Vol. 41 | No. 1 | January-June 2013 Back

Open Access

Early and Late Outcome of Surgery for Ebstein Anomaly: A 20-year Experience in Philippine Tertiary Centers

Raul Jara, Angelo Dave C. Javier, Jun Maximo F. Lasco II, Lowe L. Chiong
Jun 2013 DOI 10.69944/pjc.5b415dfa61

Abstract

BACKGROUND: Ebstein Anomaly (EA) is a rare congenital heart disease. Clinical presentation depends on the severity of tricuspid valve displacement and associated intracardiac congenital anomalies. Surgical indications have been described on recent guidelines, resulting in favorable outcomes in well-selected patients. There is no published experience in tricuspid valve surgery for EA in the Philippines. 

OBJECTIVES: To describe the clinical profile of patients who underwent cardiac surgery for EA from 1992 to 2012 in the Philippines, and to compare the clinical characteristics of survivors and immediate non-survivors of tricuspid valve surgery for EA. 

METHODOLOGY: This was a retrospective cohort study on patients who underwent cardiac surgery from 1992 to 2012, at the Philippine Heart Center and Philippine General Hospital. Characteristics between survivors and non-survivors were compared. 

RESULTS: Twenty-eight patients underwent cardiac procedures for EA from 1992 to 2012 in the Philippines. The mean age at operation was 12 years. Majority of the patients were males (57%) and were at least 18 years old (75%). Among the 28 patients, 21 were identified to have undergone a definitive treatment (i.e., either tricuspid valve (TV) repair or replacement. Mean total bypass time was 148.71 minutes ± 133.31. Mean total cross-clamp time was 89.89 minutes ± 46.65. The most common surgical complications were prolonged intubation (32%) and atrial arrhythmias (21%). The average length of hospital stay was 20.67 days ± 11.64. Follow-up was possible in 20 out of the 21 patients (95%). There were three early deaths (< 30 days), all of whom had TV repair. Of the 18 survivors, 15 underwent TV repair while three underwent TV replacement. Non-survivors had significantly lower arterial oxygen saturation (p=0.045), more post-operative bleeding (p=0.014), and greater post-operative need for hemodialysis (p=0.014). Exact logistic regression did not reveal any significant predictor of mortality among the various characteristics analyzed, probably due to the small number of patients in this study.

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