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Submitted: 12 November 2014 Modified: 08 October 2018
HERDIN Record #: PCHRD14111205541710

Early and late outcome of surgery for ebstein anomaly: A 20-year experience in Philippine tertiary centers

Raul D. Jara,
Angelo Dave  C. Javier,
Jun Maximo F. Lasco II,
Lowe L. Chiong

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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.


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  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 logistics regression did not reveal any significant predictor of mortality among the various characteristics analyzed, probably due to small number of patients in this study.

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Cardiology
Frequency
Semi-Annual
Publication Date
January-June 2013
Volume
41
Issue
1
Page(s)
17-22

Objectives

OBJECTIVES: To described 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.

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 43 Fulltext Print Format (Request Document)
Philippine Heart Association Fulltext pdf (Download)
Philippine Heart Center Medical Library Fulltext pdf (Download)

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