Long-term follow-up after repair of Ebstein's anomaly.
OBJECTIVE
We studied the long-term results of vertical plication repair of Ebstein's anomaly according to Carpentier.


METHODS
Between 1988 and 2007, 28 patients (mean age 28.8+/-15.7 years, range 4-58 years) underwent vertical plication repair of Ebstein's anomaly. At operation the anomaly was classified according to Carpentier. In three patients (11%) a cavopulmonary shunt was added at the repair on the indication of impaired right ventricular function.


RESULTS
There was no operative mortality. Early mortality was 3.6% (one patient). Actuarial survival and actuarial freedom from reoperation at 19 years were 96% (95% CI; 96-97%) and 72% (95% CI; 53-92%), respectively. Six patients required reoperation, with a successful re-repair in three patients. Mean duration of follow-up was 10.7+/-6.5 years. One year postoperatively, tricuspid incompetence had decreased significantly (p<0.001), as had New York Heart Association (NYHA) functional class (p<0.001). In addition, exercise tolerance had increased (70+/-19% to 92+/-9% of predicted values, p<0.05). Both tricuspid function and NYHA functional class remained essentially unchanged at the end of follow-up, indicating durable haemodynamic and functional results.


CONCLUSIONS
This study demonstrates favourable long-term results following vertical plication repair of Ebstein's anomaly with low mortality, acceptable morbidity and good haemodynamic and functional results.
Palmen
Meindert
M
Department of Cardiothoracic Surgery, Thoraxcentre, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. meindert_palmen@hotmail.com <meindert_palmen@hotmail.com>
de Jong
Peter L
PL
Klieverik
Loes M A
LM
Venema
Angelique C
AC
Meijboom
Folkert J
FJ
Bogers
Ad J J C
AJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004437:Ebstein Anomaly / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014463:Ultrasonography