Early and Midterm Results of Repair of Ebstein's Anomaly with Autologous Pericardium

BACKGROUND: The surgical management of Ebstein's anomaly represents a major challenge. METHODS: Thirty consecutive patients with Ebstein's anomaly received surgical treatment in the period from April 2002 to October 2009. Operations included annuloplasty, repair of the tricuspid valve using autologous pericardium and tricuspid valve replacement. In most cases, repair of the tricuspid valve was done using autologous pericardium instead of an annuloplasty with the anterior leaflet alone. Associated congenital malformations were also repaired during the operation. Follow-up ranged from 6 to 82 months. RESULTS: Intraoperative transesophageal echocardiography revealed no or only minimal tricuspid incompetence after cardiopulmonary bypass in 25 patients. Mild or moderate incompetence was observed in 3 and 2 patients, respectively. At the last follow-up echocardiography, 5 patients with mild and 2 patients with moderate tricuspid incompetence were detected. There was no sign of pericardial degeneration, tricuspid valve stenosis, or calcification of the pericardial patch in any patient during follow-up. CONCLUSIONS: Although further study is required to assess the long-term function of the reconstructed tricuspid valve, our early and midterm results from this current study indicate that repairing the tricuspid valve with autologous pericardium achieves reasonable outcomes in the majority of patients with Ebstein's anomaly, including pediatric and adult patients.