Original articleCongenital heart surgeryImproving Results of Surgery for Ebstein Anomaly: Where Are We After 235 Cone Repairs?
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Patients and Methods
After approval by the Mayo Clinic Institutional Review Board (February 2016), we searched our surgical database for patients with Ebstein anomaly who underwent cone repair from June 20, 2007, to October 6, 2015.
Operative Details and Early Results
Operative procedures and perioperative data are summarized in Table 3. Cone repair was undertaken as a TV re-repair in 27 patients (11.5%). There was 1 early death, of a 50-year old man with endocarditis preoperatively related to pacemaker leads. Despite antibiotic coverage and successful cone repair with BCPS, he had low output syndrome, required extracorporeal membrane oxygenation postoperatively, had a stroke, and died 38 days after operation.
Extracorporeal membrane oxygenation was required
Ideal Repair Is Anatomic Repair
The initial repair techniques for Ebstein anomaly focused on TV monocusp repair [11]. The Carpentier technique 12, 13 incorporated surgical delamination of the anterior leaflet with annular reattachment so monocusp mobility was optimized for ventricular septal coaptation in contrast to the Danielson method, which did not incorporate surgical delamination but rather anterior papillary muscle approximation to the ventricular septum (modified Sebening stitch) [14]. Although monocusp repairs were
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2023, HeartRhythm Case ReportsCitation Excerpt :Ebstein’s anomaly, a rare and highly variable congenital heart defect,1 still presents a treatment challenge. The currently used cone repair of the tricuspid valve has carried favorable results in suitable patients.2 Arrhythmogenic substrates including accessory pathways3,4 and right bundle branch block5 associated with electromechanical ventricular dyssynchrony present additional therapeutic targets.