Author + information
- Brandon Morrical,
- Joseph Dearani,
- David Driscoll and
- Nathaniel Taggart
Background: The circumferential “cone” repair has become the preferred method of repairing Ebstein anomaly of the tricuspid valve (TV). Reported surgical outcomes have been excellent. However, there have been no recent studies examining exercise or functional capacity in patients who have undergone tricuspid valve surgery in the modern era.
Methods: We performed a retrospective chart review of all patients with Ebstein anomaly who underwent TV surgery at Mayo Clinic between 6/07 and 1/15. We compared pre and postsurgical echos, exercise tests, and clinic visits. Statistical analysis was done using paired t-test and one-way ANOVA.
Results: TV surgery was done in 322 patients. Among this cohort, 32 patients met criteria of native TV repair or replacement and maximal pre and postsurgery exercise tests. Nineteen patients had valve repairs, and 13 had valve replacements. The average age was 41 years old (range 18-64), and consisted of 69% females. Surgery resulted in significant reduction in tricuspid regurgitation (p = 0.0001) and right ventricular size (p = 0.0003), with 72% of patients having trivial or no tricuspid regurgitation after surgery. There was a significant improvement in NYHA functional class (p = 0.001), with 69% of patients categorized as NYHA class I after surgery. No significant difference was found in functional aerobic capacity (FAC), metabolic equivalents (METs), or exercise time. There was a trend toward a decreased VO2 max after surgery (p = 0.056). Peak heart rate during exercise declined after surgery (p = 0.032). Those who had a PFO or ASD closed during surgery had improved minimum saturations during exercise (p = 0.045), though they did not have any difference in measured exercise capacity. There was no significant difference between those that had repair or replacement of the TV.
Conclusions: In our cohort, patients who had TV repair or replacement for Ebstein anomaly had improved NHYA function class. However, patient-described function was not reflected in measured exercise capacity, despite excellent surgical results by echo. Further follow-up and more consistent testing may provide more reliable information regarding these patients’ exercise and functional capacity.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Adult Patients With Congenital Heart Disease: How Do They Compare?
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1142-013
- 2017 American College of Cardiology Foundation