[Ebstein's anomaly: results of the conic reconstruction of the tricuspid valve].
OBJECTIVE
To assess the results of a technical modification of tricuspid valvuloplasty in Ebstein's anomaly.


METHODS
From November 1993 to August 2002, 21 patients with Ebstein's anomaly of the tricuspid valve, with ages ranging from 20 months to 37 years (mean, 23 years), underwent a new technique of tricuspid valvuloplasty. This technique consisted of total or almost total detachment of the anterior tricuspid megaleaflet from the ventricular wall and valvular ring, transforming it into a cone, whose vertex remained fixed in the right ventricular tip, and the base was sutured to the tricuspid ring, after its plication, adjusting it to the size of the base of the cone (tricuspid ring), including the septal region.


RESULTS
One (4.7%) patient with cardiomyopathy caused by chronic hypoxia died in the hospital due to low cardiac output. The mean follow-up lasted 4 years, and the recent echocardiograms showed good morphology of the right ventricle and tricuspid valve with mild or minimal insufficiency in 18 patients and moderate insufficiency in 2 patients. In 2 of the 3 patients with an anomalous bundle, it could be located and sectioned during surgery. No atrioventricular block occurred.


CONCLUSIONS
The technique used was efficient in repairing tricuspid insufficiency and restoring right ventricular morphology, being applicable to all anatomic types of Ebstein's anomaly, except for Carpentier classification type D.
Silva
José Pedro da
JP
Hospital São Joaquim da Real e Benemérita Sociedade Portuguêsa de Beneficência. clinicajpdasilva@uol.com.br
Baumgratz
José Francisco
JF
Fonseca
Luciana da
Ld
Afiune
Jorge Yussef
JY
Franchi
Sônia Meiken
SM
Lopes
Lílian Maria
LM
Magalhães
Daniel Marcelo Silva
DM
Vila
José Henrique Andrade
JH
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004437:Ebstein Anomaly / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*