Surgical Treatment Of Ebstein's Anomaly

Objective:Ebstein's anomaly(Downword Displacement of Tricuspid Valve,DDTV)is a relatively rare congenital malformation which is characterized by apical displacement of the septal or posterior leaflet of the tricuspid valve,resulting in 'atrialization' of the inflow tract of the right ventricle and consequently a variably small,but functional right ventricle,accounting for less than 1%of all congenital heart defects,The prevalence is equal in women and men.Up to 80%of patients with Ebstein's anomaly have a concomitant patent foramen ovale or secundum atrial septal defect Surgical Treatment of Ebstein Anomaly begins in 1950s,including Tricuspid Valve replacement, Danielson's procesure,Hardy's procesure,Carpentier's procesure,Glenn shunt and starnes operation,et which possess obvious outcomes.At present,more and more people advocate tricuspid valve annuloplasty instead of tricuspid valve replacement,but there is still not a standard procedure.especially in the treatment of subtype of Ebstein's anomaly.More discussions are needed in choosing the operation.Therefore,how to choose better and more fitable procedure to improve the patient's heart function and the quality of life is meaningful in the Surgical Treatment of Ebstein's AnomalyConclusion:Ebstein's anomaly is a complex form of congenital heart disease,which has many treatments.How to choose the treatment depends on the pathological Anatomy.Tricuspid valve annuloplasty can possess good outcomes.The indication for tricuspid valve replacement should be strictly selected.Comparing with tricuspid valve annuloplasty,tricuspid valve replacement is more complicated during the perioperative period,with more postoperative complications,and need long-term anticoagulatory therapy.The procedure is difficult to operate on children patients,part of which need a second operation.Recently some foreign researchers have tried to treat adult and young Ebstein anormaly with tricuspid valve annuloplasty,and achieved good outcomes.Some domestic researchers also treat this anormaly with tricuspid valve annuloplasty,achieving moderate efficacy.Therefore tricuspid valve annuloplasty should be considered as the first choice for all the Ebsteins.If tricuspid valve annuloplasty is not feasible,tricuspid valve replacement and conservative procedures,or heart transplantation should be considered.