Cardiac arrhythmia in patients undergoing surgical repair of Ebstein's anomaly
Identifieur interne : 001088 ( PascalFrancis/Checkpoint ); précédent : 001087; suivant : 001089Cardiac arrhythmia in patients undergoing surgical repair of Ebstein's anomaly
Auteurs : Sylvain M. Chauvaud [France] ; Gianluca Brancaccio [France] ; Alain F. Carpentier [France]Source :
- The Annals of thoracic surgery [ 0003-4975 ] ; 2001.
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Abstract
Background. Arrhythmias remain an unsolved problem in Ebstein's anomaly. The aim of this study was to investigate the evolution of arrhythmias after surgical repair. Methods. Forty-five patients with Ebstein's anomaly and arrhythmias were studied. Mean age was 33 ± 15 years. Twenty-four patients (53%) had paroxysmal supraventricular tachycardia, 12 (27%) had atrial fibrillation or flutter, 8 (18%) had ventricular preexcitation (Wolff-Parkinson-White syndrome), and 1 (2%) had a nonsustained ventricular tachycardia. Surgical technique included detachment of the tricuspid anterior leaflet and suture on the atrioventricular annulus associated with right ventricular longitudinal plication. Results. There were four hospital deaths (9%). A pacemaker was implanted early after operation in 5 patients (11%). During a mean follow-up of 57 ± 50 months (range, 4 to 226 months), there were six additional deaths, three of which were sudden. Two patients were lost to follow-up. Of the 33 surviving patients, 8 (24%) continued to have symptomatic arrhythmias, and 15 (45%) were in permanent sinus rhythm. Of the 24 patients with preoperative paroxysmal supraventricular tachycardia and the 12 with atrial fibrillation or flutter preoperatively, 9 and 2 of the survivors, respectively, have had no further episodes of arrhythmia. The incidence of arrhythmia with or without symptoms was reduced to 39% (13/33) of the surviving patients. Conclusions. Arrhythmia is not totally abolished after operation. However, patients with Ebstein's anomaly and arrhythmia show substantial improvement after conservative surgical intervention.
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Chauvaud</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Cardiovascular Surgery, Hopital Européen Georges Pompidou</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Brancaccio, Gianluca" sort="Brancaccio, Gianluca" uniqKey="Brancaccio G" first="Gianluca" last="Brancaccio">Gianluca Brancaccio</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Cardiovascular Surgery, Hopital Européen Georges Pompidou</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Carpentier, Alain F" sort="Carpentier, Alain F" uniqKey="Carpentier A" first="Alain F." last="Carpentier">Alain F. 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Chauvaud</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Cardiovascular Surgery, Hopital Européen Georges Pompidou</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Brancaccio, Gianluca" sort="Brancaccio, Gianluca" uniqKey="Brancaccio G" first="Gianluca" last="Brancaccio">Gianluca Brancaccio</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Cardiovascular Surgery, Hopital Européen Georges Pompidou</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Carpentier, Alain F" sort="Carpentier, Alain F" uniqKey="Carpentier A" first="Alain F." last="Carpentier">Alain F. Carpentier</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Cardiovascular Surgery, Hopital Européen Georges Pompidou</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">The Annals of thoracic surgery</title><title level="j" type="abbreviated">Ann. thorac. surg.</title><idno type="ISSN">0003-4975</idno><imprint><date when="2001">2001</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The Annals of thoracic surgery</title><title level="j" type="abbreviated">Ann. thorac. surg.</title><idno type="ISSN">0003-4975</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arrhythmia</term><term>Complication</term><term>Ebstein anomaly of the tricuspid valve</term><term>Evolution</term><term>Human</term><term>Morbidity</term><term>Mortality</term><term>Pathophysiology</term><term>Prognosis</term><term>Surgery</term><term>Technique</term><term>Treatment</term><term>Treatment efficiency</term><term>Tricuspid valve</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Malformation tricuspide Ebstein</term><term>Homme</term><term>Chirurgie</term><term>Trouble rythme cardiaque</term><term>Complication</term><term>Physiopathologie</term><term>Traitement</term><term>Efficacité traitement</term><term>Technique</term><term>Pronostic</term><term>Mortalité</term><term>Morbidité</term><term>Evolution</term><term>Valvule tricuspide</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Chirurgie</term><term>Mortalité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background. Arrhythmias remain an unsolved problem in Ebstein's anomaly. The aim of this study was to investigate the evolution of arrhythmias after surgical repair. Methods. Forty-five patients with Ebstein's anomaly and arrhythmias were studied. Mean age was 33 ± 15 years. Twenty-four patients (53%) had paroxysmal supraventricular tachycardia, 12 (27%) had atrial fibrillation or flutter, 8 (18%) had ventricular preexcitation (Wolff-Parkinson-White syndrome), and 1 (2%) had a nonsustained ventricular tachycardia. Surgical technique included detachment of the tricuspid anterior leaflet and suture on the atrioventricular annulus associated with right ventricular longitudinal plication. Results. There were four hospital deaths (9%). A pacemaker was implanted early after operation in 5 patients (11%). During a mean follow-up of 57 ± 50 months (range, 4 to 226 months), there were six additional deaths, three of which were sudden. Two patients were lost to follow-up. Of the 33 surviving patients, 8 (24%) continued to have symptomatic arrhythmias, and 15 (45%) were in permanent sinus rhythm. Of the 24 patients with preoperative paroxysmal supraventricular tachycardia and the 12 with atrial fibrillation or flutter preoperatively, 9 and 2 of the survivors, respectively, have had no further episodes of arrhythmia. The incidence of arrhythmia with or without symptoms was reduced to 39% (13/33) of the surviving patients. Conclusions. Arrhythmia is not totally abolished after operation. However, patients with Ebstein's anomaly and arrhythmia show substantial improvement after conservative surgical intervention.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0003-4975</s0></fA01><fA02 i1="01"><s0>ATHSAK</s0></fA02><fA03 i2="1"><s0>Ann. thorac. surg.</s0></fA03><fA05><s2>71</s2></fA05><fA06><s2>5</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Cardiac arrhythmia in patients undergoing surgical repair of Ebstein's anomaly</s1></fA08><fA11 i1="01" i2="1"><s1>CHAUVAUD (Sylvain M.)</s1></fA11><fA11 i1="02" i2="1"><s1>BRANCACCIO (Gianluca)</s1></fA11><fA11 i1="03" i2="1"><s1>CARPENTIER (Alain F.)</s1></fA11><fA14 i1="01"><s1>Department of Cardiovascular Surgery, Hopital Européen Georges Pompidou</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></fA14><fA20><s1>1547-1552</s1></fA20><fA21><s1>2001</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>13779</s2><s5>354000098281960250</s5></fA43><fA44><s0>0000</s0><s1>© 2001 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>22 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>01-0286478</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>The Annals of thoracic surgery</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Background. Arrhythmias remain an unsolved problem in Ebstein's anomaly. The aim of this study was to investigate the evolution of arrhythmias after surgical repair. Methods. Forty-five patients with Ebstein's anomaly and arrhythmias were studied. Mean age was 33 ± 15 years. Twenty-four patients (53%) had paroxysmal supraventricular tachycardia, 12 (27%) had atrial fibrillation or flutter, 8 (18%) had ventricular preexcitation (Wolff-Parkinson-White syndrome), and 1 (2%) had a nonsustained ventricular tachycardia. Surgical technique included detachment of the tricuspid anterior leaflet and suture on the atrioventricular annulus associated with right ventricular longitudinal plication. Results. There were four hospital deaths (9%). A pacemaker was implanted early after operation in 5 patients (11%). During a mean follow-up of 57 ± 50 months (range, 4 to 226 months), there were six additional deaths, three of which were sudden. Two patients were lost to follow-up. Of the 33 surviving patients, 8 (24%) continued to have symptomatic arrhythmias, and 15 (45%) were in permanent sinus rhythm. Of the 24 patients with preoperative paroxysmal supraventricular tachycardia and the 12 with atrial fibrillation or flutter preoperatively, 9 and 2 of the survivors, respectively, have had no further episodes of arrhythmia. The incidence of arrhythmia with or without symptoms was reduced to 39% (13/33) of the surviving patients. Conclusions. Arrhythmia is not totally abolished after operation. 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Chauvaud</name></region><name sortKey="Brancaccio, Gianluca" sort="Brancaccio, Gianluca" uniqKey="Brancaccio G" first="Gianluca" last="Brancaccio">Gianluca Brancaccio</name><name sortKey="Carpentier, Alain F" sort="Carpentier, Alain F" uniqKey="Carpentier A" first="Alain F." last="Carpentier">Alain F. Carpentier</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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