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Midterm result of a case after Starnes operation
Iki Adachi1, Toru Ishizaka, Hajime Ichikawa
1Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|June 16, 2004
Summary
The Starnes operation offers positive midterm outcomes for neonates with severe Ebstein's anomaly, enabling a normal childhood. This surgical approach facilitates subsequent Fontan procedures, improving long-term cardiac function in infants.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Ebstein's anomaly is a rare congenital heart defect impacting the tricuspid valve, often leading to severe symptoms in neonates.
- The Starnes operation is a palliative surgical procedure used in neonates with complex congenital heart disease.
Observation:
- A case report details a neonate with severe Ebstein's anomaly and "wall to wall heart" who underwent the Starnes operation.
- The procedure involved tricuspid valve closure without fenestration and drainage of the coronary sinus into the right ventricle.
Findings:
- The patient subsequently underwent bidirectional Glenn shunt and Fontan operation at 6 and 23 months, respectively.
- At 5-year follow-up, the patient showed a normally sized left ventricle with good function and a small right ventricle.
- No thrombus formation was observed, and systolic forward flow was present.
Implications:
- The Starnes operation can be an effective initial step in managing severely symptomatic neonates with Ebstein's anomaly.
- This approach allows for staged palliation, potentially leading to favorable long-term outcomes and improved quality of life.
- Successful staged palliation supports the feasibility of achieving normal childhood activities for affected individuals.