title: Surgical treatment for neonatal Ebstein's anomaly with circular shunting.
abstract: We report a case of surgical treatment for neonatal Ebstein's anomaly with circular shunting. A prenatal diagnosis of Ebstein's anomaly was made at 30 weeks of gestation. In addition to severe tricuspid regurgitation, severe pulmonary regurgitation was also noted, resulting in a 'circular shunt'. At 38 weeks and 2 days of gestation, the baby was delivered by Caesarean section. A two-stage palliative operation was planned. As the first palliation, the pulmonary artery was ligated 1 h after birth to eliminate the circular shunt. Lipo-prostaglandin E(1) was administrated continuously to keep the ductus arteriosus patent. Four days after first operation, modified Starnes operation was performed as the second-stage palliation. The tricuspid valve was closed by an ePTFE patch with 3-mm fenestration. Pulmonary blood flow was supplied by a right modified Blalock-Taussig shunt with a 3.5-mm diameter ePTFE graft. The infant's postoperative haemodynamic status was stable. The patient is being followed up carefully and is scheduled to have a univentricular repair in the future.
authors.affiliation: Department of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Hokkaido, Japan. yanasey@sapmed.ac.jp
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Yanase
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Natsuya
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Higami
mesh_terms: D000527:Alprostadil / Q000008:administration & dosage; D058366:Blalock-Taussig Procedure; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures; D004437:Ebstein Anomaly / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D008026:Ligation; D010166:Palliative Care; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery; D011652:Pulmonary Circulation; D011665:Pulmonary Valve Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil