23rd September 2021

A 9-year-old male presents to the cardiology clinic with increasing lethargy and shortness of breath

A 9-year-old male presents to the cardiology clinic with increasing lethargy and shortness of breath. He is being monitored for Ebstein’s anomaly, with an associated atrial septal defect, which was diagnosed antenatally. However, he had not experienced any symptoms from this previously. On examination, there is a pansystolic murmur. Echocardiography demonstrates apical displacement of the tricuspid valve, with severe right atrial enlargement, as well as an interatrial left-to-right shunt.

Which of the following is the most appropriate management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.