Document Detail


Management of Ebstein's anomaly and pure tricuspid insufficiency in the neonate.
MedLine Citation:
PMID:  17983954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Because the pulmonary vascular resistance is very elevated at birth, severe tricuspid regurgitation is poorly tolerated and even life-threatening in the newborn. The etiology may be tricuspid valve papillary muscle rupture or the more ominous Ebstein's anomaly, with its associated dysfunctional right ventricle. After the diagnosis is established and the patient is supported with prostaglandin infusion and nitric oxide, definitive surgical management is undertaken with the expectation of excellent outcomes for isolated tricuspid valve regurgitation. For neonates with Ebstein's anomaly, therapy is tailored to the severity of the malformation and the degree of right ventricular outflow tract obstruction, assessed in the context of declining pulmonary vascular resistance. The surgical approach may involve ligation of a patent ductus arteriosus, placement of a systemic to pulmonary shunt, establishment of functional tricuspid atresia, or tricuspid valve repair. With the application of these various approaches, the outlook for neonatal Ebstein's anomaly has improved remarkably.
Authors:
Robert D B Jaquiss; Michiaki Imamura
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery     Volume:  19     ISSN:  1043-0679     ISO Abbreviation:  Semin. Thorac. Cardiovasc. Surg.     Publication Date:  2007  
Date Detail:
Created Date:  2007-11-06     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917640     Medline TA:  Semin Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  258-63     Citation Subset:  IM    
Affiliation:
Division of Pediatric Cardiothoracic Surgery, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas 72202, USA. rjaquiss@uams.edu
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MeSH Terms
Descriptor/Qualifier:
Ebstein Anomaly / drug therapy,  surgery*
Humans
Infant, Newborn
Thoracic Surgery / methods*
Tricuspid Valve Insufficiency / drug therapy,  surgery*

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