Improving Results of Surgery for Ebstein Anomaly: Where Are We After 235 Cone Repairs?

Holst, Kimberly A.; Dearani, Joseph A.; Said, Sameh M.; Pike, Roxann B.; Connolly, Heidi M.; Cannon, Bryan C.; Sessions, Kristen L.; O’Byrne, Megan M.; O’Leary, Patrick

doi:10.1016/j.athoracsur.2017.09.058

Cited by 85 publications

(74 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The optimal timing for intervention in EA has been debated, in terms of perioperative risk and the potential need for redo intervention . The decision for management depends on the individual case.…”

Section: Introductionmentioning

confidence: 99%

“…In asymptomatic patients; however, surgical repair should be considered when progressive right heart dilation or reduction of RV systolic function and progressive cardiomegaly on chest radiography are present . Intermediate term outcomes have been reported for patients with EA, who have had either an operation or a conservative medical treatment . In any case, factors that might predict a poor outcome for patients with EA remain of interest.…”

Section: Introductionmentioning

confidence: 99%

“…The optimal timing for intervention in EA has been debated, in terms of perioperative risk and the potential need for redo intervention. 1,[8][9][10] The decision for management depends on the individual case. Surgical repairs may include biventricular repair, a one and a half strategy, or univentricular heart palliation based on individual EA morphology.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical repairs may include biventricular repair, a one and a half strategy, or univentricular heart palliation based on individual EA morphology. 6,[10][11][12][13][14][15] Usually, operative intervention is indicated in patients who have more than moderate TR and symptoms such as New York Heart Association (NYHA) functional class >II, arrhythmia, progressive cyanosis, paradoxical embolism, or deteriorating exercise capacity measured by cardiopulmonary exercise testing. 8,9,16 In asymptomatic patients; however, surgical repair should be considered when progressive right heart dilation or reduction of RV systolic function and progressive cardiomegaly on chest radiography are present.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Intermediate term outcomes have been reported for patients with EA, who have had either an operation or a conservative medical treatment. 10,11,[13][14][15][16][17] In any case, factors that might predict a poor outcome for patients with EA remain of interest.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Contemporary outcomes and mortality risks of Ebstein anomaly: A single‐center experience in Thailand

Pornprasertchai

Vijarnsorn

Kanjanauthai

et al. 2019

Congenital Heart Disease

View full text Add to dashboard Cite

Background The increasing number of patients with Ebstein anomaly (EA) surviving into adulthood implies improvements in the treatments for the complex lesion. We revisited the clinical outcomes of patients with EA to demonstrate their “real world” survival. Objectives To identify the survival and predictors of mortality in patients with EA who underwent medical or surgical management in the present era. Methods All patients who had EA with atrioventricular concordance between 1994 and 2016 were retrospectively reviewed. Baseline characteristics, initial echocardiographic findings, treatments, and outcomes were explored. The survival analysis was performed at the end of 2017. A multivariate analysis was used to assess mortality risks. Results A total of 153 patients (25.4 ± 20.4 years, 60% female) were analyzed. Of these, 89 patients had been diagnosed with EA in childhood. During the follow‐up [median time of 5.2 years (3 days‐23.5 years)], 32 patients (20.9%) died due to major cardiac adverse events. The overall survival at 1, 5, and 10 years were 89%, 82.2%, and 79%, respectively. Of the total 153 patients, 64 patients underwent at least one surgical intervention [median age of 17 years (1 day‐64.4 years)]. The survival at 1, 5, and 10 years were 87.5%, 82.4%, and 77.7%, respectively, in patients with EA surgery. This survival is comparable to the survival of 89 nonoperated patients with EA: 89.9%, 87.5%, and 81.8%, at 1, 5, and 10 years, respectively. The significant predictors of mortality were: age at diagnosis ≤2 years, tricuspid valve (TV) z‐score >3.80, TV displacement >19.5 mm/m2, presence of severe tricuspid regurgitation, and absence of forward flow across the pulmonic valve at the initial diagnosis. Conclusion Patients with EA had a moderately good survival in this era. In this paper, we report five simple predictors of death in this patient population.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%