Methods: Between December 1997 and July 2006, 76 consecutive patients with Ebstein's anomaly underwent this new procedure. There were 39 male and 37 female patients aged 9 months to 52 years (mean, 17 years). Tricuspid incompetence was moderate in 22 patients and severe in 54. Our repair technique is as follows: the displaced posterior leaflet with some chordae tendineae and corresponding papillary muscle are detached from the annulus and ventricular wall, respectively. The leaflet is then reattached to the native posterior annulus with reimplantation of the papillary muscle. The displaced septal leaflet is treated in the same manner. Most of the atrialized portion of the ventricular wall is excised; the tricuspid annulus is plicated. In 8 of the patients the septal leaflet was severely hypoplastic and necessitated creation of a new leaflet using autologous pericardium. The tricuspid valves were very severe hypoplastic in five patients and right ventricle's functions were very poor. Four of them received the total cavopulmonary connection procedure and one patient received the one and a half ventricle repair.

Results: All patients survived and recovered uneventfully. Postoperative echocardiography showed that tricuspid incompetence disappeared in 59 patients and was mild in 13. Right ventricular functions were well. Follow-up of patients ranged from 1 month to 9 years (mean, 46 months). They are doing well. The echocardiography showed that tricuspid incompetence disappeared in 51 patients, mild in 18 and severe in 3. The four patients with total cavopulmonary connection procedures are also doing well.

Conclusion: This new procedure to correct Ebstein's anomaly with the satisfactory early and midterm results. Most patients can be avoided the tricuspid valve replacement.