Results of Correction of Ebstein Anomaly Using the Cone Reconstruction Technique

Nikita M. Troshkinev

Tomsk NRMC Cardiology Research Institute, Tomsk, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – D

Abstract

Troshkinev N.M. ¹, Krivoschekov E.V. ¹, Podoksenov A.Ju ¹

¹Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia

The aim of the study was to evaluate results of cone reconstructions tricuspidal valve in early period after surgical correction. Wedescribe our experience from 2015 to 2017 years.

Materials and methods: Analysis was performed in 10 patients with Ebstein anomaly at age from 2 to 10 years old 5 (2,6;9,5). Tricuspidal regurgitationШ - 8 (83,3%), tricuspidal regurgitation II-III - 2 (16,7%). Anatomical types of Ebstein anomaly: type A- 2 (16,5%), type B- 2(16,5%), type C- 8(67%). All of the patients had severe Ebstein anomaly with dilated right-sided chambers and/or right ventricular dysfunction. Indexed size of right atrium (ml/m²) 96,0 (65,9;124,9). All patients had cone reconstruction of tricuspidal valve. Clinical assessment echocardiography (ECHO) with the evaluation of tricuspid regurgitation, the peak pressure gradient and mean pressure gradient were provided 10 days after surgical correction.

Results: All patients underwent cone reconstruction (360-degree leaflet tissue repair anchored at true annulus). There were no deaths. During the first 10 days after surgery significant reduction in the size of the right chambers of the heart was found in all patients. The indexed size of right atrium diminished 25,1 (19,4;43,3). Tricuspid regurgitation was reduced in all patients. We evaluated the function of the left ventricular before operation: LV end-diastolic index 37,1 (35,1;42,2) and LV end-systolic index 9,7 (7,6;11,7). This data after the operation: LV end-diastolic index 37,9 (31,6;41,3) and LV end-systolic index 11,0 (10,3;18,5).

Conclusions: Cone reconstruction of TV offers an effective repair in patients with Ebstein anomaly and severe regurgitation. The patients’ clinical status was improved. Cone reconstruction is safe and effective at reducing tricuspid regurgitation.