Modified tricuspid repair in patients with Ebstein’s anomaly

  • N. Nagdyman


Ebstein’s anomaly is an unusual congenital heart lesion notable for its extremely variable anatomy. One characteristic is the differing degree of dysplasia and displacement of the proximal attachments of the septal and posterior leaflets from the true atrioventricular junction. The anterior leaflet is normally attached to the tricuspid annulus but is usually larger than normal, with a sail-like aspect and various degrees of interchordal space obliteration and adherence to the ventricular wall. In Ebstein’s anomaly, the valve divides the right ventricle into a proximal part between the atrioventricular junction and the displaced valve, called the atrialized portion of the right ventricle, and a distal part, called the functional right ventricle. Between 10% and 15% of these patients have accessory conduction pathways, while Wolff–Parkinson–White syndrome is the most frequent. An atrial septal defect is present in most of the patients and may result in a right-to-left shunt with cyanosis.


Tricuspid Valve Anterior Leaflet Tricuspid Annulus Functional NYHA Class Atrialized Chamber 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Augustin N, Schmidt-Habelmann P, Wottke M, Meisner H, Sebening F (1997) Results after surgical repair of Ebstein’s anomaly. Ann Thorac Surg 63:1650–1656PubMedCrossRefGoogle Scholar
  2. 2.
    Augustin N, Schreiber C, Wottke M, Meisner H (1998) [Ebstein’s anomaly: when should a patient have operative treatment?] Herz 23:287–292PubMedCrossRefGoogle Scholar
  3. 3.
    Becker AE, Becker MJ, Edwards JE (1971) Pathological spectrum of dysplasia of the tricuspid valve: features in common with Ebstein’s malformation. J Pathol 103:Pxix–PxxPubMedGoogle Scholar
  4. 4.
    Carpentier A, Chauvaud S, Mace L, et al. (1988) A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 96:92–101PubMedGoogle Scholar
  5. 5.
    Chauvaud S, Fuzellier JF, Berrebi A, et al. (1998) Bi-directional cavopulmonary shunt associated with ventriculo and valvuloplasty in Ebstein’s anomaly: benefits in high risk patients. Eur J Cardiothorac Surg 13:514–519PubMedCrossRefGoogle Scholar
  6. 6.
    Chauvaud S (2000) Ebstein’s malformation. Surgical treatment and results. Thorac Cardiovasc Surg 48:220– 223PubMedCrossRefGoogle Scholar
  7. 7.
    Chauvaud S, Berrebi A, d’Attellis N, Mousseaux E, Hernigou A, Carpentier A (2003) Ebstein’s anomaly: repair based on functional analysis. Eur J Cardiothorac Surg 23:525–531PubMedCrossRefGoogle Scholar
  8. 8.
    Chen JM, Mosca RS, Altmann K, et al. (2004) Early and medium-term results for repair of Ebstein anomaly. J Thorac Cardiovasc Surg 127:990–998; discussion 998–999Google Scholar
  9. 9.
    Danielson GK, Maloney JD, Devloo RA (1979) Surgical repair of Ebstein’s anomaly. Mayo Clin Proc 54:185–192PubMedGoogle Scholar
  10. 10.
    Dearani JA, Danielson GK (2005) Surgical management of Ebstein’s anomaly in the adult. Semin Thorac Cardiovasc Surg 17:148–154PubMedCrossRefGoogle Scholar
  11. 11.
    Frescura C, Angelini A, Daliento L, Thiene G (2000) Morphological aspects of Ebstein’s anomaly in adults. Thorac Cardiovasc Surg 48:203–208PubMedCrossRefGoogle Scholar
  12. 12.
    Hancock Friesen CL, Chen R, Howlett JG, Ross DB (2004) Posterior annular plication: tricuspid valve repair in Ebstein’s anomaly. Ann Thorac Surg 77:2167–2171PubMedCrossRefGoogle Scholar
  13. 13.
    Hardy KL, May IA, Webster CA, Kimball KG (1964) Ebstein’s anomaly: a functional concept and successful definitive repair. J Thorac Cardiovasc Surg 48:927–940PubMedGoogle Scholar
  14. 14.
    Hetzer R, Nagdyman N, Ewert P, et al. (1998) A modified repair technique for tricuspid incompetence in Ebstein’s anomaly. J Thorac Cardiovasc Surg 115:857–868PubMedCrossRefGoogle Scholar
  15. 15.
    Kastor JA, Goldreyer BN, Josephson ME, et al. (1975) Electrophysiologic characteristics of Ebstein’s anomaly of the tricuspid valve. Circulation 52:987–995PubMedGoogle Scholar
  16. 16.
    Kaulitz R, Ziemer G (1995) Modified Fontan procedure for Ebstein’s anomaly of the tricuspid valve–an alternative surgical approach preserving Ebstein’s anatomy. Thorac Cardiovasc Surg 43:275–279PubMedCrossRefGoogle Scholar
  17. 17.
    Kupilik N, Simon P, Moidl R, et al. (1999) Valve-preserving treatment of Ebstein’s anomaly: perioperative and follow-up results. Thorac Cardiovasc Surg 47:229–234PubMedCrossRefGoogle Scholar
  18. 18.
    Marcelletti C, Duren DR, Schuilenburg RM, Becker AE (1980) Fontan’s operation for Ebstein’s anomaly. J Thorac Cardiovasc Surg 79:63–66PubMedGoogle Scholar
  19. 19.
    Marianeschi SM, McElhinney DB, Reddy VM, Silverman NH, Hanley FL (1998) Alternative approach to the repair of Ebstein’s malformation: intracardiac repair with ventricular unloading. Ann Thorac Surg 66:1546–1550PubMedCrossRefGoogle Scholar
  20. 20.
    Quaegebeur JM, Sreeram N, Fraser AG, et al. (1991) Surgery for Ebstein‘s anomaly: the clinical and echocardiographic evaluation of a new technique. J Am Coll Cardiol 17:722–728PubMedCrossRefGoogle Scholar
  21. 21.
    Ullmann MV, Born S, Sebening C, Gorenflo M, Ulmer HE, Hagl S (2004) Ventricularization of the atrialized chamber: a concept of Ebstein‘s anomaly repair. Ann Thorac Surg 78:918–924; discussion 924–915Google Scholar
  22. 22.
    Vargas FJ, Mengo G, Granja MA, Gentile JA, Rannzini ME, Vazquez JC (1998) Tricuspid annuloplasty and ventricular plication for Ebstein‘s malformation. Ann Thorac Surg 65:1755–1757PubMedCrossRefGoogle Scholar
  23. 23.
    Watson H (1974) Natural history of Ebstein‘s anomaly of tricuspid valve in childhood and adolescence. An international co-operative study of 505 cases. Br Heart J 36:417–427PubMedCrossRefGoogle Scholar
  24. 24.
    Wu Q, Huang Z (2004) A new procedure for Ebstein‘s anomaly. Ann Thorac Surg 77:470–476; discussion 476Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • N. Nagdyman
    • 1
  1. 1.Department of Cardiothoracic and Vascular SurgeryDeutsches Herzzentrum BerlinBerlinGermany

Personalised recommendations