Ebstein anomaly treatment in 325 Cardiac surgery clinics worldwide

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325 clinics specializing in Cardiac surgery providing treatment of Ebstein anomaly Ebstein anomaly is a rare congenital heart defect where the tricuspid valve is malformed and displaced into the right ventricle. It can cause blood flow problems and may require surgical intervention for correction and improved cardiac function.
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disease worldwide.

Africa · 5
Americas · 73
Asia · 146
Europe · 94
Oceania · 7
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Africa · 5 Americas · 73 Asia · 146 Europe · 94 Oceania · 7
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Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $3,990
  2. Dual chamber pacemaker insertion
    $3,413
  3. Coronary artery bypass graft (CABG)
    $3,110
  4. Off-pump coronary artery bypass surgery
    ≈ $5,907
  5. Fontan procedure
    ≈ $5,217
  6. Permanent pacemaker implantation
    $2,266
  7. Radiofrequency ablation (RFA)
    $583
  8. Cardiac catheterization
    ≈ $617
  9. Percutaneous ASD closure
    $1,069
photo
Colombo, Sri Lanka
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Languages: English
It is located in Sri Jayewardenepura, the capital of Sri Lanka, on nearly 30 acres of beautifully landscaped garden with serene nature. This state of read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $9,242
  2. Dual chamber pacemaker insertion
    ≈ $2,684
  3. Implantable cardioverter-defibrillator implantation (ICD)
    $16,958
  4. Coronary artery bypass graft (CABG)
    $6,700
  5. Heart valve replacement
    $6,091
  6. Heart valve repair
    $6,786
  7. Aortic valve replacement (AVR)
    $6,786
  8. Mitral valve replacement (MVR)
    $6,786
  9. Transcatheter aortic valve replacement (TAVR)
    ≈ $16,717
photo
Almaty, Kazakhstan
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology, Dentistry
Languages: English, Russian
At the Almaty SEMA Hospital Clinic, you can get a full range of medical services provided by our leading specialists. Whether you need a small read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $10,618
  2. Coronary artery bypass graft (CABG)
    ≈ $8,327
  3. Heart valve replacement
    ≈ $8,417
  4. Heart valve repair
    ≈ $8,888
  5. Aortic valve replacement (AVR)
    ≈ $9,097
  6. Mitral valve replacement (MVR)
    ≈ $8,154
  7. Transcatheter aortic valve replacement (TAVR)
    ≈ $17,131
  8. Off-pump coronary artery bypass surgery
    ≈ $9,597
  9. Fontan procedure
    ≈ $9,401
photo
Rio de Janeiro, Brazil
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The Quinta D'Or Hospital opened in September 2001 and is located opposite Quinta da Boa Vista, in Rio de Janeiro. It emerged from the renovation read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Dual chamber pacemaker insertion
    ≈ $7,103
  3. Coronary artery bypass graft (CABG)
    ≈ $18,185
  4. Heart valve replacement
    ≈ $26,095
  5. Heart valve repair
    ≈ $22,493
  6. Aortic valve replacement (AVR)
    ≈ $25,324
  7. Mitral valve replacement (MVR)
    ≈ $19,375
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $34,544
  9. Off-pump coronary artery bypass surgery
    ≈ $17,515
photo
Buenos Aires, Argentina
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
We invite you to visit one of the largest health institutions in the country… A sanatorium with history, but looking to the future. The Doctor read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Coronary artery bypass graft (CABG)
    ≈ $18,185
  3. Heart valve replacement
    ≈ $26,095
  4. Heart valve repair
    ≈ $22,493
  5. Aortic valve replacement (AVR)
    ≈ $25,324
  6. Mitral valve replacement (MVR)
    ≈ $19,375
  7. Transcatheter aortic valve replacement (TAVR)
    ≈ $34,544
  8. Off-pump coronary artery bypass surgery
    ≈ $17,515
  9. Fontan procedure
    ≈ $18,706
photo
Buenos Aires, Argentina
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The British Hospital of Buenos Aires is a non-profit civil association that aims to provide the community with highly complex health care, train medical professionals read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Dual chamber pacemaker insertion
    ≈ $7,103
  3. Coronary artery bypass graft (CABG)
    ≈ $18,185
  4. Heart valve replacement
    ≈ $26,095
  5. Heart valve repair
    ≈ $22,493
  6. Aortic valve replacement (AVR)
    ≈ $25,324
  7. Mitral valve replacement (MVR)
    ≈ $19,375
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $34,544
  9. Off-pump coronary artery bypass surgery
    ≈ $17,515
photo
Buenos Aires, Argentina
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The Hospital de Clínicas José de San Martín is the flagship teaching hospital in our country. Dependent on the University of Buenos Aires, read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Dual chamber pacemaker insertion
    ≈ $7,103
  3. Fontan procedure
    ≈ $18,706
  4. Permanent pacemaker implantation
    ≈ $8,027
  5. Radiofrequency ablation (RFA)
    ≈ $16,122
  6. Catheter cardiac ablation
    ≈ $10,329
  7. Patent ductus arteriosus (PDA) ligation in children
    ≈ $10,688
  8. Electrophysiology study (EPS)
    ≈ $2,851
  9. Removal of permanent pacemaker
    ≈ $5,519
photo
Buenos Aires, Argentina
Specializations: Cardiac surgery, Vascular surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The Ricardo Gutiérrez Children's Hospital is a highly complex, tertiary, reference hospital for the entire country and neighboring countries. Since its creation, in 1875, it read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Fetal cardiac interventions
    by request
  3. Coronary artery bypass graft (CABG)
    ≈ $18,185
  4. Off-pump coronary artery bypass surgery
    ≈ $17,515
  5. Fontan procedure
    ≈ $18,706
  6. Cardiac catheterization
    ≈ $2,163
  7. Percutaneous ASD closure
    ≈ $9,790
  8. Percutaneous closure of ventricular septal defect (VSD)
    ≈ $9,579
  9. Coronary catheterization
    ≈ $1,595
photo
Buenos Aires, Argentina
Specializations: Cardiac surgery, Vascular surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The Hospital "Prof. Dr. Juan P. Garrahan" is the pediatric center of reference in public health, free and highly complex in Argentina. Since its inauguration, read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Fetal cardiac interventions
    by request
  3. Dual chamber pacemaker insertion
    ≈ $7,103
  4. Coronary artery bypass graft (CABG)
    ≈ $18,185
  5. Heart valve replacement
    ≈ $26,095
  6. Heart valve repair
    ≈ $22,493
  7. Aortic valve replacement (AVR)
    ≈ $25,324
  8. Mitral valve replacement (MVR)
    ≈ $19,375
  9. Transcatheter aortic valve replacement (TAVR)
    ≈ $34,544
photo
Córdoba, Argentina
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
We are a benchmark health care network in Argentina and we are committed to offering the world excellent medicine. Our Hospital is among the main read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Dual chamber pacemaker insertion
    ≈ $7,103
  3. Coronary artery bypass graft (CABG)
    ≈ $18,185
  4. Heart valve replacement
    ≈ $26,095
  5. Heart valve repair
    ≈ $22,493
  6. Aortic valve replacement (AVR)
    ≈ $25,324
  7. Mitral valve replacement (MVR)
    ≈ $19,375
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $34,544
  9. Off-pump coronary artery bypass surgery
    ≈ $17,515
photo
Córdoba, Argentina
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
Instituto Modelo de Cardiologia Privado SRL (IMC) is a professional organization focused on the Vision and Mission of: Offer patients comprehensive personalized medical assistance, read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $14,568
  2. Dual chamber pacemaker insertion
    ≈ $7,103
  3. Coronary artery bypass graft (CABG)
    ≈ $18,185
  4. Heart valve replacement
    ≈ $26,095
  5. Heart valve repair
    ≈ $22,493
  6. Aortic valve replacement (AVR)
    ≈ $25,324
  7. Mitral valve replacement (MVR)
    ≈ $19,375
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $34,544
  9. Off-pump coronary artery bypass surgery
    ≈ $17,515
photo
San Fernando del Valle de Catamarca, Argentina
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
Sanatorio Junín offer the entire population of Catamarca and the NOA integrated health care at levels of low to high complexity, with a highly qualified read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $45,135
  2. Dual chamber pacemaker insertion
    ≈ $20,802
  3. Coronary artery bypass graft (CABG)
    ≈ $38,786
  4. Heart valve replacement
    ≈ $44,147
  5. Heart valve repair
    ≈ $39,126
  6. Aortic valve replacement (AVR)
    ≈ $43,637
  7. Mitral valve replacement (MVR)
    ≈ $36,409
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $80,926
  9. Off-pump coronary artery bypass surgery
    ≈ $44,544
photo
Randwick, Australia
Specializations: Cardiac surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Languages: Chinese, Russian
We have 450 inpatient beds and almost 3,000 staff. Each year we care for more than 58,000 patients in our Emergency Department and around 50,000 read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $45,135
  2. Coronary artery bypass graft (CABG)
    ≈ $38,786
  3. Heart valve replacement
    ≈ $44,147
  4. Heart valve repair
    ≈ $39,126
  5. Aortic valve replacement (AVR)
    ≈ $43,637
  6. Mitral valve replacement (MVR)
    ≈ $36,409
  7. Transcatheter aortic valve replacement (TAVR)
    ≈ $80,926
  8. Off-pump coronary artery bypass surgery
    ≈ $44,544
  9. Fontan procedure
    ≈ $37,099
photo
Brisbane, Australia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
St Andrew’s is an acute care hospital specialising in technologically advanced surgical and general medical care. The hospital has 250 beds including a new state-of-the-art read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $7,861
  2. Dual chamber pacemaker insertion
    ≈ $2,500
  3. Coronary artery bypass graft (CABG)
    ≈ $7,679
  4. Heart valve replacement
    ≈ $9,343
  5. Heart valve repair
    ≈ $7,348
  6. Aortic valve replacement (AVR)
    ≈ $11,130
  7. Mitral valve replacement (MVR)
    ≈ $7,923
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $15,082
  9. Off-pump coronary artery bypass surgery
    ≈ $5,508
photo
Dhaka, Bangladesh
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Evercare Hospital Dhaka is a 425-bed multidisciplinary super specialty tertiary care hospital which is the first and only hospital in Bangladesh to have got JCI read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $7,861
  2. Dual chamber pacemaker insertion
    ≈ $2,500
  3. Coronary artery bypass graft (CABG)
    ≈ $7,679
  4. Off-pump coronary artery bypass surgery
    ≈ $5,508
  5. Fontan procedure
    ≈ $5,701
  6. Permanent pacemaker implantation
    ≈ $2,957
  7. Radiofrequency ablation (RFA)
    ≈ $8,080
  8. Cardiac catheterization
    ≈ $873
  9. Percutaneous ASD closure
    ≈ $3,338
photo
Dhaka, Bangladesh
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Asgar Ali Hospital is the Best Hospital in Bangladesh. We are a 350 bedded multi-disciplinary tertiary-care Hospital, situated at Gandaria, Dhaka. It is a concern read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $7,861
  2. Dual chamber pacemaker insertion
    ≈ $2,500
  3. Coronary artery bypass graft (CABG)
    ≈ $7,679
  4. Heart valve replacement
    ≈ $9,343
  5. Heart valve repair
    ≈ $7,348
  6. Aortic valve replacement (AVR)
    ≈ $11,130
  7. Mitral valve replacement (MVR)
    ≈ $7,923
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $15,082
  9. Off-pump coronary artery bypass surgery
    ≈ $5,508
photo
Dhaka, Bangladesh
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The Ibn Sina Hospital was established in July 1983, Keeping in Pace with continuous development of medical technologies,Ibn Sina hospital has been rendering its services read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $7,861
  2. Dual chamber pacemaker insertion
    ≈ $2,500
  3. Coronary artery bypass graft (CABG)
    ≈ $7,679
  4. Heart valve replacement
    ≈ $9,343
  5. Heart valve repair
    ≈ $7,348
  6. Aortic valve replacement (AVR)
    ≈ $11,130
  7. Mitral valve replacement (MVR)
    ≈ $7,923
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $15,082
  9. Off-pump coronary artery bypass surgery
    ≈ $5,508
photo
Dhaka, Bangladesh
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Opening its doors in August 2006 and situated beside the picturesque Gulshan Lake, this hospital is one of the largest private sector healthcare facilities in read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $7,861
  2. Coronary artery bypass graft (CABG)
    ≈ $7,679
  3. Heart valve replacement
    ≈ $9,343
  4. Heart valve repair
    ≈ $7,348
  5. Aortic valve replacement (AVR)
    ≈ $11,130
  6. Mitral valve replacement (MVR)
    ≈ $7,923
  7. Transcatheter aortic valve replacement (TAVR)
    ≈ $15,082
  8. Off-pump coronary artery bypass surgery
    ≈ $5,508
  9. Fontan procedure
    ≈ $5,701
photo
Dhaka, Bangladesh
Specializations: Cardiac surgery, Vascular surgery, Neurosurgery, Orthopedic surgery, Oncology
Bangabandhu Sheikh Mujib Medical University (BSMMU) is the premier Postgraduate Medical Institution of the country. It bears the heritage to Institute of Postgraduate Medical Research read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $7,861
  2. Dual chamber pacemaker insertion
    ≈ $2,500
  3. Fontan procedure
    ≈ $5,701
  4. Permanent pacemaker implantation
    ≈ $2,957
  5. Radiofrequency ablation (RFA)
    ≈ $8,080
  6. Coronary catheterization
    ≈ $748
  7. Percutaneous coronary intervention (PCI) with stent insertion
    ≈ $3,286
  8. Catheter cardiac ablation
    ≈ $3,473
  9. Patent ductus arteriosus (PDA) ligation in children
    ≈ $3,510
photo
Chittagong, Bangladesh
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Oncology
Located at the heart of Chattogram, city, Max Hospital and Diagnostics limited have started out its journey in September 2015 with an aim to provide read more
Prices for popular procedures:
  1. Ebstein anomaly correction
    ≈ $11,233
  2. Coronary artery bypass graft (CABG)
    ≈ $11,223
  3. Heart valve replacement
    ≈ $12,319
  4. Heart valve repair
    ≈ $12,913
  5. Aortic valve replacement (AVR)
    ≈ $12,915
  6. Mitral valve replacement (MVR)
    ≈ $9,486
  7. Transcatheter aortic valve replacement (TAVR)
    ≈ $20,733
  8. Off-pump coronary artery bypass surgery
    ≈ $12,074
  9. Fontan procedure
    ≈ $12,963
photo
Bratislava, Slovakia
Specializations: Cardiac surgery, Vascular surgery
The National Institute of Heart and Vascular Diseases is one of the most modern and best-equipped Slovak hospitals, the top institution of cardiovascular medicine in read more

Clinics grouping by rating

Clinic with the highest rating of 5 — Clinical Hospital Lapino in Moscow, Russia and 3 more, clinic with the most reviews number of 35757 — Aster CMI hospital in Bengaluru, India.

With rating 4.0 and over — 128 clinics .

Countries with the highest number of clinics treating the diseases:

Ebstein anomaly:

Related procedures:

Procedures are likely to be used for Ebstein anomaly treatment: Ebstein anomaly correction and Fetal cardiac interventions .

Ebstein anomaly - what you should know about the disease

Classification, pathophysiology of Ebstein anomaly

Ebstein anomaly includes a wide range of morphological and clinical manifestations. Those who show symptoms in early infancy tend to be at the highest risk. This pathology affects the tricuspid valve (its other name is tricuspid) and is a congenital malformation of the cardiovascular system. At the same time, there is a shift of the point of attachment of the cusps of this valve - septal and posterior - down. However, the anterior cusp is usually not affected. The leaflets themselves are dysplastic, i.e. developed incorrectly. As a result of the displacement, poor closure of the valve leaflets (in other words, impaired coaptation) is observed, which leads to tricuspid regurgitation - the backflow of blood through the tricuspid valve. This, in turn, causes an increase in the size of the right atrium of varying degrees.

Causes and prevalence of Ebstein anomaly

No defect in any one gene has been identified with Ebstein anomaly. This pathology appears to be genetically heterogeneous; develops as a result of various, unpredictable, several gene anomalies. Several candidate genes have been proposed as culprits, including GATA4 and NKX2.5. Lithium exposure during pregnancy has been reported as a causative factor.

Ebstein anomaly accounts for 0.3 to 0.6% of all congenital heart defects. There is no preponderance towards children of any gender, and most cases are completely sporadic, i.e. occur spontaneously and randomly. The frequency of recurrence in the offspring of women is higher (6%) than in the offspring of men (0.6%).

Anatomy and pathophysiology of Ebstein anomaly

The tricuspid valve separates the right atrium (the chamber that receives blood from the body) from the right ventricle (the chamber that pumps blood to the lungs).

In Ebstein anomaly, the two leaflets of the tricuspid valve move down into the pumping chamber. The third flap has an elongated shape and can be attached to the chamber wall. In rare cases, the valve becomes so deformed that it does not allow blood to flow freely forward in the normal direction.

Most often, these anomalies cause blood to leak through the tricuspid valve from the right ventricle back into the right atrium, into the systole - i.e. when the muscles of the right ventricle contract. As a result, the right atrium expands in size, accommodating an unusually large volume of blood.

Hemodynamic disturbances depend on the severity of the lesion. The main determining factors are the degree of displacement of the tricuspid valve leaflets and the degree of tricuspid regurgitation. With a mild degree of Ebstein anomaly, the function of the tricuspid valve is close to normal. But if the tricuspid regurgitation is severe enough, with each atrial contraction blood is ejected into the right ventricle, and with ventricular contraction it is pushed back into the right atrium. This can lead to congestive heart failure.

Normally, the fetus has a communication between the right and left atria, known as the foramen ovale (foramen ovale). It usually closes after the baby is born. However, in Ebstein anomaly, there is a reverse flow of blood into the right atrium, so the pressure inside this chamber of the heart becomes very high. This keeps the foramen ovale open, and as a result, oxygen-poor blood flows from the right atrium to the left, bypassing the lungs and heading straight for the organs and tissues. This is why children with Ebstein anomaly may have a bluish, or "cyanotic" skin tone.

This heart disease can also occur with other lesions of this organ, such as stenosis or atresia of the pulmonary valve, atrial or ventricular septal defect. In addition, many patients with Ebstein anomaly have an extra conduction pathway in the heart that can potentially lead to episodes of an abnormal fast heart rate called supraventricular tachycardia (this condition is known as Wolff-Parkinson-White syndrome).

Signs and symptoms of Ebstein anomaly

Ebstein anomaly can range from very mild to very severe, having 4 degrees, from 1 to 4, respectively. Many patients with milder forms of Ebstein anomaly are asymptomatic, and as a result, the malformation may be discovered in adulthood—often due to the discovery of a heart murmur. Abnormal or extra heart sounds may also be detected during a routine examination.

In some infants and children, the skin turns bluish (cyanotic) due to blood flow from the right atrium to the left. Children may complain of heart palpitations and skipping beats, sometimes people describe this feeling as "a strange heartbeat". They are characterized by increased fatigue, shortness of breath, especially during the game, and chest pain. Growth and development in patients with Ebstein anomaly is usually normal.

Severely affected children are often critically ill at birth, with low oxygen saturation and heart failure requiring immediate intensive care.

Diagnosis of Ebstein anomaly

If you suspect a heart defect, you should immediately consult a doctor. A chest x-ray should be done to assess size. Often the diagnosis of Ebstein anomaly is suspected precisely because of a very large heart on a chest x-ray.

Echocardiography is used to definitively diagnose Ebstein anomaly and identify any associated heart defects. This study allows the pediatric cardiologist to determine the degree of valve wall displacement, the severity of valve failure, or orifice narrowing. You can determine the size of the chambers of the heart and the presence of an open foramen ovale.
An electrocardiogram records the electrical activity of the heart. It is indicated for recording the heart rhythm when there is a violation of it. An exercise stress test may be performed to better assess heart function during increased activity. Some patients with abnormal heart rhythms may require an additional electrophysiological study to more accurately identify problems with the heart rhythm.

Invasive diagnostic tests are used much less frequently today than in previous years. This is due to the availability of more informative non-invasive methods, such as echocardiography and MRI. However, some patients with Ebstein anomaly may require cardiac catheterization.

Treatment of Ebstein anomaly

Mild defects often do not require special treatment. In addition, there is no need for bacterial endocarditis prophylaxis, such as taking antibiotics during dental visits. Drug treatment is reserved for children with congestive heart failure or abnormal heart rhythms.

Surgery may only be indicated under certain circumstances. Surgical repair or replacement of the tricuspid valve and closure of the foramen ovale are sometimes recommended. Surgery may be indicated for older children with moderate to severe congestive heart failure, significant enlargement of the heart, cyanosis, or abnormal blood clots. Abnormal accessory pathways that contribute to supraventricular tachycardia may be removed.

Medical therapy for heart failure or arrhythmias is usually combined with elective surgery. Very severe forms of Ebstein anomaly may require surgery in the neonatal period, and management is more similar to that for children with single ventricular heart anomalies.

Disease prognosis

Without any treatment, the prognosis for children with Ebstein anomaly is very poor. Studies have shown that only half of all people affected by this disease, without treatment, can live up to 13 years. However, people with milder forms have a better prognosis and life expectancy close to the population average.

The Zelermeier index is used to predict outcome based on the fetal or neonatal echocardiogram. This indicator allows you to predict the likelihood of mortality. The higher the class, the higher this indicator:

  • at grade 1 (ratio less than 0.5), the mortality rate is 0%;
  • at grade 2 (ratio 0.5 to 0.99), the mortality rate is 10%;
  • at grade 3 (ratio 1.0 to 1.49), the mortality rate is 4%;
  • at grade 4 (coefficient greater than 1.5), the mortality rate is 100%.

Life of people with Ebstein anomaly

Ebstein anomaly can be diagnosed at any age, including adults. As already mentioned, people with the mildest form of the disease may not have any problems throughout their lives. Many people with this pathology develop arrhythmia, and the older the person, the higher the likelihood of such an outcome.

All people with Ebstein anomaly need lifelong medical supervision. Many needs treatment for rhythm disturbances, including ablation procedures. Episodes of life-threatening arrhythmias tend to recur; in addition, the development of other arrhythmias that require constant monitoring is possible.

References:

  1. Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Cyanotic congenital heart lesions: lesions associated with decreased pulmonary blood flow. In: Kliegman RM, St.Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 457.
  2. Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease in the adult and pediatric patient. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 75.
  3. Mulla S, Asuka E, Siddiqui WJ. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 28, 2021. Tricuspid Regurgitation.
  4. Voges I, Al-Mallah MH, Scognamiglio G, Di Salvo G. Right Heart-Pulmonary Circulation Unit in Congenital Heart Diseases. Heart Fail Clin. 2018 Jul;14(3):283-295.
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