Hetzer's Procedure for Ebstein's Anomaly in an Adult

(Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan)

Hiroyuki Nagahama Yasunori Fukushima Takuya Fukuda
Takahiro Hayase Makoto Yoshioka
Ebstein's anomaly is a rare congenital heart disease. A 51-year-old man was hospitalized due to Ebstein's anomaly with severe congestive heart failure. He underwent Hetzer's procedure for tricuspid valve incompetence and right atrial isolation technique to restore the sinus rhythm. The postoperative course was uneventful, he was discharged from the hospital on the 21st day after the operation. The cardiothoracic ratio reduced from 74% before the operation to 60%. And his New York Heart Association functional class also improved from III to I after discharge. Hetzer's procedure for tricuspid valve repair in Ebstein's anomaly restructures the valve mechanism at the level of the true tricuspid annulus by using the most mobile leaflet for valve closure without plication of the atrialized chamber. We thus conclude that Hetzer's procedure, with anatomical evaluation of the malformed tricuspid valves before or during the operation, is beneficial as a simple and reproducible method for the repair of certain cases of Ebstein's anomaly.
@Jpn. J. Cardiovasc. Surg. 35: 57-59 (2006)