Reconstructive Surgical Treatment of Ebstein's Anomaly

The aim of this study was to show early and longterm results of the reconstructive treatment of Ebstein's anomaly. Between 1985 and November, 2000, 8 patients (six of whom female) were operated. Mean age was 14.2 ± 6.7 years (range, 5 to 23). Sinus rhythm prevailed in all patients. Pulmonary embolism due to right atrial thrombosis was the presenting symptom in one patient. Associated anomalies were ASO (37.5%) and VSD (12.5%). The tricuspid valve was Iocated 2.3 ± 0.9 cm (range, 1.2- 4.6 cm) below the mitral valve. W e have performed Danielson procedure (50%), tricu spid annuloplasty (37.5%) and Hardy procedure (12.5%) as reconstructive techniques. The mean follow-up period was 7.3 ± 3 years (range, 2.5 to 1 2.5). There was no early mortality and one Iate death. Transient complete AV block developed in one-half of the patients. One patient was rehospitalized with severeTight heart failure 30 months post operatively. Another one with previous right atrial thrombosis presented again with the same finding 6 years after operation. The right atrial dimensions (5.9 ± 0.5 cm; range, 5 to 6.5) decreased signi ficantly (p = 0.001) after surgery (4.5 ± 0.5; range, 4 to 5.5). Reconstructive treatment of Ebstein's anomaly with reducing tricuspid insufficiency and remodelling of the right atrial and ventricular chambers favorably affects the functional capacity of the patients. These have to be followed up closely for the possibility of right heart failure in the Iate postoperative period.