Analysis Of Therapeutic Effect Of Cone Surgery For Ebstein’s Anomaly

Objective The purpose of this article is to collect cases of Ebstein’s Anomaly(EA)and performed Cone construction in the Department of Cardiovascular Surgery,General Hospital of Ningxia Medical University,retrospectively to summarize the efficacy of this method.Methods A retrospective analysis was made on the data of patients who visited the Department of Cardiovascular Surgery,Ningxia Medical University for Cone surgery because of Ebstein’s Anomaly(EA)from January 2009 to January 2020.The patients’ operation age :32.9±16.1(years old),and average body weight :57.0±19.4(kg).Among them,there were 7 males(39.0%)and 11 females(61.1%).5 cases were combined with patent foramen ovale(PFO),3 cases were combined with atrial septal defect(ASD),and 1 case was combined with atrial septal defect(ASD)and ventricular septal defect(VSD)at the same time.4 cases were combined with incomplete right bundle branch block,2 cases were combined with atrial fibrillation,and 1 case was combined with WPW syndrome and accompanied by degree I atrioventricular block.All patients had different degrees of symptoms during surgery,such as edema of both lower limbs,large liver,jugular vein flaring,right heart failure,chest distress,shortness of breath,cyanosis and other discomfort.These patients were all treated with Cone reconstruction.The reconstructed tricuspid valve annulus passed through Two and a half fingers of the operator.The water injection test showed that the tricuspid valve was satisfactory.For the hypoplasia of valve leaflet and poor apposition of reconstructed tricuspid valve to anatomical position,the pericardium slice could be selected to widen the valve leaflet.Meanwhile,5 cases of patent foramen ovale(PFO)were repaired,3 cases of atrial septal defect(ASD)were repaired,1 case of atrial septum defect(ASD)and ventricular septum defect(VSD)was repaired at the same time,and 1 case of WPW syndrome eliminated by surgical incision at the same time.Results 1 patient died because of right heart failure,17 patients were all improved and discharged,1 patient had sinus rhythm after rebound,which turned into III° atrioventricular block with slow heart rate.Temporary pacemaker was placed on the surface of the heart,which then turned into sinus rhythm.Reexamination of echocardiography postoperative revealed that 2 cases had moderate tricuspid regurgitation,and the rest had mild or no regurgitation,with cardiac function recovery to Class I–II(NYHA)at least six months after surgery.Conclusion Cone reconstruction can achieve good tricuspid valve apposition.The follow-up results in the first and middle terms showed that the tricuspid valve could maintain long-term function,and the regurgitation was significantly improved.The cardiac function level and activity tolerance of the patient were significantly improved,and the clinical symptoms were significantly relieved.This surgical method is worthy of promotion.