Ebstein’s Anomaly Corrected by Tissue Valve: Case Report.

Ebstein’s anomaly is a rare form of congenital heart disease with incidence of 1% of all congenital heart diseases. There are two modes of surgical correction of Ebstein’s anomaly: either biventricular repair with or without tricuspid valve replacement, or palliative univentricular repair consisting of bidirectional Glenn shunt or Fontan procedure. We treated a case of severe form of Ebstein’s anomaly with ASD secundum with WPW syndrome. Radiofrequency ablation was done to treat WPW syndrome preoperatively. Celermajer’s index is a prognostic indicator for tricuspid valve repair or replacement. On 04.03.08 tricuspid valve was replaced with 31 mm Carpentier-Edwards bovine pericardial valve under cardiopulmonary bypass. Postoperative period was uneventful. Follow up echo done on 01.06.08 which revealed normally functioning tissue valve found in tricuspid position TR Grade I. So, in conclusion, preoperative evaluation and workout of Celermajer’s index is essential before surgical intervention for decision of tricuspid valve repair or replacement. Last but not the least, any event of arrhythmia should be properly evaluated.

[Lectin histochemical method for the dectection of surface sugars in the adrenal medullary cells of embryos and newborn mice]

To distinguish the special effect of terminal sugar/sugars on development of adrenal gland medulla fetal or afterbirth. Determining the days that they are effective on development as inductive factors was another objective. In the study, we used of 12 females and 4 males BALB/c mice. Fetuses of all gestational days and newboms up to 15 days of age were fixed and processed by common histological techniques, and sections were obtained from adrenal region. The number of normal newborns and embryos were 78 heads. To distinguish the terminal sugars, we used lectins that are PNA [peanut agglutinin], VVA [vicia villosa agglutinin] and GSA1-B4 [griffonia simplia-B4]. Lectins were detected by DAB [diaminobenzidin] dye after binding to terminal sugars. Adrenal medulla cells reacted only to PNA at 13th gestational day to birth and up to 15[th] after birth. Several sections from all of specimens which we used for the lectin histochemistery study did not react to three other lectins. Findings of this study elucidated that Gal-GalNAc terminal sugar, which is specific to PNA lectin, is a key terminal sugar in studied days. So we suggest that Gal-GalNAc has a key role on adrenal medulla development at 13[th] fetal day to birth and 15 days afterbirth