Surgical Management of Ebstein's Anomaly

John M. Stulak, Joseph A. Dearani, Gordon K. Danielson

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Ebstein's malformation is a congenital anomaly of the tricuspid valve and right ventricle. Surgical repair of Ebstein's anomaly improves functional class and exercise tolerance, eliminates right-to-left intracardiac shunting (if present), and reduces the incidence of supraventricular tachyarrhythmias. As a result, quality of life and survival are improved. Because of the variable degree of malformation present, repair is predicated on favorable anatomic factors, most importantly the arrangement of the anterior leaflet of the tricuspid valve. When anatomic derangements threaten a durable tricuspid valve repair, valve replacement with protection of the conduction tissue and right coronary artery should be performed. The vast majority of patients can undergo a biventricular repair. The application of the bidirectional cavopulmonary anastomosis is reserved for patients with poor right ventricular function. Freedom from reoperation after tricuspid valve repair is similar when compared with valve replacement. In the current era, overall early mortality after surgical repair in children and adults has fallen to less than 3% in experienced centers. Surgical treatment of the symptomatic neonate remains a significant challenge, with approaches that include either a biventricular or single ventricle algorithm.

Original languageEnglish (US)
Pages (from-to)105-111
Number of pages7
JournalPediatric Cardiac Surgery Annual
Volume10
Issue number1
DOIs
StatePublished - Apr 13 2007

Keywords

  • Ebstein's anomaly
  • congenital tricuspid valve
  • heart defect

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Cardiology and Cardiovascular Medicine

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