Classification-based repair techniques to correct tricuspid valve incompetence in Ebstein’s anomaly and long-term functional outcome

Methods Sixty-eight (68) patients (mean age 26.9±7.3 years) with Ebstein’s anomaly (Types A=18, A=3, B=21, B-C=2, C=15, D=9) underwent correction of TV incompetence. The atrialized ventricle, the TV and subvalvar apparatus were inspected to analyze the precise morphology, and determine which leaflet was the most mobile. In all, the atrialized right ventricle (RV) is incorporated into the contractile RV by partial closure of the natural annulus using the most mobile leaflet for valve competence. Posterior annulorrhaphy was performed for Types A,B,C. The double orifice valve technique was employed mostly in types C and D.Sebening stitch, was applied in combination in most types. A combination of anterior and posterior annulorrhaphy was also performed for types A and B. In 3 patients with type C, additional bidirectional Glenn anastomosis was performed.