Lazoryshynets' V. Ebstein's anomaly (problems of diagnostics and surgical treatment).

The dissertation is dedicated to the problems of diagnostics and of surgical treatment of a different forms of Ebstein's anomaly. The work is based on evaluation of 278 operated upon patients, which preoperatively were investigated with the use of ECG, FCG, EchoCG, Chest X-Ray, heart catheterisation, angiocardiography, electrophysiological studies of the heart. Clinical, hemodynamical and morphological peculiarities of a different types of Ebstein's anomaly were studied, it's classification was improved. Immediate and remote results of a different methods of surgical treatment ( tricuspid valve replacement, plastic procedures on the tricuspid valve, remodeling of the right ventricle geomentry, sumultaneous ablation of accessory conduction pathways, palliative procedures and operations of the hemodynamic correction ). Algorhithm of diagnostics and of surgical treatment of Ebstein's anomaly was elaborated. As the result a marked decrease of the number of tricuspid valve prosthetic replacements was achieved and valve sparing plastic procedures became more widely used; the use of hemodynamic corrections in the most difficult cases was introduced; new type of plastic procedure on the tucuspid valve was proposed and elaborated. Electrophysiological studies in preoperative period are obligatory in patients with Ebstein's anomaly, these studies permit to diagnose accessory pathways in 24,3% of patients, 13,7% among them are concealed.Doppler EchoCG is highly informative method of Ebstein's anomaly diagnostics, which gives possibility to determine the degree of hemodynamical disturbancies and anatomical type of the lesion.