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Early and Mid-term Results for Repair of Ebstein's Anomaly  

Lee Chang-Ha (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute)
Hwang Seong Wook (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute)
Lim Hong Gook (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute)
Kim Woong-Han (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
Kim Chong Whan (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute)
Lee Cheul (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute)
Publication Information
Journal of Chest Surgery / v.38, no.4, 2005 , pp. 284-290 More about this Journal
Abstract
We evaluated the early and mid-term results for repair of Ebstein's anomaly. Material and Method: Between January 1989 and June 2004, 29 patients underwent repair of Ebstein's anomaly. The median age was 11.4 years (4 days-50 years). Tricuspid insufficiency equal to or greater than grade 3 was present in 21 $(72.4\%)$ patients. Surgical techniques included tricuspid valve repair with vertical plication of the atrialized ventricle (n=14), Carpentier's technique (n=7), tricuspid valve replacement (n=4), systemic-to-pulmonary arterial shunt (n=2), tricuspid valve repair (n=1), and Fontan operation (n=1). Bi-directional cavopulmonary shunt (BCPS) was required in 5 patients. Among the 2 neonates, one patient underwent successful biventricular repair, and the other patient underwent systemic-to-pulmonary arterial shunt. Follow-up was possible in 21 patients $(75\%)$, and the average follow-up was 37.6 months (3 months-11.3 years). Result: There were $1(3.4\%)$ early and 1 late deaths. Reoperation was required in 4 patients. Two patients underwent tricuspid valve re-replacement, and the other 2 tricuspid valve repair. At recent follow-up, only 2 patients showed tricuspid insufficiency equal to or greater than grade 3, and most patients showed clinical improvement. Excluding the patients who underwent tricuspid valve replacement, the actuarial rate of freedom from reoperation at 1 and 5 years were $94.7\%\;and\;79.0\%$, respectively. Conclusion: Tricuspid valve repair was possible in most patients with good mid-term outcome. Most patients showed clinical and hemodynamic improvement. Indications for the BCPS should be clarified.
Keywords
엡스타인 기형;삼첨판 수술;단락술;
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