Ebstein's anomaly of the tricuspid valve surgery

and Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]

Associate Editor-In-Chief:

Surgery
- Tricuspid valve repair or replacement (when possible repair is preferable to replacement as it is associated with a lower mortality rate and fewer complications).


 * Atrial septal defect repair.
 * Right atrial plication (unclear whther this improves right ventricular function).
 * Cardiac defibrillator implantation.
 * Accessory pathways may require surgical intervention or ablation.

Hospital mortality at the Mayo for valve reconstruction is 6.7%. Only 1.6% in the Mayo series required reoperation. Long term follow up in the Mayo series showed 92% to have Class I or II symptoms and a 10 year mortality rate of 8%.

Generally, surgical treatment improves the exercise intolerance from NYHA-FC III or IV to NYHA-FC I or II.

Regardless of severity of the Ebstein’s Anomaly and type of treatment, risk of sudden death remains an important issue in patients with Ebstein's anomaly.