Surgical correction of Ebstein's anomaly by tricuspid valve replacement and its late problems

The choice between valve replacement and plasty for surgical management of Ebstein's anomaly still remains controversial. Since 1960, we have treated 16 cases of Ebstein's anomaly, and 7 of the 16 cases have undergone surgical correction. Tricuspid valve replacement (TVR) without plication of the atrialized ventricle was applied in 4 cases, and Hardy's procedure was adopted in three cases. The division of the Bundle of Kent was carried out simultaneously in 2 cases with Wolff-Parkinson-White (W-P-W) syndrome of the TVR group. All patients have survived the operation. Early and late (as long as 14 years) postoperative evaluations have demonstrated superiority of the TVR group. However, the late echocardiographic findings have revealed new problems in the TVR group, such as hypokinetic or paradoxical motion of the atrialized ventricle in two cases and hypofunction of the left as well as the right heart.