Journal of Clinical Pediatrics ›› 2021, Vol. 39 ›› Issue (7): 511-.doi: 10.3969/j.issn.1000-3606.2021.07.008

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Treatment strategy for Carpentier C-type Ebstein’s anomaly in children

QIN Rong, WANG Tingting, ZHOU Xu, LI Yangxin, ZHOU Zhenfa, HONG Haifa, QIU Lisheng   

  1. Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
  • Published:2021-07-01

Abstract: Objective To explore the application of three different surgical methods in Carpentier C-type Ebstein’s anomaly (EA). Methods The clinical data of Carpentier C-type EA in 39 children who underwent surgery from June 2011 to August 2017 were retrospectively analyzed. Results A total of 39 children (18 boys and 21 girls) with Carpentier C-type EA were included. The median age was 28.3 (11.7-63.4) months and the median weight was 12.6 (8.7-19.2) kg. Among them, 13 patients underwent cone reconstruction (CR) surgery only (group A), 18 patients underwent CR combined with bidirectional cavo-pulmonary shunt (BCPS, group B), and 8 patients only underwent BCPS (group C). There were significant differences in the proportion of preoperative cyanosis and cardiac function classification among the three groups (P< 0 . 05 ). The children in group C had a higher proportion of preoperative cyanosis and worse cardiac function (grade Ⅲ and Ⅳ). The differences in the cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, mechanical ventilation time, ICU stay time, postoperative hospital stay, incidence of low cardiac output syndrome, treatment cost during hospitalization and follow-up time among the three groups were statistically significant (P< 0 . 05 ). Pairwise comparisons showed that the CPB time, ACC time, mechanical ventilation time, ICU stay time, and postoperative hospital stay of group B were longer than those of group C, while the treatment cost during hospitalization of group C was higher than that of group A, and the differences were statistically significant (P

Key words: Ebstein’s anomaly; cone reconstruction; bidirectional cavo-pulmonary shunt