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Eur J Cardiothorac Surg 2005;28:536-540
© 2005 Elsevier Science NL

Original articles

Advantages and disadvantages of one-stage and two-stage surgery for arrhythmias and Ebstein's anomaly

Bakoulev Scientific Center for Cardiovascular surgery, Rublevskoe shosse 135, Moscow 121552, Russian Federation

Received 22 October 2004; received in revised form 25 April 2005; accepted 25 April 2005.

^* Corresponding authors. Tel.: +7 95 414 7571; fax: +7 95 414 7867. (Email: leoan{at}online.ru; dadashevam{at}mail.ru).
^** Tel.: +7 095 414 7651; fax: +7 095 414 7973. (Email: leoan{at}online.ru; dadashevam{at}mail.ru).

Abstract

Objective: To evaluate efficacy of one-step and two-step surgery approach in patients with arrhythmias combined with Ebstein's anomaly. Methods: Fifty-three patients with Ebstein's anomaly combined with tachyarrhythmias (58.5% men, 41.5% women, mean age 21.6±10.7 years) were operated on. In group A (32 patients), one-step surgical correction (simultaneous intraoperative elimination of arrhythmias and congenital heart defect repair) was performed, whereas in group B (21 patients), two-step surgery was performed with initial elimination of arrhythmogenic substrate by transcatheter radiofrequency ablation (first step) and following surgical repair of congenital heart defect (second step). Results: In group A, total hospital mortality was 3.1% (1 patient) due to initial severe condition of this patient. One-step surgery was effective in 93.5% of cases. Mortality was not observed in group B. Efficacy of transcatheter radiofrequency ablation was 76.2%. Conclusions: one-stage and two-stage surgery of arrhythmias and Ebstein's anomaly are highly effective. First step of surgery of combined pathology reduces cardiopulmonary bypass time, complications and mortality while performing the second step of congenital heart defect surgery. However, simultaneous approach (one-step surgery) is better in terms of arrhythmia elimination.

Key Words: Ebstein's anomaly • Congenital heart defect • Arrhythmias • Wolff–Parkinson–White syndrome • Open heart surgery • Radiofrequency ablation

This article has been cited by other articles:

				C. H. Attenhofer Jost, H. M. Connolly, J. A. Dearani, W. D. Edwards, and G. K. Danielson Ebstein's Anomaly Circulation, January 16, 2007; 115(2): 277 - 285. [Full Text] [PDF]