title: Individualized Surgical Treatments for Children with Ebstein Anomaly.
abstract: ObjectiveEbstein anomaly is a rare type of tricuspid malformation. The present surgical methods to resolve this anomaly include tricuspid valvuloplasty, palliative surgery, and tricuspid valve replacement. The purpose of this study was to evaluate the short- and midterm outcomes of different surgical treatments among children with Ebstein anomaly.MethodsThis was a retrospective study of 136 Ebstein anomaly patients undergoing surgery at our institution from January, 2006 to August, 2015. This cohort included 118 patients receiving tricuspid valvuloplasty, 14 patients receiving palliative surgery and 4 patients receiving tricuspid valve replacement.ResultsThere were two in-hospital deaths and one delayed death 6 months after bidirectional cavopulmonary shunt during a second-stage operation; thus, the mortality rate was 2.2% (3/136). The follow-up variables included echocardiography, chest radiography, oxygen saturation, and cardiac function. After a mean follow-up duration of 35.8 ± 16.5 months (range: 6-98 months), all survivors had no indications for reoperation; the oxygen saturation following radical surgery and palliative surgery was 95 to 100% and 85 to 95%, respectively. Most of the patients exhibited an improved New York Heart Association (NYHA) functional class from III or IV preoperatively to I or II at follow-up; only two patients who underwent the Fontan procedure continued to exhibit NYHA functional class III. In most patients, tricuspid regurgitation (TR) degree decreased from moderate or severe preoperatively to mild or moderate at follow-up and only six patients continued to exhibit severe TR at follow-up.ConclusionsIndividualization of surgical methods based on different indications, including age, associated malformations, tricuspid anatomy, cardiac function, and intraoperative status, could effectively improve the outcomes of Ebstein anomaly patients.
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Zheng
authors: Z
authors: Jinghao
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Luo
authors: L
authors: Kai
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Huang
authors: H
authors: Yanhui
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Zhu
authors: Z
authors: Zhongqun
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Gao
authors: G
authors: Botao
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Du
authors: D
authors: Xinwei
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Xu
authors: X
authors: Zhiwei
authors: Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Heart Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Liu
authors: L
authors: Jinfen
mesh_terms: D000293:Adolescent; D063126:Balloon Valvuloplasty; D002648:Child; D002675:Child, Preschool; D002681:China; D004437:Ebstein Anomaly / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D010166:Palliative Care; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*