Chinese expert consensus on the surgical treatment of Ebstein anomaly in children and adults_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Hao ¹ , YANG Keming ² ,  CHEN Jimei ³ ,  CHEN Liangwan ⁴ ,  LI Shoujun ² , on behalf of the Congenital Heart Disease Committee of the National Expert Committee on Cardiovascular Diseases

1. Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200000, P. R. China;
2. Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P. R. China;
3. Guangdong Provincial People's Hospital, Guangzhou, 510180, P. R. China;
4. Union Hospital, Fujian Medical University, Fuzhou, 350001, P. R. China;

Corresponding author：

CHEN Jimei, Email: jimei1965@gmail.com; CHEN Liangwan, Email: chenliangwan@fjmu.edu; LI Shoujun, Email: drlishoujunfw@163.com

Keywords：

Congenital heart disease; Ebstein anomaly; surgery; treatment; expert consensus

DOI：

10.7507/1007-4848.202510035

Video：

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Abstract Full text Figures/Tables Video References Cited by

Ebstein anomaly (EA) is a rare type of congenital heart defect. Its incidence ranges from 0.005‰ to 0.025‰ among live-born fetuses. It is characterized by the displacement of the septal and posterior leaflets of the tricuspid valve toward the apex of the right ventricle, along with the atrialization and thinning of the right ventricle. Based on the severity of these anatomical features, EA can be classified into four types.The degree of hemodynamic abnormalities mainly depends on factors such as the volume of the atrialized right ventricle (aRV), tricuspid regurgitation, and right ventricular function. The main clinical manifestations include: heart failure, cyanosis, and arrhythmia. Echocardiography is the first-choice examination method for confirming the diagnosis. In addition, cardiac magnetic resonance (CMR) is recognized as the gold standard for evaluating tricuspid regurgitation index and right ventricular function, and it holds significant value in the preoperative diagnosis of EA, treatment decision-making, and postoperative follow-up. Surgical intervention is the primary treatment approach. Although multiple surgical methods exist, the current Cone reconstruction technique is the preferred surgical procedure for this disease. Based on evidence-based data from literature and expert opinions, this article provides a comprehensive summary and recommendations regarding the clinical classification, diagnostic criteria, surgical treatment strategies, management of complications, and prognosis evaluation of EA.

1.	Ebstein W. Ueber einen sehr seltenen fall von insufficienz der valvula tricuspidalis, bedingt durch eine angeborene hochgradige missbildung derselben. Arch Anat Physiol, 1866: 238-254.
2.	Khositseth A, Danielson GK, Dearani JA, et al. Supraventricular tachyarrhythmias in Ebstein anomaly: management and outcome. J Thorac Cardiovasc Surg, 2004, 128(5): 826-833.
3.	Genton E, Blount SG Jr. The spectrum of Ebstein’s anomaly. Am Heart J, 1967, 73(3): 395-425.
4.	Saxena A, Fong LV, Tristam M, et al. Late noninvasive evaluation of cardiac performance in mildly symptomatic older patients with Ebstein’s anomaly of tricuspid valve: role of radionuclide imaging. J Am Coll Cardiol, 1991, 17(1): 182-186.
5.	da Silva JP, Baumgratz JF, da Fonseca L, et al. The cone reconstruction of the tricuspid valve in Ebstein’s anomaly: the operation: early and midterm results. J Thorac Cardiovasc Surg, 2007, 133(1): 215-223.
6.	Carpentier A, Chauvaud S, Macé L, et al. A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg, 1988, 96(1): 92-101.
7.	Neumann S, Rüffer A, Sachweh J, et al. Narrative review of Ebstein’s anomaly beyond childhood: imaging, surgery, and future perspectives. Cardiovasc Diagn Ther, 2021, 11(6): 1310-1323.
8.	Farhan M, Prajjwal P, Sai VP, et al. Neurological, extracardiac, and cardiac manifestations of Ebstein’s anomaly along with its genetics, diagnostic techniques, treatment updates, and the future ahead. Cureus, 2023, 15(2): e35115.
9.	Schultz K, Haeffele CL. Heart failure in the adult Ebstein patient. Heart Fail Rev, 2020, 25(4): 623-632.
10.	Pasqualin G, Boccellino A, Chessa M, et al. Ebstein’s anomaly in children and adults: multidisciplinary insights into imaging and therapy. Heart, 2024, 110(4): 235-244.
11.	Fuchs MM, Connolly HM. Ebstein anomaly in the adult patient. Cardiol Clin, 2020, 38(3): 353-363.
12.	Attenhofer Jost CH, Connolly HM, Dearani JA, et al. Ebstein’s anomaly. Circulation, 2007, 115(2): 277-285.
13.	Benson LN, Child JS, Schwaiger M, et al. Left ventricular geometry and function in adults with Ebstein’s anomaly of the tricuspid valve. Circulation, 1987, 75(2): 353-359.
14.	Bitterman Y, Friedberg MK. Ventricular-ventricular interactions in critically ill infants with Ebstein anomaly or dysplasia of the tricuspid valve: time to remember the forgotten left ventricle. J Am Soc Echocardiogr, 2024, 37(2): 255-258.
15.	Lee AH, Moore IE, Fagg NL, et al. Histological changes in the left and right ventricle in hearts with Ebstein’s malformation and tricuspid valvar dysplasia: a morphometric study of patients dying in the fetal and perinatal periods. Cardiovasc Pathol, 1995, 4(1): 19-24.
16.	Kumor M, Lipczyńska M, Biernacka EK, et al. Cardiac arrest and ventricular arrhythmia in adults with Ebstein anomaly and left ventricular non-compaction. J Cardiol, 2018, 71(5): 484-487.
17.	Dearani JA, Mora BN, Nelson TJ, et al. Ebstein anomaly review: what’s now, what’s next? Expert Rev Cardiovasc Ther, 2015, 13(10): 1101-1109.
18.	Possner M, Gensini FJ, Mauchley DC, et al. Ebstein’s anomaly of the tricuspid valve: an overview of pathology and management. Curr Cardiol Rep, 2020, 22(12): 157.
19.	Delhaas T, Sarvaas GJ, Rijlaarsdam ME, et al. A multicenter, long-term study on arrhythmias in children with Ebstein anomaly. Pediatr Cardiol, 2010, 31(2): 229-233.
20.	Oh JK, Holmes DR Jr, Hayes DL, et al. Cardiac arrhythmias in patients with surgical repair of Ebstein’s anomaly. J Am Coll Cardiol, 1985, 6(6): 1351-1357.
21.	Watson H. Natural history of Ebstein’s anomaly of tricuspid valve in childhood and adolescence: an international co-operative study of 505 cases. Br Heart J, 1974, 36(5): 417-427.
22.	Davidson LJ, Tang GHL, Ho EC, et al. The tricuspid valve: a review of pathology, imaging, and current treatment options: a scientific statement from the American Heart Association. Circulation, 2024, 149(22): e1223-e1238.
23.	Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr, 2015, 28(1): 1-39. e14.
24.	Egbe AC, Miranda WR, Jain CC, et al. Prognostic performance of right ventricular global longitudinal strain measurements in patients with Ebstein anomaly. J Am Coll Cardiol, 2023, 82(6): 503-513.
25.	Qureshi MY, O'Leary PW, Connolly HM. Cardiac imaging in Ebstein anomaly. Trends Cardiovasc Med, 2018, 28(6): 403-409.
26.	Antunes MJ, Rodríguez-Palomares J, Prendergast B, et al. Management of tricuspid valve regurgitation: position statement of the European Society of Cardiology Working Groups of Cardiovascular Surgery and Valvular Heart Disease. Eur J Cardiothorac Surg, 2017, 52(6): 1022-1030.
27.	Geerdink LM, van Everdingen WM, Kuipers IM, et al. Comprehensive evaluation of pediatric patients with Ebstein anomaly requires both echocardiography and cardiac magnetic resonance imaging. Pediatr Cardiol, 2023, 44(1): 75-85.
28.	Fernandez-Badillo V, Serrano-Roman J, Antonio-Villa NE, et al. Assessment of left ventricular myocardial fibrosis in adult patients with Ebstein anomaly: a retrospective cohort study based on cardiac magnetic resonance and histopathological samples. Circ Cardiovasc Imaging, 2023, 16(5): e015011.
29.	Nakamura I, Kotooka N, Komori Y, et al. Ebstein anomaly by cardiac magnetic resonance imaging. J Am Coll Cardiol, 2009, 53(17): 1568.
30.	Sharma V, Sharma A, Kumar V. Himalayan P waves. Intern Emerg Med, 2011, 6(1): 81-82.
31.	Giuliani ER, Fuster V, Brandenburg RO, et al. Ebstein’s anomaly: the clinical features and natural history of Ebstein’s anomaly of the tricuspid valve. Mayo Clin Proc, 1979, 54(3): 163-173.
32.	Hebe J. Ebstein’s anomaly in adults: arrhythmias: diagnosis and therapeutic approach. Thorac Cardiovasc Surg, 2000, 48(4): 214-219.
33.	Ho SY, Goltz D, McCarthy K, et al. The atrioventricular junctions in Ebstein malformation. Heart, 2000, 83(4): 444-449.
34.	Smith WM, Gallagher JJ, Kerr CR, et al. The electrophysiologic basis and management of symptomatic recurrent tachycardia in patients with Ebstein’s anomaly of the tricuspid valve. Am J Cardiol, 1982, 49(5): 1223-1234.
35.	Viray MC, Wiener PC, Batnyam U, et al. A young woman with recurrent palpitations: a case of Ebstein anomaly with Mahaim fiber tachycardia. CASE (Phila), 2019, 3(4): 145-148.
36.	Anderson KR, Zuberbuhler JR, Anderson RH, et al. Morphologic spectrum of Ebstein’s anomaly of the heart: a review. Mayo Clin Proc, 1979, 54(3): 174-180.
37.	Radojevic J, Inuzuka R, Alonso-Gonzalez R, et al. Peak oxygen uptake correlates with disease severity and predicts outcome in adult patients with Ebstein’s anomaly of the tricuspid valve. Int J Cardiol, 2013, 163(3): 305-308.
38.	Buber J, Vatury O, Klempfner R, et al. The impact of tricuspid valve regurgitation severity on exercise capacity and cardiac-related hospitalisations among adults with non-operated Ebstein’s anomaly. Cardiol Young, 2019, 29(6): 800-807.
39.	Cifra B, Cordina RL, Gauthier N, et al. Cardiopulmonary exercise test interpretation across the lifespan in congenital heart disease: a scientific statement from the American Heart Association. J Am Heart Assoc, 2025, 14(4): e038200.
40.	凌靖, 温树生. 三尖瓣下移畸形诊断与治疗进展. 中国心血管病研究, 2024, 22(5): 405-409.Ling J, Wen SS. Ebstein's anomaly: diagnosis and management. Chin J Cardiovasc Res, 2024, 22(5): 405-409.
41.	Yang Y, Zhang W, Liu Y, et al. Preoperative percutaneous oxygen saturation is a predictor of postoperative adverse events after Ebstein’s anomaly reconstruction. J Card Surg, 2021, 36(3): 1012-1017.
42.	He Y, Feng Y, Zhang TZ, et al. Analysis of the risk factors of delayed extubation after surgery for Ebstein’s anomaly. J Cardiothorac Surg, 2025, 20(1): 56.
43.	Mrad Agua K, Burri M, Cleuziou J, et al. Preoperative predictability of right ventricular failure following surgery for Ebstein’s anomaly. Eur J Cardiothorac Surg, 2019, 55(6): 1187-1193.
44.	Burri M, Mrad Agua K, Cleuziou J, et al. Cone versus conventional repair for Ebstein’s anomaly. J Thorac Cardiovasc Surg, 2020, 160(6): 1545-1553.
45.	Park I, Jun TG, Yang JH, et al. Long-term outcomes of modified cone reconstruction for Ebstein’s anomaly in pediatric patients in a single center. Korean Circ J, 2024, 54(2): 78-90.
46.	Lou Q, Zou Y, Wu J, et al. Impact of Cone vs. Hetzer repair on postoperative outcomes in patients with Ebstein’s anomaly: 10-year experience from a single institution. Front Cardiovasc Med, 2021, 8: 710168.
47.	Phillips KA, Dearani JA, Wackel PL, et al. Contemporary early postoperative cone repair outcomes for patients with Ebstein anomaly. Mayo Clin Proc, 2023, 98(2): 290-298.
48.	Dearani JA, Bacha E, Da Silva JP. Cone reconstruction of the tricuspid valve for Ebstein’s anomaly: anatomic repair. Oper Tech Thorac Cardiovasc Surg, 2008, 13(2): 109-125.
49.	Dearani JA. Ebstein repair: how I do it. J Thorac Cardiovasc Surg Tech, 2020, 3: 269-276.
50.	Sainathan S, da Fonseca da Silva L, da Silva JP. Ebstein’s anomaly: contemporary management strategies. J Thorac Dis, 2020, 12(3): 1161-1173.
51.	Quinonez LG, Dearani JA, Puga FJ, et al. Results of the 1. 5-ventricle repair for Ebstein anomaly and the failing right ventricle. J Thorac Cardiovasc Surg, 2007, 133(5): 1303-1310.
52.	Liu J, Qiu L, Zhu Z, et al. Cone reconstruction of the tricuspid valve in Ebstein anomaly with or without one and a half ventricle repair. J Thorac Cardiovasc Surg, 2011, 141(5): 1178-1183.
53.	Stephens EH, Qureshi MY, Anderson JH, et al. Bidirectional cavopulmonary shunt for right ventricular unloading. Ann Thorac Surg, 2021, 111(5): 1435-1441.
54.	Das BB, Chrisant M, Lavandosky G, et al. An adolescent with left ventricular noncompaction and Ebstein anomaly presenting with advanced heart failure: discharge from hospital with a biventricular assist device. J Pediatr, 2018, 202: 304-310.
55.	Husain SA, Brown JW. When reconstruction fails or is not feasible: valve replacement options in the pediatric population. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2007: 117-124.
56.	Kiziltan HT, Theodoro DA, Warnes CA, et al. Late results of bioprosthetic tricuspid valve replacement in Ebstein’s anomaly. Ann Thorac Surg, 1998, 66(5): 1539-1545.
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1. Ebstein W. Ueber einen sehr seltenen fall von insufficienz der valvula tricuspidalis, bedingt durch eine angeborene hochgradige missbildung derselben. Arch Anat Physiol, 1866: 238-254.
2. Khositseth A, Danielson GK, Dearani JA, et al. Supraventricular tachyarrhythmias in Ebstein anomaly: management and outcome. J Thorac Cardiovasc Surg, 2004, 128(5): 826-833.
3. Genton E, Blount SG Jr. The spectrum of Ebstein’s anomaly. Am Heart J, 1967, 73(3): 395-425.
4. Saxena A, Fong LV, Tristam M, et al. Late noninvasive evaluation of cardiac performance in mildly symptomatic older patients with Ebstein’s anomaly of tricuspid valve: role of radionuclide imaging. J Am Coll Cardiol, 1991, 17(1): 182-186.
5. da Silva JP, Baumgratz JF, da Fonseca L, et al. The cone reconstruction of the tricuspid valve in Ebstein’s anomaly: the operation: early and midterm results. J Thorac Cardiovasc Surg, 2007, 133(1): 215-223.
6. Carpentier A, Chauvaud S, Macé L, et al. A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg, 1988, 96(1): 92-101.
7. Neumann S, Rüffer A, Sachweh J, et al. Narrative review of Ebstein’s anomaly beyond childhood: imaging, surgery, and future perspectives. Cardiovasc Diagn Ther, 2021, 11(6): 1310-1323.
8. Farhan M, Prajjwal P, Sai VP, et al. Neurological, extracardiac, and cardiac manifestations of Ebstein’s anomaly along with its genetics, diagnostic techniques, treatment updates, and the future ahead. Cureus, 2023, 15(2): e35115.
9. Schultz K, Haeffele CL. Heart failure in the adult Ebstein patient. Heart Fail Rev, 2020, 25(4): 623-632.
10. Pasqualin G, Boccellino A, Chessa M, et al. Ebstein’s anomaly in children and adults: multidisciplinary insights into imaging and therapy. Heart, 2024, 110(4): 235-244.
11. Fuchs MM, Connolly HM. Ebstein anomaly in the adult patient. Cardiol Clin, 2020, 38(3): 353-363.
12. Attenhofer Jost CH, Connolly HM, Dearani JA, et al. Ebstein’s anomaly. Circulation, 2007, 115(2): 277-285.
13. Benson LN, Child JS, Schwaiger M, et al. Left ventricular geometry and function in adults with Ebstein’s anomaly of the tricuspid valve. Circulation, 1987, 75(2): 353-359.
14. Bitterman Y, Friedberg MK. Ventricular-ventricular interactions in critically ill infants with Ebstein anomaly or dysplasia of the tricuspid valve: time to remember the forgotten left ventricle. J Am Soc Echocardiogr, 2024, 37(2): 255-258.
15. Lee AH, Moore IE, Fagg NL, et al. Histological changes in the left and right ventricle in hearts with Ebstein’s malformation and tricuspid valvar dysplasia: a morphometric study of patients dying in the fetal and perinatal periods. Cardiovasc Pathol, 1995, 4(1): 19-24.
16. Kumor M, Lipczyńska M, Biernacka EK, et al. Cardiac arrest and ventricular arrhythmia in adults with Ebstein anomaly and left ventricular non-compaction. J Cardiol, 2018, 71(5): 484-487.
17. Dearani JA, Mora BN, Nelson TJ, et al. Ebstein anomaly review: what’s now, what’s next? Expert Rev Cardiovasc Ther, 2015, 13(10): 1101-1109.
18. Possner M, Gensini FJ, Mauchley DC, et al. Ebstein’s anomaly of the tricuspid valve: an overview of pathology and management. Curr Cardiol Rep, 2020, 22(12): 157.
19. Delhaas T, Sarvaas GJ, Rijlaarsdam ME, et al. A multicenter, long-term study on arrhythmias in children with Ebstein anomaly. Pediatr Cardiol, 2010, 31(2): 229-233.
20. Oh JK, Holmes DR Jr, Hayes DL, et al. Cardiac arrhythmias in patients with surgical repair of Ebstein’s anomaly. J Am Coll Cardiol, 1985, 6(6): 1351-1357.
21. Watson H. Natural history of Ebstein’s anomaly of tricuspid valve in childhood and adolescence: an international co-operative study of 505 cases. Br Heart J, 1974, 36(5): 417-427.
22. Davidson LJ, Tang GHL, Ho EC, et al. The tricuspid valve: a review of pathology, imaging, and current treatment options: a scientific statement from the American Heart Association. Circulation, 2024, 149(22): e1223-e1238.
23. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr, 2015, 28(1): 1-39. e14.
24. Egbe AC, Miranda WR, Jain CC, et al. Prognostic performance of right ventricular global longitudinal strain measurements in patients with Ebstein anomaly. J Am Coll Cardiol, 2023, 82(6): 503-513.
25. Qureshi MY, O'Leary PW, Connolly HM. Cardiac imaging in Ebstein anomaly. Trends Cardiovasc Med, 2018, 28(6): 403-409.
26. Antunes MJ, Rodríguez-Palomares J, Prendergast B, et al. Management of tricuspid valve regurgitation: position statement of the European Society of Cardiology Working Groups of Cardiovascular Surgery and Valvular Heart Disease. Eur J Cardiothorac Surg, 2017, 52(6): 1022-1030.
27. Geerdink LM, van Everdingen WM, Kuipers IM, et al. Comprehensive evaluation of pediatric patients with Ebstein anomaly requires both echocardiography and cardiac magnetic resonance imaging. Pediatr Cardiol, 2023, 44(1): 75-85.
28. Fernandez-Badillo V, Serrano-Roman J, Antonio-Villa NE, et al. Assessment of left ventricular myocardial fibrosis in adult patients with Ebstein anomaly: a retrospective cohort study based on cardiac magnetic resonance and histopathological samples. Circ Cardiovasc Imaging, 2023, 16(5): e015011.
29. Nakamura I, Kotooka N, Komori Y, et al. Ebstein anomaly by cardiac magnetic resonance imaging. J Am Coll Cardiol, 2009, 53(17): 1568.
30. Sharma V, Sharma A, Kumar V. Himalayan P waves. Intern Emerg Med, 2011, 6(1): 81-82.
31. Giuliani ER, Fuster V, Brandenburg RO, et al. Ebstein’s anomaly: the clinical features and natural history of Ebstein’s anomaly of the tricuspid valve. Mayo Clin Proc, 1979, 54(3): 163-173.
32. Hebe J. Ebstein’s anomaly in adults: arrhythmias: diagnosis and therapeutic approach. Thorac Cardiovasc Surg, 2000, 48(4): 214-219.
33. Ho SY, Goltz D, McCarthy K, et al. The atrioventricular junctions in Ebstein malformation. Heart, 2000, 83(4): 444-449.
34. Smith WM, Gallagher JJ, Kerr CR, et al. The electrophysiologic basis and management of symptomatic recurrent tachycardia in patients with Ebstein’s anomaly of the tricuspid valve. Am J Cardiol, 1982, 49(5): 1223-1234.
35. Viray MC, Wiener PC, Batnyam U, et al. A young woman with recurrent palpitations: a case of Ebstein anomaly with Mahaim fiber tachycardia. CASE (Phila), 2019, 3(4): 145-148.
36. Anderson KR, Zuberbuhler JR, Anderson RH, et al. Morphologic spectrum of Ebstein’s anomaly of the heart: a review. Mayo Clin Proc, 1979, 54(3): 174-180.
37. Radojevic J, Inuzuka R, Alonso-Gonzalez R, et al. Peak oxygen uptake correlates with disease severity and predicts outcome in adult patients with Ebstein’s anomaly of the tricuspid valve. Int J Cardiol, 2013, 163(3): 305-308.
38. Buber J, Vatury O, Klempfner R, et al. The impact of tricuspid valve regurgitation severity on exercise capacity and cardiac-related hospitalisations among adults with non-operated Ebstein’s anomaly. Cardiol Young, 2019, 29(6): 800-807.
39. Cifra B, Cordina RL, Gauthier N, et al. Cardiopulmonary exercise test interpretation across the lifespan in congenital heart disease: a scientific statement from the American Heart Association. J Am Heart Assoc, 2025, 14(4): e038200.
40. 凌靖, 温树生. 三尖瓣下移畸形诊断与治疗进展. 中国心血管病研究, 2024, 22(5): 405-409.Ling J, Wen SS. Ebstein's anomaly: diagnosis and management. Chin J Cardiovasc Res, 2024, 22(5): 405-409.
41. Yang Y, Zhang W, Liu Y, et al. Preoperative percutaneous oxygen saturation is a predictor of postoperative adverse events after Ebstein’s anomaly reconstruction. J Card Surg, 2021, 36(3): 1012-1017.
42. He Y, Feng Y, Zhang TZ, et al. Analysis of the risk factors of delayed extubation after surgery for Ebstein’s anomaly. J Cardiothorac Surg, 2025, 20(1): 56.
43. Mrad Agua K, Burri M, Cleuziou J, et al. Preoperative predictability of right ventricular failure following surgery for Ebstein’s anomaly. Eur J Cardiothorac Surg, 2019, 55(6): 1187-1193.
44. Burri M, Mrad Agua K, Cleuziou J, et al. Cone versus conventional repair for Ebstein’s anomaly. J Thorac Cardiovasc Surg, 2020, 160(6): 1545-1553.
45. Park I, Jun TG, Yang JH, et al. Long-term outcomes of modified cone reconstruction for Ebstein’s anomaly in pediatric patients in a single center. Korean Circ J, 2024, 54(2): 78-90.
46. Lou Q, Zou Y, Wu J, et al. Impact of Cone vs. Hetzer repair on postoperative outcomes in patients with Ebstein’s anomaly: 10-year experience from a single institution. Front Cardiovasc Med, 2021, 8: 710168.
47. Phillips KA, Dearani JA, Wackel PL, et al. Contemporary early postoperative cone repair outcomes for patients with Ebstein anomaly. Mayo Clin Proc, 2023, 98(2): 290-298.
48. Dearani JA, Bacha E, Da Silva JP. Cone reconstruction of the tricuspid valve for Ebstein’s anomaly: anatomic repair. Oper Tech Thorac Cardiovasc Surg, 2008, 13(2): 109-125.
49. Dearani JA. Ebstein repair: how I do it. J Thorac Cardiovasc Surg Tech, 2020, 3: 269-276.
50. Sainathan S, da Fonseca da Silva L, da Silva JP. Ebstein’s anomaly: contemporary management strategies. J Thorac Dis, 2020, 12(3): 1161-1173.
51. Quinonez LG, Dearani JA, Puga FJ, et al. Results of the 1. 5-ventricle repair for Ebstein anomaly and the failing right ventricle. J Thorac Cardiovasc Surg, 2007, 133(5): 1303-1310.
52. Liu J, Qiu L, Zhu Z, et al. Cone reconstruction of the tricuspid valve in Ebstein anomaly with or without one and a half ventricle repair. J Thorac Cardiovasc Surg, 2011, 141(5): 1178-1183.
53. Stephens EH, Qureshi MY, Anderson JH, et al. Bidirectional cavopulmonary shunt for right ventricular unloading. Ann Thorac Surg, 2021, 111(5): 1435-1441.
54. Das BB, Chrisant M, Lavandosky G, et al. An adolescent with left ventricular noncompaction and Ebstein anomaly presenting with advanced heart failure: discharge from hospital with a biventricular assist device. J Pediatr, 2018, 202: 304-310.
55. Husain SA, Brown JW. When reconstruction fails or is not feasible: valve replacement options in the pediatric population. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2007: 117-124.
56. Kiziltan HT, Theodoro DA, Warnes CA, et al. Late results of bioprosthetic tricuspid valve replacement in Ebstein’s anomaly. Ann Thorac Surg, 1998, 66(5): 1539-1545.
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