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Erschienen in: Pediatric Cardiology 7/2013

01.10.2013 | Original Article

Outcome of Neonates with Ebstein’s Anomaly in the Current Era

verfasst von: Jeong Jin Yu, Tae-Jin Yun, Hye-Sung Won, Yu Mi Im, Byong Sop Lee, So Yeon Kang, Hong Ki Ko, Chun Soo Park, Jeong-Jun Park, Mijeung Gwak, Ellen Ai-Rhan Kim, Young-Hwue Kim, Jae-Kon Ko

Erschienen in: Pediatric Cardiology | Ausgabe 7/2013

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Abstract

Ebstein’s anomaly is frequently detected before birth, with prenatal detection accounting for the majority of cases in the current population. This study aimed to identify the outcome variables among these infants. The medical records of 59 patients with neonatal Ebstein’s anomaly managed at the Asan Medical Center between January, 2001 and June, 2012 were investigated retrospectively. In 46 cases, the diagnosis was made prenatally. Surgical/interventional procedures were performed for 27 of the analyzed patients. Biventricular repair was successful for 12 patients but not for 9 patients with pulmonary atresia. The median follow-up period was 1.96 years (range 0.0–10.4 years). The overall mortality rate was 23.7 % (14/59). Of the 14 deaths, 5 occurred within several hours after birth. The 1- and 5-year survival rates were 78.6 and 76.3 %, respectively. Univariate analysis identified several variables related to the time to death: fetal distress (p = 0.002), prematurity (p = 0.036), low birth weight (p = 0.003), diameter of the atrial septal defect (p = 0.022), and pulmonary stenosis/atresia (p = 0.001). Neither the Carpentier classification (p = 0.175) nor the Celermajer index (p = 0.958) was a significant variable. According to the multivariate analysis, fetal distress (p = 0.004) and pulmonary atresia/stenosis (p < 0.001) were significant determinants of outcome. In conclusion, fetal distress and pulmonary atresia/stenosis are significant predictors of mortality in the current population of patients with neonatal Ebstein’s anomaly. A close cooperation of associated clinicians is required for an improvement in outcome. To establish a better surgical strategy for patients with Ebstein’s anomaly and pulmonary atresia, studies of larger populations are required.
Literatur
1.
Zurück zum Zitat Atz AM, Nunoz RA, Adatia I, Wessel DL (2003) Diagnostic and therapeutic uses of inhaled nitric oxide in neonatal Ebstein’s anomaly. Am J Cardiol 91:906–908CrossRefPubMed Atz AM, Nunoz RA, Adatia I, Wessel DL (2003) Diagnostic and therapeutic uses of inhaled nitric oxide in neonatal Ebstein’s anomaly. Am J Cardiol 91:906–908CrossRefPubMed
2.
Zurück zum Zitat Barre E, Durand I, Hazelzet T (2012) Ebstein’s anomaly and tricuspid valve dysplasia: prognosis after diagnosis in utero. Pediatr Cardiol 33:1391–1396CrossRefPubMed Barre E, Durand I, Hazelzet T (2012) Ebstein’s anomaly and tricuspid valve dysplasia: prognosis after diagnosis in utero. Pediatr Cardiol 33:1391–1396CrossRefPubMed
3.
Zurück zum Zitat Carpentier A, Chauvaud S, Mace L, Relland J, Mihaileanu S, Marino JP, Abry B, Guibourt P (1988) A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 96:92–101PubMed Carpentier A, Chauvaud S, Mace L, Relland J, Mihaileanu S, Marino JP, Abry B, Guibourt P (1988) A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 96:92–101PubMed
4.
Zurück zum Zitat Celermajer DS, Cullen S, Sullivan ID, Spiegelhalter DJ, Wyse RKH, Deanfield JE (1992) Outcome in neonates with Ebstein’s anomaly. J Am Coll Cardiol 19:1041–1045CrossRefPubMed Celermajer DS, Cullen S, Sullivan ID, Spiegelhalter DJ, Wyse RKH, Deanfield JE (1992) Outcome in neonates with Ebstein’s anomaly. J Am Coll Cardiol 19:1041–1045CrossRefPubMed
5.
Zurück zum Zitat Celermajer DS, Bull C, Till JA, Cullen S, Vassillikos VP, Sullivan ID, Allan L, Nihoyannopoulos P, Soerville J, Deanfield JE (1994) Ebstein’s anomaly: presentation and outcome from fetus to adult. J Am Coll Cardiol 23:170–176CrossRefPubMed Celermajer DS, Bull C, Till JA, Cullen S, Vassillikos VP, Sullivan ID, Allan L, Nihoyannopoulos P, Soerville J, Deanfield JE (1994) Ebstein’s anomaly: presentation and outcome from fetus to adult. J Am Coll Cardiol 23:170–176CrossRefPubMed
6.
Zurück zum Zitat Chauvaud S (2000) Ebstein’s malformation: surgical treatment and results. Thorac Cardiovasc Surg 48:220–223CrossRefPubMed Chauvaud S (2000) Ebstein’s malformation: surgical treatment and results. Thorac Cardiovasc Surg 48:220–223CrossRefPubMed
7.
Zurück zum Zitat Jaquiss RDB, Imamura M (2007) Management of Ebstein’s anomaly and pure tricuspid insufficiency in the neonate. Semin Thorac Cardiovasc Surg 19:258–263CrossRefPubMed Jaquiss RDB, Imamura M (2007) Management of Ebstein’s anomaly and pure tricuspid insufficiency in the neonate. Semin Thorac Cardiovasc Surg 19:258–263CrossRefPubMed
8.
Zurück zum Zitat Knott-Craig CJ, Overholt ED, Ward KE, Razook JD (2000) Neonatal repair of Ebstein’s anomaly: indications, surgical technique, and medium-term follow-up. Ann Thorac Surg 69:1505–1510CrossRefPubMed Knott-Craig CJ, Overholt ED, Ward KE, Razook JD (2000) Neonatal repair of Ebstein’s anomaly: indications, surgical technique, and medium-term follow-up. Ann Thorac Surg 69:1505–1510CrossRefPubMed
9.
Zurück zum Zitat Knott-Craig CJ, Overholt ED, Ward KE, Ringewald JM, Baker SS, Razook JD (2002) Repair of Ebstein’s anomaly in the symptomatic neonate: an evolution of technique with 7-year follow-up. Ann Thorac Surg 73:1786–1793CrossRefPubMed Knott-Craig CJ, Overholt ED, Ward KE, Ringewald JM, Baker SS, Razook JD (2002) Repair of Ebstein’s anomaly in the symptomatic neonate: an evolution of technique with 7-year follow-up. Ann Thorac Surg 73:1786–1793CrossRefPubMed
10.
Zurück zum Zitat Oxenius A, Attenhofer Jost CH, Prêtre R, Dave H, Bauersfeld U, Kretschmar O, Seifert B, Balmer C, Valsangiacomo Buechel ER (2012) Management and outcome of Ebstein’s anomaly in children. Cardiol Young 15:1–8. doi:10.1017/S1047951112000224 Oxenius A, Attenhofer Jost CH, Prêtre R, Dave H, Bauersfeld U, Kretschmar O, Seifert B, Balmer C, Valsangiacomo Buechel ER (2012) Management and outcome of Ebstein’s anomaly in children. Cardiol Young 15:1–8. doi:10.​1017/​S104795111200022​4
11.
Zurück zum Zitat Pflaumer A, Eicken A, Augustin N, Hess J (2004) Symptomatic neonates with Ebstein anomaly. J Thorac Cardiovasc Surg 127:1208–1209CrossRefPubMed Pflaumer A, Eicken A, Augustin N, Hess J (2004) Symptomatic neonates with Ebstein anomaly. J Thorac Cardiovasc Surg 127:1208–1209CrossRefPubMed
12.
Zurück zum Zitat Santoro G, Palladino MT, Russo MG, Calabrò R (2008) Neonatal patent ductus arteriosus recanalization and stenting in critical Ebstein’s anomaly. Pediatr Cardiol 29:176–179CrossRefPubMed Santoro G, Palladino MT, Russo MG, Calabrò R (2008) Neonatal patent ductus arteriosus recanalization and stenting in critical Ebstein’s anomaly. Pediatr Cardiol 29:176–179CrossRefPubMed
13.
Zurück zum Zitat Sarris EG, Giannopoulos NM, Tsoutsinos AJ, Chatzis AK, Kirvassilis G, Brawn WJ, Comas JV, Corno AF, Di Carlo D, Fragata J, Hraska V, Jacobs JP, Krupianko S, Sairanen H, Stellin G, Urban A, Ziemer G (2006) Results of surgery for Ebstein anomaly: a multicenter study from the European Congenital Heart Surgeons Association. J Thorac Cardiovasc Surg 132:50–57CrossRefPubMed Sarris EG, Giannopoulos NM, Tsoutsinos AJ, Chatzis AK, Kirvassilis G, Brawn WJ, Comas JV, Corno AF, Di Carlo D, Fragata J, Hraska V, Jacobs JP, Krupianko S, Sairanen H, Stellin G, Urban A, Ziemer G (2006) Results of surgery for Ebstein anomaly: a multicenter study from the European Congenital Heart Surgeons Association. J Thorac Cardiovasc Surg 132:50–57CrossRefPubMed
14.
Zurück zum Zitat Starnes VA, Pitlick PT, Bernstein D, Griffin ML, Choy M, Shumway NE (1991) Ebstein’s anomaly appearing in the neonate. A new surgical approach. J Thorac Cardiovasc Surg 101:1082–1087PubMed Starnes VA, Pitlick PT, Bernstein D, Griffin ML, Choy M, Shumway NE (1991) Ebstein’s anomaly appearing in the neonate. A new surgical approach. J Thorac Cardiovasc Surg 101:1082–1087PubMed
15.
Zurück zum Zitat Wald RM, Adatia I, Van Arsdell GS, Hornberger LK (2005) Relation of limiting ductal patency to survival in neonatal Ebstein’s anomaly. Am J Cardiol 96:851–856CrossRefPubMed Wald RM, Adatia I, Van Arsdell GS, Hornberger LK (2005) Relation of limiting ductal patency to survival in neonatal Ebstein’s anomaly. Am J Cardiol 96:851–856CrossRefPubMed
16.
Zurück zum Zitat Yetman AT, Freedom RM, McCrindle BW (1998) Outcome in cyanotic neonates with Ebstein’s anomaly. Am J Cardiol 81:749–754CrossRefPubMed Yetman AT, Freedom RM, McCrindle BW (1998) Outcome in cyanotic neonates with Ebstein’s anomaly. Am J Cardiol 81:749–754CrossRefPubMed
17.
Zurück zum Zitat Yun TJ, Lee SH, Ko JK (2006) Neonatal stenotic Ebstein’s anomaly: a novel technique of right ventricular exclusion. J Thorac Cardiovasc Surg 131:469–471CrossRefPubMed Yun TJ, Lee SH, Ko JK (2006) Neonatal stenotic Ebstein’s anomaly: a novel technique of right ventricular exclusion. J Thorac Cardiovasc Surg 131:469–471CrossRefPubMed
Metadaten
Titel
Outcome of Neonates with Ebstein’s Anomaly in the Current Era
verfasst von
Jeong Jin Yu
Tae-Jin Yun
Hye-Sung Won
Yu Mi Im
Byong Sop Lee
So Yeon Kang
Hong Ki Ko
Chun Soo Park
Jeong-Jun Park
Mijeung Gwak
Ellen Ai-Rhan Kim
Young-Hwue Kim
Jae-Kon Ko
Publikationsdatum
01.10.2013
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 7/2013
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-013-0680-x

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