| Surgical Treatment of Ebstein
Anomaly in Two Adult Cases: Limitations and Difficulties of Carpentier's
Procedure |
(Department of Cardiovascular Surgery, Hokkaido
University Graduate School of Medicine, Sapporo, Japan and Department
of Surgery, Hokkaido Kin-I-Kyou Central Hospital, Sapporo, Japan
and Department of Surgery, Hokkaido Kin-I-Kyou Central Hospital*,
Sapporo, Japan)
| Tomoji Yamakawa* |
Toshihumi Murashita |
Jun-ichi Oka |
| Takehiro Kubota |
Michiaki Imamura |
Norihiko Shiiya |
| Keishu Yasuda |
|
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|
In repair of the tricuspid valve
(TV) due to Ebstein's anomaly, mobilization of the anterior leaflet
associated with longitudinal right ventricle plication (Carpentier's
procedure) has provided good results in both short- and long-term
follow-up. However, if the anterior leaflet is small or severely
deformed, such repair may be ineffective. We report two cases
of Ebstein's anomaly (63 and 53 years old) with deformed anterior
leaflets of the TV in whom Carpentier's procedure was not feasible.
In one patient, the anterior leaflets were broadly plastered
on the right ventricle and Carpentier's procedure was tried.
However, the repair was converted to valve replacement because
of significant residual regurgitation. The other patient had
a cleft in the anterior leaflet, therefore Carpentier's procedure
was not suitable. The repair restructured the valve mechanism
below the true annulus by using the most mobile leaflets for
valve closure (modified Hetzer's procedure). This method of repair
could be an alternative method to repair of the TV in Ebstein's
anomaly, particularly when the anterior leaflet is deformed.
Jpn. J. Cardiovasc. Surg. 31: 414-417 (2002) |
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