Total correction of Ebstein's anomaly by replacement with a biological aortic valve without plication of the atrialized ventricle.

For the surgical management of Ebstein's anomaly, the preferred operation will be Hardy's procedure, which preserves the patient's valve. However, we have encountered 3 cases of this disease in which the downward displacement of the tricuspid valve was so severe and the functioning right ventricle was so small that Hardy's method could not be adapted without causing tricuspid regurgitation and making the right ventricular chamber more narrow. We treated these patients by replacing the tricuspid valve with an inverted aortic valve with a stent and not plicating the atrialized ventricle. The results have been proved satisfactory through about 7 years' follow-up, suggesting that our technique will be remarkably effective as a radical corrective operation for Ebstein's anomaly with severe intracardiac abnormalities.