Results of the 1.5-ventricle repair for Ebstein anomaly and the failing right ventricle

Quiñonez, Luis G.; Dearani, Joseph A.; Puga, Francisco J.; O’Leary, Patrick; Driscoll, David J.; Connolly, Heidi M.; Danielson, Gordon K.

doi:10.1016/j.jtcvs.2006.12.007

Cited by 79 publications

(41 citation statements)

References 18 publications

(28 reference statements)

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“…It should be considered in select neonates when the valve anatomy is favorable (hemodynamically stable infants with adequate anterior and septal leaflet tissue). The monocusp techniques described by Knott‐Craig and the single‐ventricle pathway advocated by Starnes for when pulmonary atresia is present are reasonable alternatives in the unstable patient …”

Section: Discussionmentioning

confidence: 99%

Cone Reconstruction in Children with Ebstein Anomaly: The Mayo Clinic Experience

et al. 2013

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CR in children and young adults with Ebstein anomaly can be performed with low early mortality and excellent durability at short-term follow-up. CR represents an important surgical option for young patients. It is applicable to patients with a broad range of anatomic variability and precludes valve replacement in the vast majority. CR should be considered prior to the deleterious effects of chronic right ventricular volume overload and the development of systolic dysfunction, which hamper long-term prognosis. Therefore, early referral for surgical evaluation is recommended.

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Section: Discussionmentioning

confidence: 99%

Cone Reconstruction in Children with Ebstein Anomaly: The Mayo Clinic Experience

et al. 2013

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“…To decide whether to repair or replace the tricuspid valve, the surgeon needs to know the degree of delamination of the anterior leaflet and the status of its leading edge. In general, for standard tricuspid valve repair, a large, sail-like anterior leaflet with a very mobile edge is preferred because it facilitates coaptation with the ventricular septum or, in some cases, the abnormal septal leaflet [43][44][45]. Tethering or adherence of the leading edge of the anterior leaflet to the underlying endocardium precludes a satisfactory repair.…”

Section: Importance Of Mri In Eamentioning

confidence: 99%

Prospective comparison of echocardiography versus cardiac magnetic resonance imaging in patients with Ebstein’s anomaly

Jost

Edmister

Julsrud

et al. 2011

Int J Cardiovasc Imaging

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Ebstein's anomaly (EA) is primarily diagnosed by echocardiography. The purpose of this study was to compare echocardiography and magnetic resonance imaging (MRI) in EA. Data from cardiac MRI and echocardiography were prospectively collected from 16 patients with EA. Imaging data also were compared with intraoperative findings. Information provided by MRI and echocardiography were comparable for left ventricular size and function, tricuspid valve repairability, qualitative assessment of right-sided cavities, and visibility of septal and anterior tricuspid valve leaflets. The posterior tricuspid valve leaflet and tricuspid valve fenestrations were better visualized with MRI; associated heart defects were equally recognized, apart from small shunts that tended to be more readily diagnosed with echocardiography. Quantification of right-cavity size and right ventricular ejection fraction was possible only with cardiac MRI. The degree of tricuspid valve regurgitation was underestimated by echocardiography (2 patients) and by MRI (4 patients) when compared with intraoperative assessment. When evaluating EA, echocardiography and MRI provide complementary data. For visualization of the posterior tricuspid valve leaflet and quantitative assessment of right ventricular size and function, MRI is preferable. For appropriate risk stratification in EA, both MRI and echocardiography should be performed before cardiac surgery.

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“…In addition, the bidirectional cavopulmonary shunt is helpful if the resultant tricuspid valve repair has a small effective orifi ce. Finally, the bidirectional cavopulmonary shunt may reduce hemodynamic stress on a more complex (multiple suture lines) tricuspid valve repair because the volume of the right ventricle can be reduced by 35% to 45%, depending on the patient's age [28][29][30].…”

Section: 5-ventricle Repairmentioning

confidence: 99%

Ebstein malformation of the tricuspid valve: Current concepts in management and outcomes

Brown

Dearani

2009

Curr Treat Options Cardio Med

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Ebstein anomaly is a myopathy of the right ventricle that results in variable degrees of failure of delamination of the tricuspid valve leaflets from the underlying endocardium, leading to severe tricuspid valve regurgitation and some degree of right ventricular dysfunction. In neonates or infants who remain in congestive heart failure or profoundly cyanotic while receiving appropriate medical therapy, operation is required. Current strategies include biventricular or single-ventricle repair. In children and adults, medical management may be used, but most patients eventually require surgery. Tricuspid valve repair is preferred; we believe the cone repair is the most anatomic repair and is the operation of choice. Tricuspid valve replacement may be necessary in cases in which the valve is not repairable. A bidirectional cavopulmonary shunt is useful in patients with severe right ventricular dilatation and/or dysfunction. Transplantation rarely is necessary.

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Results of the 1.5-ventricle repair for Ebstein anomaly and the failing right ventricle

Cited by 79 publications

References 18 publications

Cone Reconstruction in Children with Ebstein Anomaly: The Mayo Clinic Experience

Cone Reconstruction in Children with Ebstein Anomaly: The Mayo Clinic Experience

Prospective comparison of echocardiography versus cardiac magnetic resonance imaging in patients with Ebstein’s anomaly

Ebstein malformation of the tricuspid valve: Current concepts in management and outcomes

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