The Modified Cone Reconstruction In The Treatment Of Ebstein’s Anomaly

Objective:To investigate the early and m id-term clinical outcomes of the m odified Cone reconstruction in the treatm ent of Ebstei n’s Anomaly(EA)which provide appropriate surgical treatment for clinical and reduce the inc idence of re-operation and valve replacement.Methods:Clinical data of 18 consecutive patients with EA in Shanxi Medical University Second Hospital between May 2008 and August 2015 year were analyzed retrospectively.All patients were diagnosed by echocardiography.There were 8 m ales and 10 fe males aged between 5 to 41 years old,an d the average age were 20.3.Preoperative electrocardiogram examination of 8 pttients of right bundle branch block.Among these patients,according to New York Heart Association functional grade,there were 12 patients with cardiac function II grade and g rade III in 6 patien ts.1 case wa s acute arterial em bolism,amputation and gangrene of left lower extremity caused by paradoxical embolism of combined secundum atrial septal defect,and another 1 case was combined with double-orifice technique due to postoperative poor closure of tricuspid valve.All patients were given ca rdiac,diuretic and vasodilator therapy preoperation and were treated with m odified cone reconstruction to correct EA.All patients had s evere tricuspid regurgitation grade.The m odified Cone reconstruction in the treatment of EA of the tricuspid valve its own tissues to form not only central bloodstream,but also the co aption between leaflet and leaflet.F or those patients whose anterior leaflet developed poor and sm aller,valve leaflet was w idened by using autologous pericardial.For all patients,tric uspid annulus were reinforced by autologous pericardial.Results:There were 2 cases with arrhythmia,and they returned to normal after medication.The rest patients recovered smoothly with no death.Review of echocardiography: 1 patient with moderate regurgitation,the rest of patients’ leaflets coapted well and had no tricuspid stenosis.Followed up postoperatively was 9 to 38 months,and patients with cardiac function I grade was 14 cases and grade II 4 cases.Conclusion:The early and mid-term clinical outcomes of the modified cone reconstruction in the treatment of EA were affirmative which can make leaflets coapt and h ad a strong antiregurgitation ability,it is more closer to the anatomical structure of the heart itself.Especially for young people under the age of 18,to m ake up for the shortcomings of other previous surgery with the patient’ s body grow up and shortcom ings.reducing the incidence of reoperation,valve replacement and postoperative mortality.Cone reconstruction(CR)is an ideal surgical method at present.