Surgical treatment of Ebstein's anomaly. Early and late results in twenty patients subjected to valve replacement

Twenty patients with Ebstein's anomaly underwent corrective operations between 1965 and 1978. Sixteen were in Functional Class III or IV (N.Y.H.A.) and four were in Class II but were having episodes of anoxia, syncope, or a rapid increase in cardiac size. In the first 10 cases (1965 to 1972) the tricuspid valve was replaced with a Starr-Edwards prosthesis, and in the second group (1972 to 1978) a dura mater valve was used. Five patients also underwent plication of a very large atrialized right ventricular segment. The atrial septal defect was closed totally in four cases, partially in eleven cases, and left open in five cases; one patient also underwent closure of the ventricular septal defect. Four patients died in the immediate postoperative period, three of whom were in the first group. There were three late postoperative deaths in the remaining 16 patients, all of them in the first group. All 13 of the surviving patients are in Functional Class I, except for one patient who is in Class II.