The Association of Age and Repair Modification with Outcome after Cone Repair for Ebstein's Malformation

Schulz, Antonia; Marathe, Supreet P; Chávez, Mariana; Sleeper, Lynn A.; Emani, Sitaram M.; Marx, Gerald R.; Nido, Pedro J. del; Baird, Christopher W.

doi:10.1053/j.semtcvs.2021.03.034

Cited by 10 publications

(11 citation statements)

References 16 publications

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“…Another unresolved issue is the need for an additional bidirectional cavopulmonary connection (BCPC), and this might be actually dependent on age. In the current study, the rate of BCPC was 28%, which is similar to the 30% of the paediatric cohort of the Mayo Clinic [ 4 ] and much higher than the 6% of the Boston group [ 6 ]. The difference might lie within the age of the patients’ population.…”

supporting

confidence: 72%

“…Another debate is the need to plicate the atrialized RV, to reduce its size. Liu et al performed it in about 60% of the patients, other authors have similar rates with 55% [ 6 ] and 65% [ 4 ]. Mostly, authors do not explain the reason of plicating the atrialized RV or not.…”

mentioning

confidence: 90%

“…What is missing are age-dependent results and the answer to the most important question on what is the right time to repair the tricuspid valve. However, there is a trend towards repairing the valve at an earlier stage [ 6 ] but still, large cohorts with an emphasis on age are seldom but required to draw adequate consequences.…”

mentioning

confidence: 99%

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Ebstein anomaly in children—is the cone procedure a valid option?

Cleuziou

2023

Interdisciplinary CardioVascular and Thoracic Surgery

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supporting

confidence: 72%

mentioning

confidence: 90%

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Ebstein anomaly in children—is the cone procedure a valid option?

Cleuziou

2023

Interdisciplinary CardioVascular and Thoracic Surgery

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“…Some may argue on the grounds that Badiu et al [ 25 ] and Schulz et al [ 27 ] have, respectively, suggested a higher likelihood of reintervention rate in children with EA aged <12 and <4 years. Of note, we should interpret these data with cautions because increased age at the time of operation implies a less anatomically severe form of EA; however, it may also stand for a postponement of surgery in asymptomatic patients, given the treatment algorithms varying among institutions, which can potentially confound the results.…”

Section: Discussionmentioning

confidence: 99%

Review of surgical experience in 188 infants and young children with Ebstein anomaly

Liu

Wen

Shentu

et al. 2023

Interdisciplinary CardioVascular and Thoracic Surgery

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OBJECTIVES This study sought to review our single-institutionally surgical experience in paediatric Ebstein anomaly (pEA). METHODS We retrospectively reviewed the paediatric patients with Ebstein anomaly undergoing operation between 2004 and 2020. Time-to-event analysis was studied using Kaplan–Meier estimates. Cox regression model was used to identify risk factors for recurrent moderate-severe or greater tricuspid regurgitation (TR). RESULTS A total of 188 patients at a median age of 3.0 (interquartile range [IQR], 1.6–5.6) years were included, among whom 108 (57.4%) underwent cone reconstruction (CR). Bidirectional cavopulmonary shunt (BCPS) was required in 53 patients (28.2%). There were no in-hospital death. The median follow-up time was 5.6 (IQR, 2.9–8.9) years. Twenty-three (12.2%) developed recurrent moderate-severe or greater TR, among whom 9 required reoperation and 1 had late death. There was a lower incidence of recurrent TR (P = 0.006) and reoperation for TR (P = 0.037) in CR group compared with non-CR group. There was no difference in the incidence of recurrent TR (P = 0.61), reoperation (P = 0.9) and death (P = 0.48) among patients less than 1 year old, patients with 1–4 and 4–18 years of age. CONCLUSIONS Acceptable outcomes can be anticipated in pEA undergoing CR in terms of freedom from TR of > moderate degree at a mid-term follow-up.

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“… 1) 2) Cone reconstruction of Ebstein’s anomaly was introduced by da Silva and colleagues, 3) and has since been applied as a standard treatment for this condition with low rates of recurrent tricuspid regurgitation (TR) and reoperation, including in neonates. 3) 4) 5) 6) 7) 8) 9) 10) …”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Modified Cone Reconstruction for Ebstein’s Anomaly in Pediatric Patients in a Single Center

Park,

Jun,

Yang

et al. 2024

Korean Circ J

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Author's summary Cone reconstruction is a standard treatment for Ebstein’s anomaly. It involves suturing the displaced tricuspid valve (TV) annulus to the anatomical TV annulus, resulting in a smaller annulus and improved coaptation. Concerns arise when applying this technique to pediatric patients, as TV annular growth may not occur with somatic growth. Additionally, Ebstein's anomaly often involves left ventricular (LV) dysfunction, and it is crucial to ensure long-term restoration of LV function and reverse remodeling. This study demonstrates that modified cone reconstruction provides durable tricuspid valve repair, appropriate annular growth, and possible progressive LV reverse remodeling in children with Ebstein’s anomaly.

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The Association of Age and Repair Modification with Outcome after Cone Repair for Ebstein's Malformation

Cited by 10 publications

References 16 publications

Ebstein anomaly in children—is the cone procedure a valid option?

Ebstein anomaly in children—is the cone procedure a valid option?

Review of surgical experience in 188 infants and young children with Ebstein anomaly

Long-Term Outcomes of Modified Cone Reconstruction for Ebstein’s Anomaly in Pediatric Patients in a Single Center

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