PMID- 28566198
OWN - NLM
STAT- MEDLINE
DCOM- 20180105
LR  - 20221207
IS  - 1875-2128 (Electronic)
IS  - 1875-2128 (Linking)
VI  - 110
IP  - 5
DP  - 2017 May
TI  - Ebstein's anomaly in adults: Modified cone reconstruction of the tricuspid valve 
      is associated with promising outcomes.
PG  - 325-333
LID - S1875-2136(17)30094-3 [pii]
LID - 10.1016/j.acvd.2017.03.003 [doi]
AB  - BACKGROUND: Ebstein's anomaly is a complex malformation. Justification of a 
      procedure in mildly symptomatic adults is debatable: repair techniques are 
      demanding and valve replacement is associated with poorer outcome. OBJECTIVES: We 
      report our initial experience with the cone procedure versus medical follow-up. 
      METHODS: Patients aged>/=15years with Ebstein's anomaly were enrolled during 
      2007-2014. The cone procedure was performed in consecutive patients with severe 
      tricuspid regurgitation (TR); those with less severe disease did not undergo 
      surgery, although some underwent percutaneous catheter atrial septal defect 
      closure. RESULTS: The cone procedure was performed in 20 patients (mean age 
      34.3+/-14.4years; TR grade 3.3+/-0.7) because of impaired functional capacity: six 
      New York Heart Association (NYHA) class II, 14 class III. No surgical patient 
      died during a mean (range) follow-up of 2.8 (0.5-5.0) years. One patient required 
      subsequent repair for suture dehiscence 6 months postoperatively. All patients 
      presented with mild or less TR at last echocardiographic follow-up. NYHA 
      functional class was significantly improved at follow-up (P<0.0001): 16 NYHA 
      class I and four class II. Of 24 non-surgical patients (mean age 37.3+/-16.9 years; 
      TR grade 2.2+/-0.8), seven underwent percutaneous ASD closure. During a mean 
      (range) follow-up of 4.8 (3.6-5.0) years, two patients died: one sudden death and 
      one stroke. CONCLUSION: The cone repair of the tricuspid valve in adults with 
      Ebstein's anomaly provided excellent mid-term results and significantly improved 
      functional status. This procedure might be considered even in mildly symptomatic 
      patients in the presence of severe valve regurgitation.
CI  - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.
FAU - Belli, Emre
AU  - Belli E
AD  - Institut Jacques-Cartier, Department of Pediatric and Congenital Heart Surgery, 
      Noyer-Lambert avenue, 91300 Massy, France. Electronic address: emrebel@gmail.com.
FAU - Rabot, Martin
AU  - Rabot M
AD  - Marie-Lannelongue Hospital, Department of Pediatric and Congenital Heart Disease, 
      92330 Le Plessis Robinson, France.
FAU - Petit, Jerome
AU  - Petit J
AD  - Marie-Lannelongue Hospital, Department of Pediatric and Congenital Heart Disease, 
      92330 Le Plessis Robinson, France.
FAU - Gouton, Marielle
AU  - Gouton M
AD  - Marie-Lannelongue Hospital, Department of Pediatric and Congenital Heart Disease, 
      92330 Le Plessis Robinson, France.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20170526
PL  - Netherlands
TA  - Arch Cardiovasc Dis
JT  - Archives of cardiovascular diseases
JID - 101465655
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Cardiac Valve Annuloplasty/adverse effects
MH  - Ebstein Anomaly/diagnostic imaging/physiopathology/*surgery
MH  - Female
MH  - Health Status
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/diagnostic imaging/physiopathology/*surgery
MH  - Postoperative Complications/etiology
MH  - *Plastic Surgery Procedures/adverse effects
MH  - Recovery of Function
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
MH  - Tricuspid Valve/abnormalities/diagnostic imaging/physiopathology/*surgery
MH  - Young Adult
OTO - NOTNLM
OT  - Cardiopathie congenitale
OT  - Chirurgie
OT  - Congenital heart disease
OT  - Right ventricle
OT  - Surgery
OT  - Tricuspid valve
OT  - Valve tricuspide
OT  - Ventricule droit
EDAT- 2017/06/02 06:00
MHDA- 2018/01/06 06:00
CRDT- 2017/06/02 06:00
PHST- 2016/10/20 00:00 [received]
PHST- 2017/03/29 00:00 [revised]
PHST- 2017/03/30 00:00 [accepted]
PHST- 2017/06/02 06:00 [pubmed]
PHST- 2018/01/06 06:00 [medline]
PHST- 2017/06/02 06:00 [entrez]
AID - S1875-2136(17)30094-3 [pii]
AID - 10.1016/j.acvd.2017.03.003 [doi]
PST - ppublish
SO  - Arch Cardiovasc Dis. 2017 May;110(5):325-333. doi: 10.1016/j.acvd.2017.03.003. 
      Epub 2017 May 26.