Surgical Treatment of Ebstein Anomaly: Long-term Results and Outcomes

Leo Bockeria, Olga Bockeria, Merab Sanakoev, Zamik Fatulaev, Pavel Rubtsov

Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.25 13:30, Press Hall, 2F

Abstract

Surgical treatment of Ebstein anomaly(EA) includes tricuspid valve repair\prosthesis, geometrical reconstruction of the increased right ventricle andcorrection of concomitant pathologies.

AIM:Evaluate the results of tricuspid valve repair or replacement and determine current trends in surgical correction of TK

METHODS:

A retrospective review was performed of 143 patients withEA, who underwent tricuspid valve surgery. There were 3 groups composed according to the time of operation and reoperation: I(1982–2006): tricuspid valve(TV) replacement-23,II(2007-2009):TV replacment-28,TV repair-16,redo operations-5,III(2010-2016):TV replacement-40,TV repair - 22, redo operations - 9.Forvalve replacement biologicalprosthesis BioLAB-KS produced at Bakulev Center facility and certified by Russian regulation authority was used.For tricuspid valve repair various techniques were implemented:DeVega-3,Carpentier's-11,creation of a new septal leaflet+annuloplasty-25.Verticalplication of theatrialized chamber performedin all cases.In 33 patients ablation of concomitant arrhythmiaswas executed.

RESULTS

The median follow-up was7.5 years (from 1 to 34 years). In the early postoperative period there was 1 death, no late death during late follow-up. Redo surgeries performed during same hospitalization in 5 patients was required due to early infective endocarditis of implanted valve, Other 9 cases of redo surgeries resulted from, valve degeneration at15,1(8-22) years after implantation .At this period of follow up after reconstructive operations tricuspid regurgitation was trivial to mild in 94% of cases, two patients underwent reoperation - tricuspid valve replacement at 12 months, in one patient tricuspid valve replacement with the bidirectional superior cavopulmonary anastomosis was performed on the next day due to the development of acute right ventricular failure. Permanent pacemaker implantation required in 7 patients.

CONCLUSION

Longevity of the original prostetic valve BioLAB-KS of 15,1 years provides optimal results in valve replacement surgery in patients with Ebstein anomaly . The tendency nowadays are valve repair technique that allows to prolong time before replacement.