Open Access

ARTICLE

Predictors of Early Right Ventricular Dysfunction after Cone Reconstruction for Ebstein’s Anomaly: A Retrospective Cohort Study

Jing Ling¹, Naijimuding Abudurexiti¹, Jiaxiong Wu¹, Runzhang Liang¹, Zirui Peng¹, Yuting Huang², Haiyun Yuan^1,3,4,*, Shusheng Wen^1,3,4,*

1 Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
2 National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510080, China
3 Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
4 Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510080, China

* Corresponding Authors: Haiyun Yuan. Email: ; Shusheng Wen. Email:

Congenital Heart Disease 2025, 20(1), 13-25. https://doi.org/10.32604/chd.2025.063437

Received 14 January 2025; Accepted 24 February 2025; Issue published 18 March 2025

Abstract

Background: Although Cone reconstruction has been shown to improve biventricular function over time, postoperative right ventricular dysfunction (RVD) is frequently observed, signiffcantly affecting reoperation and long-term prognosis. This study aims to identify the predictors for postoperative RVD. Methods: This retrospective cohort study included 51 patients with Ebstein’s anomaly who underwent the Cone reconstruction. RVD was deffned as right ventricular fractional area change (RV-FAC) less than 35% and tricuspid annular plane systolic excursion (TAPSE) less than 17 mm through pre-discharge echocardiography. Univariate and multivariate analyses were used to analyze the pre-operative predictors. Results: The median age at surgery was 37.7 (±15.3) years, RVD was documented in 25 patients (49%) of the 51 patients. Patients with RVD had signiffcantly higher right ventricular end-systolic volume index (RVESVi) (p = 0.001), right ventricular end-diastolic volume index (RVEDVi) (p = 0.03), and septal leaffet displacement (p = 0.003). Multivariate analysis conffrmed that septal leaffet displacement was independently associated with postoperative RVD (p = 0.02). Additionally, RVD was not related to the cardiopulmonary bypass time, ICU stay and total hospital time. Conclusions: This study suggests that preoperative right ventricular ejection fraction (RVEF) reduction, severe septal leaffet displacement and signiffcant right ventricular dilatation are key predictors of early postoperative RVD. RVD may exacerbate tricuspid regurgitation, and this ffnding indicates that predicting RVD may aid in identifying high-risk patients prone to recurrence of tricuspid regurgitation after Cone reconstruction

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