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[A case report of Ebstein's anomaly treated with Carpentier's procedure]
M Nagashima1, Y Takeuchi, A Gomi
1Department of Cardiovascular Surgey, Kanto Teishin Hospital, Tokyo, Japan.
Insights
Carpentier's procedure effectively treats Ebstein's anomaly by longitudinally plicating the right atrium and transposing tricuspid valve leaflets. This surgical approach preserves right ventricular function and significantly improves patient outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Ebstein's anomaly is a congenital heart defect characterized by displacement of the tricuspid valve.
- Severe tricuspid valve incompetence can lead to congestive heart failure.
Observation:
- A 42-year-old male presented with congestive heart failure due to Ebstein's anomaly and severe tricuspid valve incompetence.
- The patient underwent the Carpentier's procedure, a novel surgical technique.
Findings:
- Carpentier's procedure involves longitudinal plication of the right atrium and atrialized ventricle, and transposition of tricuspid valve leaflets.
- This technique preserves right ventricular cavity and function, unlike transverse plication methods.
- Postoperatively, the patient exhibited trivial residual tricuspid regurgitation but remarkable clinical improvement.
Implications:
- Carpentier's procedure represents an effective surgical option for managing Ebstein's anomaly.
- The technique's ability to preserve right ventricular function offers significant advantages for long-term patient prognosis.
- This case highlights the successful application of Carpentier's procedure in improving heart failure symptoms.
Abstract:
A 42-year-old male patient was admitted with congestive heart failure. Echocardiogram and cardiac angiogram revealed Ebstein's anomaly and severe tricuspid valve incompetence. He underwent Carpentier's procedure for the treatment of Ebstein's anomaly. Carpentier's procedure consists of the following two new points; (1) the right atrium and atrialized ventricle is plicated longitudinally; (2) the anterior leaflet and the posterior leaflet of tricuspid valve are transposed with a clockwise rotation to the level of the normal tricuspid anulus. Compared with Hardy's procedure (transverse plication), longitudinal plication preserves the cavity and the function of the right ventricle and excludes atrialized chamber. In our case, there is a trivial residual regurgitation of tricuspid valve postoperatively, but the patient's clinical status has improved remarkably. We conclude that Carpentier's procedure is an effective operation for Ebstein's anomaly.