Ebstein's anomaly: sixteen years' experience with valve replacement without plication of the right ventricle.

From June 1967 to February 1983 10 patients aged from 13 to 51 years underwent surgery for Ebstein's anomaly. Nine patients were in class III according to the New York Heart Association (NYHA) classification and one was in class IV. The interatrial communication was closed in all patients; the tricuspid valve was repaired in one patient and replaced in the other nine patients. There were no deaths in hospital but there were two late deaths. One patient died when the tricuspid prosthesis clotted seven years after its insertion. The other patient committed suicide 11 years after surgery. The remaining eight patients have been followed up for periods ranging from six months to 16 years (mean 10 years). Seven of the eight survivors are well and in NYHA class I, the eighth being in class II. Cardiac arrhythmias have been a problem in only one patient. Tricuspid valve replacement combined with closure of interatrial communication without right ventricular plication has given satisfactory clinical results and has improved the quality of life.