Abstract
Background
Despite numerous types of valve repairs currently being available for Ebstein’s anomaly, primary tricuspid valve replacement still hold its place in the surgical treatment of this disease, and is particularly valuable when the valve cannot be repaired for any reason.
Objective
The purpose of the present study was to determine the current risk and the early and late results of bioprosthetic tricuspid valve replacement in Ebstein’s anomaly.
Material and methods
42 consecutive cases of Ebstein’s Anamoly who underwent tricuspid valve replacement with a bioprosthetic valve during the period of January 1991 to June 2007 were reviewed retrospectively to obtain early and late mortalities. Kaplan-Meier analyses were performed to estimate patient survival and freedom from valve degeneration.
Results
Mean age of patients was 11.76 yrs ± 4.56 yrs (range 6–22 yrs). Types of bioprosthetic valves implanted included Carpentier-Edwards (n = 12, 28.57%) and Hancock (n = 30, 71.43%) with valve size ranging from 21 to 33 mm (mean 28.3 ± 1.68 mm). Overall in-hospital mortality was 7.14% (n = 3, 2 females and 1 male). There was no early valve related complications in the present study. Follow up of 39 survived patients ranged from 1.5 years to 15 years with an average postoperative period of 7.1 yrs (median 6.5 years). There were 2 late deaths (5.13%). 2 patients (5.13%) had bioprosthetic valve degeneration during follow up (10.5 yrs and 14 after initial operations). Late survival among early survivor was found to be 96.6% at 5 yrs and 92.2% at 10 yrs and 15 yrs while freedom from bioprosthetic valve degeneration was estimated to be 91.7% at 5 yrs and 61.1% at 10 and 15 yrs.
Conclusion
Valve replacement with a bioprosthesis produces good and long-lasting clinical improvement in patients with Ebstein’s anomaly and can be performed with acceptable mortality considering the very complex nature of the disease.
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Prakash, S., Agarwal, S., Singh, A.K. et al. Bioprosthetic valve replacement in Ebstein’s anomaly. Indian J Thorac Cardiovasc Surg 26, 179–184 (2010). https://doi.org/10.1007/s12055-010-0031-y
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DOI: https://doi.org/10.1007/s12055-010-0031-y