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Contemporary Early Postoperative Cone Repair Outcomes for Patients With Ebstein Anomaly
Kari A Phillips1, Joseph A Dearani2, Philip L Wackel3
1Department of Pediatrics, Mayo Clinic, Rochester, MN, USA; Department of Pediatric Cardiology, University of Utah, Salt Lake City, UT, USA.
Mayo Clinic Proceedings
|February 3, 2023
Summary
Cone repair (CR) for Ebstein anomaly (EA) shows excellent early outcomes in children and adults. Waiting until age 4 may reduce complications and the need for superior cavopulmonary anastomosis in select patients.
Area of Science:
- Congenital heart disease
- Pediatric cardiology
- Cardiac surgery
Background:
- Ebstein anomaly (EA) is a rare congenital heart defect affecting the tricuspid valve.
- Cone repair (CR) is a surgical technique used to correct EA.
- Understanding early postoperative outcomes is crucial for patient management.
Purpose of the Study:
- To evaluate early postoperative outcomes following cone repair (CR) for Ebstein anomaly (EA).
- To analyze outcomes across different age groups and disease severities.
Main Methods:
- Retrospective analysis of 284 patients aged 1-73 years who underwent CR.
- Patients were stratified by age (1-<4, 4-<19, 19-<40, 40+ years) and disease severity.
- Outcomes assessed included mortality, reoperation, readmission, complications, and length of stay.
Main Results:
- Zero 30-day mortality.
- Overall reoperation rate was 4.9%, readmission rate 2%, and complication rate 8.8%.
- Youngest age group (<4 years) had higher complication rates (21%) and need for superior cavopulmonary anastomosis (37%).
Conclusions:
- Cone repair (CR) for Ebstein anomaly (EA) demonstrates favorable early postoperative results with low mortality, reoperation, and complication rates.
- Delaying CR until age 4 may reduce early complications and the need for superior cavopulmonary anastomosis in specific cases.
- CR is effective across the age spectrum for Ebstein anomaly management.
