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Open Access 12-03-2025 | Patent Ductus Arteriosus | Review

Hemodynamic considerations for prenatal treatment of severe Ebstein anomaly with circular shunt based on two cases and review of the literature

Authors: Adeline Walter, Ruben Plöger, Florian Recker, Boulos Asfour, Nathalie Mini, Annegret Geipel, Ulrich Gembruch, Brigitte Strizek

Published in: Archives of Gynecology and Obstetrics

Abstract

Prenatal severe Ebstein anomaly might be complicated by a circular shunt. In these cases, persistently elevated right atrial and venous pressure (due to severe tricuspid regurgitation) is complicated by a systemic ineffective blood shunt via a DA, resulting in diminished end-organ perfusion and acidosis, due to overall low cardiac output. Affected fetuses are at a significantly higher risk of intrauterine fetal demise. Reduction of ductal flow by prenatal treatment with nonsteroidal anti-inflammatory drugs has recently been described as a potential treatment option. However, published data are limited and management during the antenatal course is not well defined. We provide a literature review to propose a possible algorithm for prenatal assessment and initiation of treatment.

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Title: Hemodynamic considerations for prenatal treatment of severe Ebstein anomaly with circular shunt based on two cases and review of the literature
Authors: Adeline Walter
Ruben Plöger
Florian Recker
Boulos Asfour
Nathalie Mini
Annegret Geipel
Ulrich Gembruch
Brigitte Strizek
Publication date: 12-03-2025
Publisher: Springer Berlin Heidelberg
Keywords: Patent Ductus Arteriosus
Patent Ductus Arteriosus
Patent Ductus Arteriosus
Patent Ductus Arteriosus
Indomethacin
CSF Drainage
Echocardiography
Echocardiography
Published in: Archives of Gynecology and Obstetrics
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-025-07990-z

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