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In Ebstein's Anomaly, the Tricuspid valve, normally present between
the upper and lower chambers on the right side, is displaced into the
right ventricle.
In this situation, when the right ventricle contracts, blood goes
backward to the right atrium.
How does it affect the Child:
Symptoms will depend on the severity of the case. If the
Ebstein's anomaly is mild,, no symptoms will appear. However, when more
severe cases are diagnosed, symptoms like rhythm disturbances, fatigue,
cyanosis or heart failure are apparent.
An Echocardiography can confirm the diagnosis.
Can it be fixed:
Medications can be used to decrease the pressure in the
right ventricle to prevent the leakage. Medications like Prostaglandin are
given to keep the ductus arteriosus open, thus helping the blood to get
from the aorta to the lungs. When the pressure in the lungs is decreased,
then prostaglandin can be stopped.
If the medications are not helping to lower the pressure,
then a surgery should be done.
The surgical operation, also called Fontan operation, aims
at closing the valve to stop the leakage. The surgery can also be used to
repair the valve, however in babies with severe Ebstein's anomaly, the
success rate is low. Replacing the valve with an artificial one is also
one possibility for older children.
After surgery, some complications like stenosis or
bleeding can occur. The outlook for very severe Ebstein's anomaly is not
very good, and surgical operations have not been very satisfactory if done
in early childhood.
In older children, replacement of the tricuspid valve
gives better results but still requires lifelong follow-up.
If the Ebstein's anomaly is mild, the child will have a
near normal life.
What should the parents do:
Follow the Doctor's advice on:
1- Giving Medicine
2- Return visits to doctor
3- Special tests
4- Extreme care with Dental procedures. Tell the dentist about the
problem BEFORE he fixes child's teeth to avoid infection in the heart.
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