Ebstein’s Anomaly – ABC CARDIOL

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Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly

Marcia Ferreira Alves Barberato et al. Silvio Henrique Barberato

Circular shunt is a condition in which blood from a cardiac chamber is diverted through the heart to return to the original chamber without reaching the pulmonary capillary bed. A 27-year-old pregnant woman, G1, P0, A0, 25 gestational weeks, was referred for fetal echocardiography due to an increased cardiac area on morphological obstetric ultrasound in the second trimester. She had no comorbidities, and early pregnancy ultrasound findings were normal.

A 25-week fetal echocardiogram showed cardiomegaly, attachment of the tricuspid valve septal leaflet to the interventricular septum, and significant tricuspid insufficiency compatible with Ebstein’s anomaly (). A small pericardial effusion was seen and Huhta cardiovascular score was 6. An adequate pulmonary artery diameter (Z-score 1.9) was noted () with no anterograde flow, only retrograde flow coming from the ductus arteriosus characteristic of a circular shunt. At 29 gestational weeks, fetal hydrops was observed, with zero umbilical artery diastolic flow and a Huhta score of 4 (). Fetal death occurred at 30 gestational weeks.

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Ebstein’s anomaly, noncompaction cardiomyopathy, and mitral valve stenosis

Anderson da Costa Armstrong et al. Gustavo Volpe Tiago Augusto Magalhães Dinani Armstrong Marcelo Nacif

A 29-year-old woman who was previously diagnosed with Ebstein’s anomaly was referred for magnetic resonance imaging of the heart due to progressively worsening dyspnea on exertion.

Cardiac magnetic resonance images (Siemens Essenza 1.5T) showed right atrial dilation and low insertion of the tricuspid valve septal leaflet. The patient also presented with increased left ventricular trabeculation characteristic of noncompaction cardiomyopathy and signs of posterior mitral leaflet restriction secondary to probable rheumatic valvular disease.

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Ebstein's anomaly: results of the conic reconstruction of the tricuspid valve

José Pedro da Silva et al. José Francisco Baumgratz Luciana da Fonseca Jorge Yussef Afiune … Sônia Meiken Franchi Lílian Maria Lopes Daniel Marcelo Silva Magalhães José Henrique Andrade Vila

OBJECTIVE: To assess the results of a technical modification of tricuspid valvuloplasty in Ebstein’s anomaly. METHODS: From November 1993 to August 2002, 21 patients with Ebstein’s anomaly of the tricuspid valve, with ages ranging from 20 months to 37 years (mean, 23 years), underwent a new technique of tricuspid valvuloplasty. This technique consisted of total or almost total detachment of the anterior tricuspid megaleaflet from the ventricular wall and valvular ring, transforming it into a cone, whose vertex remained fixed in the right ventricular tip, and the base was sutured to the tricuspid ring, after its plication, adjusting it to the size of the base of the cone (tricuspid ring), including the septal region. RESULTS: One (4.7%) patient with cardiomyopathy caused by chronic hypoxia died in the hospital due to low cardiac output. The mean follow-up lasted 4 years, and the recent echocardiograms showed good morphology of the right ventricle and tricuspid valve with mild or minimal insufficiency in 18 patients and moderate insufficiency in 2 patients. In 2 of the 3 patients with an anomalous bundle, it could be located and sectioned during surgery. No atrioventricular block occurred. CONCLUSION: The technique used was efficient in repairing tricuspid insufficiency and restoring right ventricular morphology, being applicable to all anatomic types of Ebstein’s anomaly, except for Carpentier classification type D.

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Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly

Ebstein’s anomaly, noncompaction cardiomyopathy, and mitral valve stenosis

Ebstein's anomaly: results of the conic reconstruction of the tricuspid valve

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)