Severe Ebstein's anomaly in a premature, low-weight neonate

Commentary: Neonatal Ebstein: Starnes procedure first … Fontan not necessarily the lastThe Journal of Thoracic and Cardiovascular SurgeryVol. 166Issue 6PreviewCleveland and colleagues1 present a case of a critically ill neonate with Ebstein anomaly with an accompanying thoughtful discussion. The key strengths of the paper include successful management of this baby born premature with intrauterine growth restriction through the neonatal period (although the patient remains hospitalized at time of paper submission) and the center's focused approach and successful track record with the Starnes procedure for management of neonatal Ebstein anomaly. However, their unique strategy for a long central shunt many surgeons may find controversial, particularly in a baby of low birth weight, where the ideal length is not certain and optimization of pulmonary/systemic blood flow would be difficult. Full-Text PDF