Staged Treatment for Critically Ill Neonates With Ebstein Anomaly: Cone Repair After Starnes Procedure

Q2 Medicine

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI:10.1053/j.pcsu.2025.02.007

Luciana da Fonseca da Silva MD , Victor Morell MD , Mario Castro Medina MD , Jose Pedro da Silva MD

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引用次数: 0

Abstract

Following the Starnes procedure, a progressive reduction in the RV cavity occurs, suggesting that the RV was unsuitable for a biventricular repair. For that reason, those patients traditionally followed the single ventricle pathway. In 2019, we performed the initial tricuspid valve (TV) repair cases after Starnes. Since then, we have routinely applied the staged treatment with Cone repair after Starnes achieving 2-ventricle or one-and-a-half ventricle repair in 17 patients. A Glenn procedure associated with pulmonary valve (PV) commissurotomy has been offered as an intermediate stage in patients with associated pulmonary atresia (PAt). Aiming to facilitate the following surgical steps and allow RV growth, we have described some maneuvers for these patients during the Starnes and the Glenn procedure. In this paper, we describe the up-to-date staged repair for critical neonatal Ebstein, emphasizing surgical details of the Starnes procedure, the intermediate interventions, and the Cone repair after Starnes.

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危重新生儿Ebstein异常的分阶段治疗：Starnes手术后椎体修复

在Starnes手术后，右心室腔出现进行性缩小，提示右心室不适合双心室修复。因此，这些患者传统上遵循单心室路径。2019年，我们进行了Starnes术后的首次三尖瓣（TV）修复病例。从那时起，我们在Starnes完成2脑室或一个半脑室修复后常规应用锥体修复分阶段治疗，共有17例患者。Glenn手术联合肺动脉瓣（PV）合拢切开术被认为是相关肺闭锁（PAt）患者的中间阶段。为了便于后续手术步骤和允许右心室生长，我们描述了在Starnes和Glenn手术过程中这些患者的一些操作。在本文中，我们描述了最新的新生儿Ebstein的分期修复，强调了Starnes手术的手术细节，中间干预措施，以及Starnes手术后的锥体修复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Cardiac Surgery Annual Medicine-Surgery

CiteScore

3.80

自引率

0.00%

发文量

期刊介绍： The Pediatric Cardiac Surgery Annual is a companion to Seminars in Thoracic and Cardiovascular Surgery . Together with the Seminars, the Annual provides complete coverage of the specialty by focusing on important developments in pediatric cardiac surgery. Each annual volume has an expert guest editor who invites prominent surgeons to review the areas of greatest change in pediatric cardiac surgery during the year. Topics include 1) Complete Atrioventricular Canal; 2) New Concepts of Cardiac Anatomy and Function -- The Helical Heart; 3) Valve Reconstruction (Replacement) in Congenital Heart Disease; 4) Evolving Developments in Congenital Heart Surgery.