Format

Send to

Choose Destination
J Korean Med Sci. 2016 Nov;31(11):1749-1754. doi: 10.3346/jkms.2016.31.11.1749.

Natural Course of Adult Ebstein Anomaly When Treated according to Current Recommendation.

Kim HY1,2, Jang SY1,2, Moon JR1,2,3, Kim EK1,2, Chang SA1,2, Song J2,3, Huh J2,3, Kang IS2,3, Yang JH2,4, Jun TG2,4, Park SW1,5.

Author information

1
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2
Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
4
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
5
Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. parksmc@gmail.com.

Abstract

The objectives of this study were to assess the clinical outcomes of adults with Ebstein Anomaly (EA) according to their treatment modalities. All adult EA patients diagnosed between October 1994 and October 2014 were retrospectively evaluated by medical record review. Total 60 patients were categorized into 3 groups according to their treatment strategy, i.e. non-operative treatment (Group I, n = 23), immediate operative treatment (Group II, n = 27), and delayed operative treatment (Group III, n = 10). A composite of major adverse cardiac and cerebrovascular events (MACCE) and factors associated with MACCE were assessed in each treatment group. MACCE occurred in 13.0% patients in Group I, 55.6% patients in Group II and 50% in Group III (P = 0.006). Event free survivals at 5 years were 90% in Group I, 52.7% in Group II, 50.0% in Group III (P = 0.036). Post-operatively, most patients showed improvement on clinical symptoms. However, event free survival rate was lower in patients with operation compared to those with non-operative treatment (58.7% vs. 90.9%; P = 0.007). Major arrhythmic event occurred more frequently even after surgical ablation (50.0% vs. 20.0%; P = 0.034). Re-operation was more frequent in patients underwent delayed surgery compared to those with immediate surgery (50.0% vs. 18.5%; P = 0.001). Current guideline to decide patient's treatment strategy appeared to be appropriate in adult patients with EA. However, surgical ablation for arrhythmia was not enough so that concomitant medical treatment should be considered. Therefore, attentive risk stratification and cautious decision of treatment strategy by experienced cardiac surgeon are believed to improve clinical outcome.

KEYWORDS:

Adults; Clinical Outcome; Ebstein Anomaly; Treatment

PMID:
27709852
PMCID:
PMC5056206
DOI:
10.3346/jkms.2016.31.11.1749
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Korean Academy of Medical Sciences Icon for PubMed Central
Loading ...
Support Center