Background: Presently, it is still lack of evidence whether a mechanical prosthesis is superior or inferior to a biological prosthesis in patients with Ebstein’s anomaly. The aim of this study was to compare the long-term results of mechanical and biological prostheses of patients with Ebstein’s anomaly at two major cardiac surgical centers in central China. Methods: From January 1999 to June 2020, 85 patients with Ebstein’s anomaly (mean age: 42 ± 17 years, male to female ratio = 19: 66) underwent tricuspid valve replacement. 22 patients (26%) underwent mechanical valve implantation, and 63 (74%) were implanted with a bioprosthesis. Median follow-up duration was 145 months and mean follow-up duration was 146 ± 13 months. Operative results, long-term survival, and tricuspid valve-related events were compared. Results: Eight patients suffered from cardiac failure and died within 30 days after the surgery. Mechanical prostheses demonstrated a better survival outcome compared with biological prostheses before (p = 0.043) and after (p = 0.039) propensity score matching. Tricuspid valve-related events occurred in 20 patients. There was no statistical significance between mechanical and biological tricuspid valves before (p = 0.87) and after (p = 0.91) propensity score matching. Conclusions: Tricuspid valve replacement for patients with Ebstein’s anomaly is a high-risk operation and should be cautious, especially for patients with poor conditions. Although mechanical prostheses demonstrated a better survival outcome compared with biological prostheses in our study, the selection of prostheses should be individualized and consider each patient’s characteristics and needs.

Background and Aim: Interrupted aortic arch (IAA) is defined as a complete interruption of aortic lumen between the ascending and descending aorta. It is an uncommon and complicated congenital heart disease with high mortality in infants. It is rare for patients with isolated IAA to survive to adulthood without operation unless the extensive collateral vessels joining the descending aorta. Here we present three unique cases with isolated IAA together with a review of the literature. Methods: case presentation: We retrospectively searched the hospital patient databases for patients (>14 years) with IAA diagnosed at the Wuhan Union Hospital over the past 10 years and excluded the patients with other cardiac malformations. Three patients were identified. Two were referred to us for hypertension management and were diagnosed with IAA at our hospital. They both declined surgical treatments and underwent conservative therapy including management of their hypertension. One patient was referred to our hospital for further treatment options after the patient was diagnosed with IAA at another hospital. This patient received an extra-anatomic bypass surgery from ascending aorta to descending aorta. His high blood pressure did not resolve and was subsequently managed by anti-hypertensives medications after the surgery. Discussion and conclusions: Adult patients with isolated IAA usually have extensive collateral vessels joining the descending aorta. Surgical intervention may not be necessary for these patients if the patients have no symptoms except hypertension. Anti-hypertensives medical management with long term follow-up appears to be a reasonable treatment option for these patients.