J Thorac Cardiovasc Surg 2004;128:799
© 2004 The American Association for Thoracic Surgery
Reply
Jonathan M. Chen, MD
Pediatric Cardiac Surgery,
Columbia University College of Physicians and Surgeons,
New York, NY 10032
Reply to the Editor:
My coauthors and Iare in agreement with Dr Chauvaud's impression that the Ebstein anomaly is a combination of ventricular and valvular disease. In our study, the right ventricle, as analyzed by transthoracic echocardiography, was considered to be the effective right ventricle below the attachment of the valve. In several patients—most notably the adults—the right anterior wall was indeed hypokinetic. Care certainly must be taken not to assign hypokinetic areas of atrialized ventricle to the true right ventricle. We have not routinely used a Glenn cavopulmonary shunt in our Ebstein repair, but we recognize it as a viable strategy in those patients for whom reduction in right-sided volume loading may be beneficial.
