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      Ectopia Cordis Associated with Pentalogy of Cantrell-A Case Report Translated title: Ectopia cordis associada à pentalogia de Cantrell-relato de caso

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          Abstract

          Abstract Pentalogy of Cantrell (PC) is a rare congenital anomaly characterized by changes in the mesodermal median structures and congenital heart disease, often with a poor prognosis. In 1958, Cantrell et al2 defined the full spectrum of the syndrome with the following anomalies: defects of the anterior diaphragm, of the lower part of the sternum, of the supraumbilical region and the abdominal wall, of the diaphragmatic pericardium, and various intracardiac congenital abnormalities. The present report describes a case of ectopia cordis associated with PC and the importance of the participation of a multidisciplinary team in the treatment of this condition.

          Translated abstract

          Resumo A pentalogia de Cantrell (PC) é uma rara anomalia congênita caracterizada por alterações nas estruturas medianas mesodérmicas e doenças cardíacas congênitas, cursando muitas vezes com um mau prognóstico. Em 1958, Cantrell et al2 definiram o espectro completo da síndrome com as seguintes anomalias: defeitos do diafragma anterior, da parte inferior do esterno, da região supraumbilical e parede abdominal, do pericárdio diafragmático, e várias anormalidades congênitas intracardíacas. O presente relato relaciona-se a um caso de ectopia cordis associado à PC e à importância da participação de uma equipe multidisciplinar no acompanhamento da doença.

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          Most cited references31

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          A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart.

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            Combined congenital defects of the anterior abdominal wall, sternum, diaphragm, pericardium, and heart: a case report and review of the syndrome.

            W M Toyama (1972)
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              Ectopia cordis and other midline defects.

              Thoracic ectopia cordis and other midline defects are rare congenital anomalies that often occur with other intracardiac defects. Despite significant improvements in neonatal and infant cardiac surgeries, operations for thoracoabdominal ectopia cordis carry an extremely high mortality with only a few reported survivors of thoracic ectopia cordis. The clinical charts of 4 patients with ectopia cordis over a 6-year period were reviewed. Three of the patients showed varying degrees of Cantrell's Pentalogy; thoracic ectopia cordis was found in 1. We have reviewed our surgical strategies and reported the patients' clinical outcomes. All 4 patients are alive at follow-up. Two infants with double-outlet right ventricle have been fully corrected, and extracorporeal membrane oxygenation was necessary in 1 infant for cardiac failure following the cardiac repair. A newborn with thoracoabdominal ectopia cordis underwent primary repair of his diaphragmatic defect, and a silo was used to progressively reduce the omphalocele. He is currently awaiting elective repair of tetralogy of Fallot. Lastly, the patient with thoracic ectopia cordis underwent successful soft tissue coverage, and she is being followed in the clinic with restrictive muscular ventricular septal defects and a left ventricular diverticulum. Our experience along with other reports in the literature demonstrates that patients with thoracic and thoracoabdominal ectopia cordis can undergo and survive full cardiac, neurologic, and abdominal repair during infancy. Furthermore we advocate different approaches determined by the severity of the presentation and the presence of other complicating factors.

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbgo
                Revista Brasileira de Ginecologia e Obstetrícia
                Rev. Bras. Ginecol. Obstet.
                Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (Rio de Janeiro, RJ, Brazil )
                0100-7203
                1806-9339
                May 2019
                : 41
                : 5
                : 352-356
                Affiliations
                [3] Caxias do Sul Rio Grande do Sul orgnameUniversidade de Caxias do Sul orgdiv1Faculty of Medicine orgdiv2Department of Pediatrics and Neonatology Brazil
                [2] Caxias do Sul Rio Grande do Sul orgnameUniversidade de Caxias do Sul orgdiv1Hospital Geral de Caxias do Sul orgdiv2Department of Radiology Brazil
                [1] Caxias do Sul Rio Grande do Sul orgnameUniversidade de Caxias do Sul orgdiv1Faculty of Medicine orgdiv2Department of Obstetrics and Gynecology Brazil
                [4] Caxias do Sul Rio Grande do Sul orgnameUniversidade de Caxias do Sul orgdiv1Faculty of Medicine orgdiv2Department of Endocrinology Brazil
                Article
                S0100-72032019000500352
                10.1055/s-0039-1679878
                30912088
                48383ad6-376e-45bb-b4d7-3f70121ba040

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 January 2019
                : 10 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 5
                Product

                SciELO Brazil

                Categories
                Case Report

                pentalogy of Cantrell,umbilical hernia,congenital heart defects,defeitos da parede abdominal,defeitos congênitos cardíacos,hérnia umbilical,ectopia cordis,abdominal wall defects,pentalogia de Cantrell

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