Ebstein's anomaly and critical aortic coartation in a newborn. An atypical combination

Abstract

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.