Modified carpentier's technique for Ebstein's anomaly repair

Abstract

Objectives: This retrospective study assesses the outcomes of a modified Carpentier's technique for Ebstein's anomaly repair in respect to functional and anatomical recovery of the right ventricle and tricuspid valve.

Patients and methods: From August 2005 to December 2010, 52 patients with Ebstein's anomaly were operated in Hanoi Heart Hospital, Vietnam using the modified Carpentier's technique: (1) extensive mobilization of the tricuspid leaflet by detachment of the posterior, septal, and the adjacent part of the anterior leaflet; (2) longitudinal plication of the atrialized chamber and the right atrium to reconstruct the right ventricle and reduce the size of the dilated right atrium; (3) relocation of the anterior, posterior, and septal leaflets to the normal tricuspid annulus; and (4) tricuspid annuloplasty.

Results: Mean age was 20 years (3-49 years). Tricuspid regurgitation (in four-grade scale) was reduced from 3.72 ± 0.48 to 1.56 ± 0.48 (p < 0.01) and NYHA functional class was improved from 2.53 ± 0.53 to 1.14 ± 0.35 (p < 0.01). There was one hospital death (1, 95%) due to postoperative severe bleeding. There was no long-term mortality or reoperation after 42.4 months (17-81 months) follow-up.

Conclusion: Satisfactory outcomes can be achieved with complete repair of Ebstein's anomaly using the modified Carpentier's technique.