etd Ege Tıp Dergisi 1016-9113 2147-6500 Ege Üniversitesi 10.19161/etd.551164 Health Care Administration Sağlık Kurumları Yönetimi Surgical treatment of Ebstein anomaly: A unicenter experience Ebstein anomalisinin cerrahi tedavisi: Tek merkez deneyimi https://orcid.org/0000-0002-0509-1971 Akkaya Gökmen Ege University Faculty of Medicine, Department of Pediatric Cardiovascular Surgery, İzmir https://orcid.org/0000-0002-9158-5627 Bilen Çağatay Ege University Faculty of Medicine, Department of Pediatric Cardiovascular Surgery, İzmir https://orcid.org/0000-0001-6495-1639 Tuncer Osman Nuri Ege University Faculty of Medicine, Department of Pediatric Cardiovascular Surgery, İzmir https://orcid.org/0000-0002-0780-3047 Ayık Mehmet Fatih Ege University Faculty of Medicine, Department of Pediatric Cardiovascular Surgery, İzmir https://orcid.org/0000-0002-5717-0057 Atay Yüksel Ege University Faculty of Medicine, Department of Pediatric Cardiovascular Surgery, İzmir 06 28 2019 58 2 161 165 03 01 2018 06 01 2018 Copyright © 1962, Ege Tıp Dergisi 1962 Ege Tıp Dergisi

Aim: Ebsteinanomaly is a rare congenital cardiac disorder that causing by failure ofdelamination of the tricuspid valve. Various surgical methods have beendeveloped so far as treatment options. Our initial experience and short termfollow up reported herein.Materials and Methods:Ten patients underwent surgical treatment with a diagnosis ofEbstein anomaly in our center between 2007 and 2017. Two patients underwent oneand a half ventricle repair and Danielson method applied to eight patients. TheX-clamping and cardiopulmonary by-pass (CPB) timing, duration in intensive careunit (ICU), extubation time and need for blood product were compared betweenDanielson and one and a half ventricle repair applied patients.Results: Therewas no mortality among patients. In the one and a half repair applied groupboth X-clamping (p=0.044) and CPB time (p=0.044) was longer compared toDanielson group. On the other hand there is no significantly difference betweengroups in ICU duration (p=0.400) or extubation timing (p=0.889). Furthermore,need for blood product and amount of drainage were not different between groupswhen two infant age cases were excepted while calculating.Conclusion: Danielson method is safe and effective in the repair of Ebstein anomalyand can be applied at infant age with similar clinical outcomes. Nevertheless,one and a half repair option is also beneficial in patients with a large sizeatrialized right ventricular volume. The last decision should be confirmed byheart team considering patient characteristics and surgeons’ past experience.

Amaç: Ebstein anomalisitriküspid kapak delaminasyonundaki yetersizlik sonucu oluşan nadir birkonjenital kalp hastalığıdır. Hastalığın tedavisinde farklı cerrahi yöntemlerbugüne dek tanımlanmıştır. Bu çalışmada cerrahi deneyim ve kısa dönem cerrahisonuçlarımızı belirtmekteyiz.Gereç ve Yöntem: Çalışmaya 2007-2017 yılları arasında merkezimizde Ebstein anomalisitanısı ile opere edilen on hasta dahil edildi. İki hastaya bir buçuk ventrikültamiri uygulanırken diğer sekiz hasta Danielson metodu ile opere edildi. Buhasta grupları arasında kros klemp ve kardiyopulmoner by-pass zamanları ileyoğun bakım ve entübasyon süreleri ve kan ürünü replasman gereksinimlerikarşılaştırıldı.Bulgular: Hastalarda mortalite gözlenmedi. Bir buçuk ventrikül tamiri uygulananhastalarda Danielson uygulanan hasta grubuna göre hem kros klemp (p=0,044) hemde kardiyopulmoner by-pass süresi (p=0,044) daha az izlendi. Diğer yönden ikigrup arasında yoğun bakım yatış süreleri (p=0,400) veya entübasyon süreleri(p=0,889) arasında anlamlı fark izlenmedi. Danielson ameliyatı uygulanan ikiinfant hasta hesaplamaya dahil edilmediği durumda yapılan karşılaştırmada, kanürünü gereksinimi ve drenaj miktarlarında gruplar arasında belirgin farkizlenmedi.Sonuç: Danielson metodu, infantyaş grubunda Ebstein anomalisi tedavisinde diğer tanımlanmış tamir yöntemlerinebenzer klinik sonuçlarla, güvenli ve etkin bir biçimde uygulanabilir. Yine debir buçuk ventrikül tamir seçeneği geniş atriyalize ventrikülü olan hastalardafaydalı bir yöntemdir. Nihai karar hastanın karakteri ve cerrahi ekibin geçmiştecrübeleri göz önüne alınarak kalp ekibi tarafından verilmelidir.

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