Section: Methodsmentioning

confidence: 99%

Impact of Surgery in Ebstein’s Anomaly Using Current Surgical Criteria

Ávila-Vanzzini

Fritche-Salazar

Herrera-Bello

et al. 2017

Circ J

View full text Add to dashboard Cite

terns depend on anatomical severity, degree of right-to-left atrial shunt, and age at presentation. 4, 5 Long-term outcome is usually good for patients who survive the neonatal period and for those with no symptoms following the first years of life. 3 Therefore, many patients will develop symptoms and surgical treatment may be necessary. Current surgical criteria according to European or US guidelines include: (1) presence of symptoms or worsening functional class; (2) cyanosis (oxygen saturation <90%); (3) paradoxical embolism; (4) progressive cardiomegaly on chest X-ray; and (5) progressive RV dilation or RV systolic dysfunction. 6 Other authors recommend surgical repair in patients with more than moderate TR in the presence of symptoms (New York Heart Association [NYHA] class >II or arrhythmias) or worsening exercise capacity. 7 Optimal timing for surgical management in this patient subset remains controversial. Badiu et al found that NYHA functional class >II and cardiothoracic index >0.6 are important prognostic factors associated with long-term mortal-E bstein's anomaly (EA) accounts for <1% of all congenital heart disease. There is general consensus that EA affects not only the tricuspid valve but also the whole right ventricle (RV). This results in a particular type of right-sided cardiomyopathy. 1 The characteristic features of this anomaly are: (1) predominant septal and inferior tricuspid leaflet attachment to the underlying myocardium due to failure of delamination; (2) anterior and apical rotational displacement of the functional annulus; (3) dilation of the "atrialized" portion of the RV with variable degrees of hypertrophy and wall thinning; (4) redundancy, fenestration and tethering of the anterior leaflet; (5) dilation of the right atrioventricular junction (the true tricuspid annulus); and (6) variable degree of ventricular myocardial dysplasia and dysfunction. 1-3These anatomical and functional abnormalities cause important tricuspid regurgitation (TR) in many patients that contributes to right chamber dilation and atrial or ventricular arrhythmias. Hemodynamics and clinical pat-

show abstract