[Surgical repair and late problem for Ebstein's anomaly--surgical cases with severe tricuspid stenosis or regurgitation].
In this report, we described our surgical experiences of Ebstein's anomaly with severe tricuspid stenosis (TS) or regurgitation (TR). Long-term clinical assessments and late problems of the treatment were also mentioned. From 1953 to 1988, a total of 2850 patients with congenital heart malformation underwent surgery in our hospital. During this period, 32 patients with Ebstein's anomaly were admitted, and surgical treatment was performed in 10 of these patients. Thus, the surgical treatment of Ebstein's anomaly took only 0.35% of total surgeries of congenital heart diseases. According to Takayasu's classification of Ebstein's anomaly, 6 of our these patients were classified into TS, and 4 into TR type. The operative methods were shunt operation in 3 patients, plication in 2 patients and tricuspid valve replacement (TVR) in 5 patients. One patient was died during the operative course of Glenn's procedure. Other 9 patients are alive and the longest follow-up period is 18 years at this moment. In the remaining two patients with shunt operation, Blalock-Taussig's procedure completely diminished their polycythemia. In the cases of TVR, the replaced valve was sutured to the right atrium in 2 patients with TS, true annulus in 2 patients with TR, valve remnant in one patient with TR type. Delayed cardiac tamponade occurred in 2 patients and calcification of Xenograft valve was observed at 8 years after the surgery in one patient with TVR. Although the hemodynamics did not improve immediately just after open heart surgery, cardio-thoracic ratio reduced and clinical symptoms were improved remarkably throughout the long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
Hata
T
T
Namba
H
H
Eishi
K
K
Shinoka
T
T
Sone
Y
Y
Takata
S
S
Kuinose
M
M
Taniguchi
G
G
D000328:Adult; D002648:Child; D002675:Child, Preschool; D004437:Ebstein Anomaly / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*; D014264:Tricuspid Valve Stenosis / Q000601:surgery*