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KMID : 0364020070400070473
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Korean Journal of Thoracic and Cardiovascular Surgery
2007 Volume.40 No. 7 p.473 ~ p.479
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Hetzer Technique for Surgical Correction of Ebstein’s Anomaly
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Chung Jin-Woo
Yun Tae-Jin
Im Yu-Mi
Jung Sung-Ho
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Abstract
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Background:The Hetzer procedure for the correction of Ebstein’s anomaly has the advantages of technical feasibility and incorporation of the atrialized right ventricle (RV) into the functional RV.
Material and Method:We preformed a retrospective review of 11 patients with Ebstein’s anomaly and they had undergone a Hetzer procedure between March 2002 and December 2006.
Result:The median age at operation was 19.8 years (range: 6 months∼56 years). There were 4 males and 7 females. All patients showed severe tricuspid regurgitation (TR) preoperatively, and arterial desaturation (＜95%) was present in 3 patients. The original Hetzer technique was employed in 6 patients with the Carpentier type A anomaly. In the remaining 5 patients with the Carpentier type B or C anomalies, valve competence was restored at the level of the displaced tricuspid valve mechanism. Adjunct bidirectional cavo-pulmonary shunt, or one and a half ventricle repair strategy was employed for all the patients. The median follow-up was 8.6 months (range: 0.8∼51.9 months). There was no early or late death, and the immediate postoperative TR was trivial to mild in 8 patients. The median cardio-thoracic ratios on chest X-ray at the preoperative period and at postoperative 0, 1 and 6 months were 65%, 62%, 55% and 55%, respectively.
Conclusion:The original or modified Hetzer procedure for Ebstein’s anomaly shows excellent intermediate-term outcomes.
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KEYWORD
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Tricuspid valve, Ebstein’s anomaly, Bidirectional cavopulmonary shunt, Tricuspid valve surgery, Surgery method
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