@Article{chd.2025.063437,
AUTHOR = {Jing Ling, Naijimuding Abudurexiti, Jiaxiong Wu, Runzhang Liang, Zirui Peng, Yuting Huang, Haiyun Yuan, Shusheng Wen},
TITLE = {Predictors of Early Right Ventricular Dysfunction after Cone Reconstruction for Ebstein’s Anomaly: A Retrospective Cohort Study},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {20},
YEAR = {2025},
NUMBER = {1},
PAGES = {13--25},
URL = {http://www.techscience.com/schd/v20n1/60017},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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)
(<i>p</i> = 0.001), right ventricular end-diastolic volume index (RVEDVi) (<i>p</i> = 0.03), and septal leaffet displacement
(<i>p</i> = 0.003). Multivariate analysis conffrmed that septal leaffet displacement was independently associated
with postoperative RVD (<i>p</i> = 0.02). Additionally, RVD was not related to the cardiopulmonary bypass time,
ICU stay and total hospital time. <b>Conclusions:</b> 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},
DOI = {10.32604/chd.2025.063437}
}