Ebstein's anomaly: surgical treatment with tricuspid replacement without right ventricular plication

Two patients with Ebstein's anomaly and severe cardiac impairment underwent surgical repair with tricuspid valve replacement and closure of associated congenital septal defects. No attempt was made to plicate the atrialized right ventricle. Good cardiac function was obtained at the end of the procedure, with uniform contractions of the whole right ventricle. Both patients are leading normal and active lives 38 and 32 months after operation. We believe that successful repair is achieved chiefly by placing a competent tricuspid valve on its true anatomical position, leaving the underlying atrialized portion of the ventricular wall undisturbed. That portion will contract and work synchronously with the rest of the right ventricle.