Objective
To summarize the experience and prognosis of Cone reconstruction used in Ebstein's anomaly.
Methods
We retrospectively analyzed the clinical data of 10 consecutive patients with Ebstein's anomaly, who underwent Cone reconstruction in our hospital from January 1, 2012 through February 1, 2015. According to Carpentier's classification, there were 2 patients of type A, 4 of type B, 2 of type B-C and 2 of type C.
Results
There was no death. One patient had arrhythmia after operation. The mean regurgitation area was 1.4±1.8 cm2 after operation, 6.4±6.9 cm2 at the time of discharge, respectively. Both of them were lower than preoperative regurgitation area (18.7±11.4 cm2) with statistical differences (95%CI –25.154 to –9.573,P=0.001; 95%CI 6.567 to 18.113,P=0.001). Three months after operation, the regurgitation was improved significantly compared to the preoperative regurgitation (95%CI 4.523 to 12.052,P=0.004). While it was higher in the regurgitation area when the patients were discharged. However, there was no statistical difference (95%CI –5.783 to 1.039,P=0.126). The incidence of severe regurgitation was about 85.7% at end of 3 months after operation, while decreased to 32.1%, 13 months later. The size of right atrium was much smaller than preoperative size (95%CI 1.033 to 31.480,P=0.039) when the patients were discharged.
Conclusion
Cone technique with ringed annuoplasty permits a good leaflet-to-leaflet coaptation. Tricuspid competence after operation could be sustained for a long time. However, postoperative short term is the crisis period to severe regurgitation. Further investigation for more appropriate surgical strategy should be carried on.
