Cone reconstruction for Ebstein anomaly: Late biventricular function and possible remodeling.

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Disease
• Cardiac Imaging

Background:

• Ebstein anomaly is a congenital heart defect affecting the tricuspid valve.
• Cone reconstruction is a surgical technique used to repair the tricuspid valve in Ebstein anomaly.
• Long-term outcomes regarding biventricular function and remodeling after this procedure require further evaluation.

Purpose of the Study:

• To assess late-term tricuspid valve competence after cone reconstruction.
• To evaluate biventricular function and remodeling post-cone reconstruction for Ebstein anomaly.
• To explore changes in cardiac dimensions and performance over time.

Main Methods:

• Retrospective study of adult and pediatric patients who underwent cone reconstruction (2009-2019).
• Cardiac magnetic resonance imaging (CMR) used to assess tricuspid regurgitation fraction, biventricular ejection fraction, and volumes.
• Statistical analysis included paired t tests or Wilcoxon signed-rank tests.

Main Results:

• Significant decrease in tricuspid regurgitation fraction (69% to 10%) and increase in antegrade pulmonary artery and aortic volumes.
• Left ventricle stroke volume and antegrade aortic volume increased, showing progressive improvement over time.
• Positive biventricular remodeling observed, with decreased right atrium area and increased functional right ventricle and left heart areas.

Conclusions:

• Cone reconstruction for Ebstein anomaly sustains valve integrity.
• Biventricular function shows progressive improvement during long-term follow-up.
• The study demonstrates positive signs of biventricular remodeling following cone reconstruction.