Document Detail


Surgical management of Ebstein's anomaly.
MedLine Citation:
PMID:  17434001     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
John M Stulak; Joseph A Dearani; Gordon K Danielson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual     Volume:  -     ISSN:  1092-9126     ISO Abbreviation:  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu     Publication Date:  2007  
Date Detail:
Created Date:  2007-04-16     Completed Date:  2007-09-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9815944     Medline TA:  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-11     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Bioprosthesis
Cardiac Surgical Procedures* / methods
Child
Child, Preschool
Ebstein Anomaly / complications,  epidemiology,  physiopathology,  surgery*
Heart Valve Prosthesis Implantation
Humans
Infant
Middle Aged
Minnesota / epidemiology
Retrospective Studies
Risk Factors
Survival Analysis
Suture Techniques
Tachycardia, Supraventricular / etiology,  physiopathology,  prevention & control,  surgery
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  physiopathology,  prevention & control
Ventricular Dysfunction, Right / etiology,  physiopathology,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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