Advancements in the Diagnosis and Surgical Management of Ebstein’s Anomaly: A Comprehensive Review

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Donaldo Emiliano Silva López
Juan Fausto Martínez González
José Anthar Ávalos Narváez
Karla Vanessa Moreno Carreon
Pablo Emilio Patiño Córdova
Miguel Fernando Tovar Chávez

Abstract

Ebstein’s anomaly is a rare congenital heart defect characterized by the apical displacement of the septal and posterior leaflets of the tricuspid valve, resulting in atrialization of the right ventricle and significant hemodynamic disturbances. This anomaly often presents with a spectrum of clinical manifestations, ranging from asymptomatic cases to severe heart failure and cyanosis in neonatal life. The diagnostic process has been significantly enhanced by advancements in echocardiography, magnetic resonance imaging (MRI), and electrocardiographic techniques, enabling early detection and detailed assessment of structural abnormalities.


Treatment strategies for Ebstein’s anomaly are tailored according to the severity of the condition and patient age. While mild cases may be managed conservatively, severe forms necessitate surgical interventions, including tricuspid valve repair or replacement, bidirectional Glenn shunt, and occasionally the Fontan procedure. Novel approaches, such as cone repair, have shown promising outcomes in improving valve function and overall cardiac performance. This review article provides a detailed exploration of the pathophysiology, clinical manifestations, diagnostic advancements, and therapeutic options for Ebstein’s anomaly, with an emphasis on surgical innovations.

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Donaldo Emiliano Silva López, Juan Fausto Martínez González, José Anthar Ávalos Narváez, Karla Vanessa Moreno Carreon, Pablo Emilio Patiño Córdova, & Miguel Fernando Tovar Chávez. (2024). Advancements in the Diagnosis and Surgical Management of Ebstein’s Anomaly: A Comprehensive Review. International Journal of Medical Science and Clinical Research Studies, 4(12), 2156–2162. https://doi.org/10.47191/ijmscrs/v4-i12-09
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References

I. Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: Updated systematic review and meta-analysis of 260 studies. Int J Epidemiol 2019;48:455-63. 10.1093/ije/dyz009

II. Correa-Villaseñor A, Ferencz C, Neill CA, et al. Ebstein’s malformation of the tricuspid valve: Genetic and environmental factors. Teratology 1994;50:137-47. 10.1002/tera.1420500208

III. Patorno E, Huybrechts KF, Bateman BT, et al. Lithium Use in Pregnancy and the Risk of Cardiac Malformations. N Engl J Med 2017;376:2245-54. 10.1056/NEJMoa1612222

IV. Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J 2021;42:563-645. 10.1093/eurheartj/ehaa554

V. Anderson KR, Lie JT. Pathologic anatomy of Ebstein’s anomaly of the heart revisited. Am J Cardiol 1978;41:739-45. 10.1016/0002-9149(78)90826-3

VI. Dearani JA, Mora BN, Nelson TJ, et al. Ebstein anomaly review: What’s now, what’s next? Expert Rev Cardiovasc Ther 2015;13:1101-9. 10.1586/14779072.2015.1087849

VII. Schreiber C, Cook A, Ho SY, et al. Morphologic spectrum of Ebstein’s malformation: Revisitation relative to surgical repair. J Thorac Cardiovasc Surg 1999;117:148-55. 10.1016/S0022-5223(99)70480-0

VIII. Carpentier A, Chauvaud S, Mace L, et al. A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 1988;96:92-101. 10.1016/S0022-5223(19)35302-4

IX. Badiu CC, Schreiber C, Hörer J, et al. Early timing of surgical intervention in patients with Ebstein’s anomaly predicts superior long-term outcome. Eur J Cardiothorac Surg 2010;37:186-92. 10.1016/j.ejcts.2009.06.052

X. Holst KA, Dearani JA, Said S, et al. Improving Results of Surgery for Ebstein Anomaly: Where Are We After 235 Cone Repairs? Ann Thorac Surg 2018;105:160-8. 10.1016/j.athoracsur.2017.09.058

XI. Brown ML, Dearani JA, Danielson GK, et al. The outcomes of operations for 539 patients with Ebstein anomaly. J Thorac Cardiovasc Surg. 2008;135:1120-36. 10.1016/j.jtcvs.2008.02.034

XII. 12.Celermajer DS, Dodd SM, Greenwald SE, et al. Morbid anatomy in neonates with Ebstein’s anomaly of the tricuspid valve: Pathophysiologic and clinical implications. J Am Coll Cardiol 1992;19:1049-53. 10.1016/0735-1097(92)90293-V

XIII. Benson LN, Child JS, Schwaiger M, et al. Leftventricular geometry and function in adults with Ebstein’s anomaly of the tricuspid valve. Circulation 1987;75:353-9. 10.1161/01.CIR.75.2.353

XIV. Lee AHS, Moore IE, Fagg NLK, et al. Histological changes in the left and right ventricle in hearts with Ebstein’s malformation and tricuspid valvar dysplasia: A morphometric study of patients dying in the fetal and perinatal periods. Cardiovasc Pathol 1995;4:19-24. 10.1016/1054-8807(94)00027-O

XV. Watson H. Natural history of Ebstein ’ s anomaly of tricuspid valve in childhood and adolescence An international co-operative study of 505 cases. Br Heart J 1974;36:417-27. 10.1136/hrt.36.5.417

XVI. Shivapour JKL, Sherwin ED, Alexander ME, et al. Utility of preoperative electrophysiologic studies in patients with Ebstein ’ s anomaly undergoing the Cone procedure. Heart Rhythm 2014;11:182-6. 10.1016/j.hrthm.2013.10.045

XVII. Attenhofer Jost CH, Connolly HM, O’Leary PW, et al. Left heart lesions in patients with ebstein anomaly. Mayo Clin Proc 2005;80:361-8. 10.4065/80.3.361

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