- Ebstein’s anomaly and critical aortic coartation in a newborn. An atypical combination
Ebstein’s anomaly and critical aortic coartation in a newborn. An atypical combination
Modern Pediatrics. Ukraine. 8(112): 63-67. doi 10.15574/SP.2020.112.63
Malska A. A.1, Kurilyak O. B.2
1Danylo Halytskyy Lviv National Medical University, Ukraine
2Public Noncomercial Enterprise of Lviv Regional Council «Lviv Regional Children's Clinical Hospital «OHMATDYT», Ukraine
For citation: Malska AA, Kurilyak OB. (2020). Ebstein’s anomaly and critical aortic coartation in a newborn. An atypical combination. Modern Pediatrics. Ukraine. 8(112): 63–67. doi 10.15574/SP.2020.112.63
Article received: Aug 23, 2020. Accepted for publication: Dec 07, 2020.
This article presents a rare case of combination of Ebstein's anomaly with critical aortic coarctation in a newborn baby, who was admitted to the neonatal intensive care unit of the Regional Children's Hospital needed urgent surgical correction.
Purpose — to conduct a literature review of the clinical cases of association of Ebstein's abnormality with critical aortic coarctation in newborns and to present a clinical case of such a rare combination in a newborn boy.
Clinical case. A newborn boy was admitted to the neonatal intensive care unit of the Lviv Regional Children's Hospital OHMATDYT, on the second day after his birth with an established diagnosis of Ebstein's anomaly. On admission, the child's general condition was moderate. On ausculation: rhythmic heart tones, tachycardia (heart rate 160 bpm), loud S2 above the pulmonary artery and loud 4/6 systolic murmur across the left sternal border and under the left scapula. The weakened pulsation of the femoral arteries was determined. On Echocardiographic examination: critical aortic coarctation and Ebstein's abnormality have been diagnosed, which is an extremely rare combination. Clinically on the 6th day of the child's life condition significantly worsened: respiratory and cardiovascular failure increased, diuresis decreased, urea and creatinine levels increased. The child was urgently transferred to the intensive care unit to the pediatric cardiac surgery center, where a surgical correction of aortic coarctation was successfully carried out. Surgical correction of Ebstein's anomaly was not performed.
Conclusions. The presented clinical case is extremely rare, despite the combination of Ebstein's anomaly and aortic coartation in the neonatal period is not described in the literature, specialists of ultrasound diagnostics should closely monitor the protocol of echocardiographic examination and conduct it in full to diagnose the pathology and perform a timely surgical correction.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
Key words: Ebstein's anomaly, critical aortic coarcia, newborns.
REFERENCES
1. Brickner ME, Hillis LD, Lange RA. (2000). Congenital heart disease in adults: second of two parts. N Engl J Med. 342: 334-342. https://doi.org/10.1056/NEJM200002033420507; PMid:10655533
2. Christine H, Attenhofer Jos, Heidi M, Connolly, Patrick, W O'Leary. (2005, Mar). Left Heart Lesions in Patients With Ebstein Anomaly. Mayo Clinic Proceedings. 80 (3): 361-368. https://doi.org/10.4065/80.3.361; PMid:15757018
3. Ebaid M, Azeka E, Ikari NM, Sosa EA, Marcial MB, Atik E. (1999). Ebstein's anomaly with coarctation of the aorta-an unusual association. Arq Bras Cardiol. 73: 219-224. https://doi.org/10.1590/S0066-782X1999000800010
4. Espinola-Zavaleta N, Hernandez-Pacheco G, Munoz-Castellanos L, Avendano-Perez L, Melendez-Ramirez G. (2017). Ebstein's Anomaly Associated with Left Heart Malformations: Presentation of Two Cases and Review of the Literature. J Clin Exp Cardiolog. 8: 515. https://doi.org/10.4172/2155-9880.1000515
5. Mishra AK, Barwad P, Bansal V, Mandal B, Srivastava A, Naganur SH. (2020). Ebstein's anomaly of tricuspid valve with aortic stenosis and coarctation of aorta: Successful single-stage repair of a rare adult congenital heart disease. J Card. Surg: 1-6. https://doi.org/10.1111/jocs.15004; PMid:32939805
6. Munoz-Castellanos L, Espinola-Zavaleta N, Kuri-Nivon M, Keirns C. (2007, Nov 23). Ebstein's Anomaly: anatomo-echocardiographic correlation. Cardiovasc Ultrasound. 5: 43. https://doi.org/10.1186/1476-7120-5-43; PMid:18034907 PMCid:PMC2217516
7. Subban V, Lakshmanan A, Kalidoss L, Pandurangi UM, Mullasari AS. (2013). Ebstein's anomaly with severe aortic stenosis and syncope: Implications in management. Sahel Med J. 16: 130-132. https://doi.org/10.4103/1118-8561.121927