Right Ventricular Exclusion and Univentricular Palliation for Failed One and a Half Ventricle Repair for Ebstein's Anomaly

• Published in: Heart, lung & circulation Vol. 22; no. 8; pp. 685 - 687
• Main Authors: Sasikumar, Navaneetha, Krishna Manohar, Soman R., Philip, Saji, Cherian, Kottoorathu Mammen, Suresh Kumar, Raghavannair
• Format: Journal Article
• Language: English
• Published: Australia Elsevier B.V 01.08.2013
• Subjects: Adult; Cardiopulmonary Bypass; Cardiovascular; Ebstein Anomaly - complications; Ebstein Anomaly - pathology; Ebstein Anomaly - physiopathology; Ebstein Anomaly - surgery; Ebstein's anomaly; Fontan surgery; Heart Ventricles - pathology; Heart Ventricles - physiopathology; Heart Ventricles - surgery; Humans; Male; One and a half ventricle repair; Right ventricular dysfunction; Right ventricular exclusion; Ventricular Dysfunction, Right - complications; Ventricular Dysfunction, Right - pathology; Ventricular Dysfunction, Right - physiopathology; Ventricular Dysfunction, Right - surgery; Right ventricular exclusion; Ebstein's anomaly; One and a half ventricle repair; Right ventricular dysfunction; Fontan surgery
• ISSN: 1443-9506; 1444-2892; 1444-2892
• DOI: 10.1016/j.hlc.2012.11.019

A 20 year-old male was diagnosed to have Ebstein's anomaly with severe right ventricular dysfunction. He was taken up for 1.5 ventricle repair. Post procedure, there was difficulty in weaning from cardiopulmonary bypass due to progressive right ventricular dilatation compromising the systemic output. An atrial septectomy did not help. Progressive right ventricular dilatation compressing the left ventricle, demonstrated on transoesophageal echocardiogram, prompted us to perform a right ventricular exclusion and univentricular palliation. The patient was successfully weaned off cardiopulmonary bypass and had a smooth postoperative recovery. Judicious use of right ventricular exclusion and univentricular palliation could be an effective bailout strategy in difficult surgical scenarios in Ebstein's anomaly.