Management of Ebstein's anomaly and pure tricuspid insufficiency in the neonate.


Other Article (Review)

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.

Full Text

Cited Authors

  • Jaquiss, RDB; Imamura, M

Published Date

  • September 2007

Published In

Volume / Issue

  • 19 / 3

Start / End Page

  • 258 - 263

PubMed ID

  • 17983954

Pubmed Central ID

  • 17983954

Electronic International Standard Serial Number (EISSN)

  • 1532-9488

International Standard Serial Number (ISSN)

  • 1043-0679

Digital Object Identifier (DOI)

  • 10.1053/j.semtcvs.2007.07.004


  • eng