Zusammenfassung
Die bereits in der Fetal- und/oder Neonatalzeit symptomatische Form der Ebstein-Anomalie ist ein schweres Krankheitsbild mit hoher intrauteriner und neonataler Mortalität. Intrauterin können kardiale Insuffizienzen und Hydrops auftreten, postpartal gelingt es oft nicht, eine ausreichende Lungenperfusion und Herzauswurf zu sichern. Neue Aspekte der intrauterinen Überwachung, des perinatalen und postnatalen Managements werden ausführlich diskutiert.
Abstract
The form of Ebstein’s anomaly that is already symptomatic in utero is a severe disease that is associated with a high intrauterine as well as neonatal mortality. Cardiac insufficiency and hydrops may already occur in utero; in the postnatal period establishment of sufficient pulmonary perfusion and/or cardiac output often fails. This review focuses on new aspects of intrauterine monitoring, as well as peri- and postnatal management in these patients.
Literatur
Ahel V, Kilvain S, Rozmanic V, Taylor JF, Vukas D (2001) Right atrial reduction for tachyarrhythmias in Ebstein’s anomaly in infancy. Tex Heart Inst J 28: 297–300
Andelfinger G, Wright KN, Lee HS, Siemens LM, Benson DW (2003) Canine tricuspid valve malformation, a model of human Ebstein anomaly, maps to dog chromosome 9. J Med Genet 40: 320–324
Arizmendi AF, Pineda LF, Jiménez CQ (2004) The clinical profile of Ebstein’s malformation as seen form the fetus to the adult in 52 patients. Cardiol Young 14: 55–63
Attenhofer Jost CH, Connolly HM, O’Leary PW, Tajik AJ, Pellikka PA, Seward JB (2004) Non-compacted myocardium in Ebstein’s anomaly: Initial description in three patients. J Am Soc Echocardiogr 17: 677–680
Attenhofer Jost CH, Connolly HM, Edwards WD, Warnes CA, Danielson GK (2005) Ebstein’s anomaly — review of a multifacted congenital cardiac condition. Swiss Med Wkly 135: 269–281
Attenhofer Jost CH, Connolly HM, O’Leary PW, Warnes CA, Tajik AJ, Seward JB (2005) Left heart lesions in patients with Ebstein’s anomaly. Mayo Clin Proc 80: 361–368
Atz AM, Munoz RA, Adatia I, Wessel DL (2003) Diagnostic and therapeutic uses of inhaled nitric oxide in neonatal Ebstein’s anomaly. Am J Cardiol. 91: 906–908
Berg C, Kremer C, Geipel A, Kohl T, Germer U, Gembruch U (2005) Ductus venous blood flow alterations in fetuses with obstructive lesions of the right heart. Ultrasound Obstet Gynecol (in press)
Carpentier A, Chauvaud S, Macé L (1998) A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 96: 92–101
Celermajer DS, Cullen S, Sullivan ID, Spiegelhalter DJ, Wyse RK, Deanfield JE (1992) Outcome in neonates with Ebstein’s anomaly. J Am Coll Cardiol 19: 1041–1046
Celermajer DS, Dodd SM, Greenwald SE, Wyse RK, Deanfield JE (1992) Morbid anatomy in neonates with Ebstein’s anomaly of the tricuspid valve: pathophysiological and clinical implications. J Am Coll Cardiol 19: 1049–1053
Celermajer DS, Bull C, Till JA (1994) Ebstein’s anomaly: presentation and outcome from fetus to adult. J Am Coll Cardiol 23: 170–176
Chauvaud S, Fuzellier JF, Berrebi A, Lajos P, Marino JP, Mihaileanu S, Carpentier A (1998) Bi-directional cavopulmonary shunt associated with ventriculo and valvuloplasty in Ebstein’s anomaly: benefits in high risk patients. Eur J Cardiothorac Surg 13: 514–519
Chauvaud S (2000) Ebstein’s malformation. Surgical treatment and results. Thorac Cardiovasc Surg 48: 220–223
Chauvaud S, Berrebi A, d’Attellis N, Mousseaux E, Hernigou A, Carpentier A (2003) Ebstein’s anomaly: repair based on functional analysis. Eur J Cardiothorac Surg 23: 525–531
Chetaille P, Walsh EP, Triedman JK (2004) Outcomes of radiofrequency catheter ablation of atrioventricular reciprocating tachycardia in patients with congenital heart disease. Heart Rhythm 1: 168–173
Cohen LS, Friedman JM, Jefferson JW, Johnson EM, Weiner ML (1994) A reevaluation of risk of in utero exposure to lithium. JAMA 271: 146–150
Danielson GK, Driscoll DJ, Mair DD, Warnes CA, Oliver WC Jr (1992) Operative treatment of Ebstein’s anomaly. J Thorac Cardiovasc Surg 104: 1195–1202
Dearani JA, Danielson GK (2000) Congenital Heart Surgery Nomenclature and Database Project. Ebstein’s malformation and tricuspid valve disease. Ann Thorac Surg 69: 8106–8117
Ebstein W (1866) Über einen sehr seltenen Fall von Insuffizienz der Valvula tricuspidalis, bedingt durch eine angeborene hochgradige Missbildung derselben. Arch Anat Physiol 238–254
Edwards WD (1993) Embryology and pathologic features of Ebstein’s anomaly. Progr Pediatr Cardiol 2: 5–15
Fouron JC (2003) Anomalies of the right heart. In: Yagel S, Silverman N, Gembruch U (eds) Fetal cardiology. Martin Dunitz, London, pp 183–200
Freedom RM, Yoo SY (2004) Ebstein’s malformation of the tricuspid valve. In: Freedom RM, Yoo SJ, Mikailian H, Williams WG (eds) The natural and modified history of congenital heart disease. Blackwell/Futura, Elmsford, pp 91–96
Gembruch U (2003) Fetal tachyarrhythmia. In: Yagel S, Silverman N, Gembruch U (eds) Fetal cardiology. Martin Dunitz, London, pp 355–372
Gembruch U, Holzgreve W (2003) Cardiac diseases in association with hydrops fetalis. In: Yagel S, Silverman N, Gembruch U (eds) Fetal cardiology. Martin Dunitz, London, pp 373–401
Greason KL, Dearani JA, Theodoro DA, Porter CB, Warnes CA, Danielson GK (2003) Surgical management of atrial tachyarrhythmias associated with congenital cardiac anomalies: Mayo Clinic experience. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 6: 59–71
Hebe J (2000) Ebstein’s anomaly in adults. Arrhythmias: diagnosis and therapeutic approach. Thorac Cardiovasc Surg 48: 214–219
Hornberger LK, Sahn DJ, Kleinman CS, Copel JA, Reed KL (1991) Tricuspid valve disease with significant tricuspid insufficiency in the fetus: diagnosis and outcome. J Am Coll Cardiol 17: 167–173
Inamura N, Taketazu M, Smallhorn JF, Hornberger LK (2005) Left ventricular myocardial performance in the fetus with severe tricuspid valve disease and tricuspid insufficiency. Am J Perinatol 22: 91–97
Kanani M, Moorman AFM, Cook AC, Webb S, Brown NA, Lamers WH, Anderson RH (2005) Development of the atrioventricular valves: clinicomorphological correlations. Ann Thor Surg 79: 1797–1804
Khositseth A, Danielson GK, Dearani JA, Munger TM, Porter CJ (2004) Supraventricular tachyarrhythmias in Ebstein anomaly: management and outcome. J Thorac Cardiovasc Surg 128: 826–833
Kiziltan HT, Theodoro DA, Warnes CA, O’Leary PW, Anderson BJ, Danielson GK (1998) Late results of bioprosthetic tricuspid valve replacement in Ebstein’s anomaly. Ann Thorac Surg 66: 1539–1545
Knott-Craig CJ, Overholt ED, Ward KE, Ringewald JM, Baker SS, Razook JD (2002) Repair of Ebstein’s anomaly in the symptomatic neonate: an evolution of technique with 7-year follow-up. Ann Thorac Surg 73: 1786–1792
Lang D, Oberhoffer R, Cook A, Sharland G, Allan L, Fagg N, Anderson RH (1991) Pathologic spectrum of malformations of the tricuspid valve in prenatal and neonatal life. J Am Coll Cardiol 17: 1161–1167
Malec E, Dangel J, Mroczek T, Procelewska M, Januszewska K, Ko Cz J (2005) Successful surgical treatment of a neonate with prenatal diagnosis of severe Ebstein’s anomaly. Pediatr Cardiol (in press)
McElhinney DB, Salvin JW, Colan SD, Thiagarajan R, Crawford EC, Marcus EN, del Nido PJ, Tworetzky W (2005) Improving outcomes in fetuses and neonates with congenital displacement (Ebstein’s malformation) or dysplasia of the tricuspid valve. Am J Cardiol 96: 582–586
Mann RJ, Lie JT (1979) The life story of Wilhelm Ebstein (1836–1912) and his almost overlooked description of a congenital heart disease. Mayo Clin Proc 54: 197–204
Oberhoffer R, Cook AC, Lang D, Sharland G, Alan LD, Fagg NL, Anderson RH (1992) Correlation between echocardiographic and morphological investigations of lesions of the tricuspid valve diagnosed during fetal life. Br Heart J 68: 580–585
Pass RH, Williams MR, Quaegebeur JM, Liberman L, Hordof AJ (2002) Intraoperative radiofrequency linear catheter ablation of accessory pathways in children with Ebstein’s anomaly undergoing tricuspid annuloplasty. Am J Cardiol 90: 817–819
Pavlova M, Fouron JC, Drblik SP, van Doesburg NH, Bigras JL, Smallhorn J, Harder J, Robertson M (1998) Factors affecting the prognosis of Ebstein’s anomaly during fetal life. Am Heart J 135: 1081–1085
Roberson DA, Silverman NH (1989) Ebstein’s anomaly: echocardiographic and clinical features in the fetus and neonate. J Am Coll Cardiol 14: 1300–1307
Rudolph AM (2001) Ebstein malformation of the tricuspid valve. In: Rudolph AM: Congenital diseases of the heart: clinical-physiological considerations, 2nd edn. Futura, Armonk, pp 655–672
Sharland GK, Chita SK, Allan LD (1991) Tricuspid valve dysplasia or displacement in intrauterine life. J Am Coll Cardiol 17: 944–949
Sharland G, Tingay R, Jones A, Simpson JM (2005) Atrioventricular and ventriculo-arterial discordance (congenitally corrected transposition of the great arteries): echocardiographic features, associations and outcome in 34 fetuses. Heart 91: 1453–1458
Silverman NH, Gerlis LM, Horowitz ES, Ho SY, Neches WH, Anderson RH (1995) Pathologic elucidation of the echocardiographic features of Ebstein’s malformation of the morphologically tricuspid valve in discordant atrioventricular connections. Am J Cardiol 76: 1277–1283
Smrcek JM, Krapp M, Axt-Fliedner R, Kohl T, Geipel A, Diedrich K, Gembruch U, Berg C (2005) Atypical ductus venosus blood flow pattern in fetuses with severe tricuspid valve regurgitation. Ultrasound Obstet Gynecol 26: 180–182
Starnes VA, Pitlick PT, Bernstein D, Griffin ML, Choy M, Shumway NE (1991) Ebstein’s anomaly appearing in the neonate. A new surgical approach. J Thorac Cardiovasc Surg 101: 1082–1087
Tanaka T, Yammaki S, Ohno T, Ozawa A, Kakizawa H, Iinuma K (1998) The histology of the lung in neonates with tricuspid valve disease and gross cardiomegaly due to severe regurgitation. Pediatr Cardiol 19: 133–138
Yetman AT, Freedom RM, McCrindle BW (1998) Outcome in cyanotic neonates with Ebstein’s anomaly. Am J Cardiol 81: 749–754
Wu Q, Huang Z (2004) A new procedure for Ebstein’s anomaly. Ann Thorac Surg 77: 470–476
Watanabe M, Harada Y, Takeuchi T, Satomi G, Yasukouchi S (2002) Modified Starnes operation for neonatal Ebstein’s anomaly. Ann Thorac Surg 74: 916–917
Zuberbuhler JR, Allwork SP, Anderson RH (1979) The spectrum of Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovas Surg 77: 202–211
Interessenkonflikt:
Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gembruch, U., Kohl, T., Geipel, A. et al. Ebstein-Anomalie des Fetus. Gynäkologe 39, 39–47 (2006). https://doi.org/10.1007/s00129-005-1785-y
Issue Date:
DOI: https://doi.org/10.1007/s00129-005-1785-y