Abstract
Thirty five cases of Ebstein's anomaly were diagnosed by cardiac catheter study or echocardiography between 1962 and 1984. The anomaly was an isolated abnormality in 27 patients; the remainder had additional heart lesions. Six patients have died and four of these had other cardiac lesions. Thirteen are currently symptom free. Twelve cases presented with cyanosis and heart murmur on the first day of life. Eight of these had associated thrill which is a rare finding in neonates. As pulmonary vascular resistance fell there was clinical improvement. This was assisted by oxygen treatment. Another two cases presented in the first week of life and 10 in the first decade with a murmur or supraventricular tachycardia. Eleven cases presented as adolescents or adults with a murmur, cardiomegaly, or cardiac symptoms. Three patients were seen initially in the sixth decade. Clinical diagnosis was correct in only one adult. Twenty five patients had cardiac catheterisation. Important arrhythmias occurred in 10 cases, and two required cardioversion. Difficulty was experienced in entering the pulmonary artery in 11 infants and children. Diagnosis at initial catheter study was incorrect in four patients. Echocardiograms were recorded in 29 cases. Earlier M mode measurements of time delay of tricuspid closure compared with mitral closure did not always lead to the correct diagnosis. Cross sectional studies gave good images of tricuspid leaflet displacement, its tethering, and the atrialised portion of the right ventricle and have facilitated the diagnosis of more cases in recent years. Echocardiography is the procedure of choice for diagnosis of Ebstein's anomaly.
Full text
PDF





Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson K. R., Zuberbuhler J. R., Anderson R. H., Becker A. E., Lie J. T. Morphologic spectrum of Ebstein's anomaly of the heart: a review. Mayo Clin Proc. 1979 Mar;54(3):174–180. [PubMed] [Google Scholar]
- Bialostozky D., Horwitz S., Espino-Vela J. Ebstein's malformation of the tricuspid valve. A review of 65 cases. Am J Cardiol. 1972 Jun;29(6):826–836. doi: 10.1016/0002-9149(72)90503-6. [DOI] [PubMed] [Google Scholar]
- Daniel W., Rathsack P., Walpurger G., Kahle A., Gisbertz R., Schmitz J., Lichtlen P. R. Value of M-mode echocardiography for non-invasive diagnosis of Ebstein's anomaly. Br Heart J. 1980 Jan;43(1):38–44. doi: 10.1136/hrt.43.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Danielson G. K., Fuster V. Surgical repair of Ebstein's anomaly. Ann Surg. 1982 Oct;196(4):499–504. doi: 10.1097/00000658-198210000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Freedon R. M., Culham G., Moes F., Olley P. M., Rowe R. D. Differentiation of functional and structural pulmonary atresia: role of aortography. Am J Cardiol. 1978 May 1;41(5):914–920. doi: 10.1016/0002-9149(78)90733-6. [DOI] [PubMed] [Google Scholar]
- Giuliani E. R., Fuster V., Brandenburg R. O., Mair D. D. Ebstein's anomaly: the clinical features and natural history of Ebstein's anomaly of the tricuspid valve. Mayo Clin Proc. 1979 Mar;54(3):163–173. [PubMed] [Google Scholar]
- Gussenhoven E. J., Stewart P. A., Becker A. E., Essed C. E., Ligtvoet K. M., De Villeneuve V. H. "Offsetting" of the septal tricuspid leaflet in normal hearts and in hearts with Ebstein's anomaly. Anatomic and echographic correlation. Am J Cardiol. 1984 Jul 1;54(1):172–176. doi: 10.1016/0002-9149(84)90324-2. [DOI] [PubMed] [Google Scholar]
- Hansen J. F., Leth A., Dorph S., Wennevold A. The prognosis in Ebstein's disease of the heart. Long-term follow-up of 22 patients. Acta Med Scand. 1977;201(4):331–335. doi: 10.1111/j.0954-6820.1977.tb15708.x. [DOI] [PubMed] [Google Scholar]
- Kumar A. E., Fyler D. C., Miettinen O. S., Nadas A. S. Ebstein's anomaly. Clinical profile and natural history. Am J Cardiol. 1971 Jul;28(1):84–95. doi: 10.1016/0002-9149(71)90038-5. [DOI] [PubMed] [Google Scholar]
- Littler W. A. Successful pregnancy in a patient with Ebstein's anomaly. Br Heart J. 1970 Sep;32(5):711–713. doi: 10.1136/hrt.32.5.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mann R. J., Lie J. T. The life story of Wilhelm Ebstein (1836-1912) and his almost overlooked description of a congenital heart disease. Mayo Clin Proc. 1979 Mar;54(3):197–204. [PubMed] [Google Scholar]
- Park J. M., Sridaromont S., Ledbetter E. O., Terry W. M. Ebstein's anomaly of the tricuspid valve associated with prenatal exposure to lithium carbonate. Am J Dis Child. 1980 Jul;134(7):703–704. doi: 10.1001/archpedi.1980.02130190069018. [DOI] [PubMed] [Google Scholar]
- Ports T. A., Silverman N. H., Schiller N. B. Two-dimensional echocardiographic assessment of Ebstein's anomaly. Circulation. 1978 Aug;58(2):336–343. doi: 10.1161/01.cir.58.2.336. [DOI] [PubMed] [Google Scholar]
- Schiebler G. L., Gravenstein J. S., Van Mierop L. H. Ebstein's anomaly of the tricuspid valve. Translation of original description with comments. Am J Cardiol. 1968 Dec;22(6):867–873. doi: 10.1016/0002-9149(68)90185-9. [DOI] [PubMed] [Google Scholar]
- Shiina A., Seward J. B., Edwards W. D., Hagler D. J., Tajik A. J. Two-dimensional echocardiographic spectrum of Ebstein's anomaly: detailed anatomic assessment. J Am Coll Cardiol. 1984 Feb;3(2 Pt 1):356–370. doi: 10.1016/s0735-1097(84)80020-0. [DOI] [PubMed] [Google Scholar]
- Shiina A., Seward J. B., Tajik A. J., Hagler D. J., Danielson G. K. Two-dimensional echocardiographic--surgical correlation in Ebstein's anomaly: preoperative determination of patients requiring tricuspid valve plication vs replacement. Circulation. 1983 Sep;68(3):534–544. doi: 10.1161/01.cir.68.3.534. [DOI] [PubMed] [Google Scholar]
- Simcha A., Bonham-Carter R. E. Ebstein's anomaly. Clinical study of 32 patients in childhood. Br Heart J. 1971 Jan;33(1):46–49. doi: 10.1136/hrt.33.1.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smallhorn J. F., Izukawa T., Benson L., Freedom R. M. Noninvasive recognition of functional pulmonary atresia by echocardiography. Am J Cardiol. 1984 Oct 1;54(7):925–926. doi: 10.1016/s0002-9149(84)80239-8. [DOI] [PubMed] [Google Scholar]
- Waickman L. A., Skorton D. J., Varner M. W., Ehmke D. A., Goplerud C. P. Ebstein's anomaly and pregnancy. Am J Cardiol. 1984 Jan 15;53(2):357–358. doi: 10.1016/0002-9149(84)90466-1. [DOI] [PubMed] [Google Scholar]
- Watson H. Natural history of Ebstein's anomaly of tricuspid valve in childhood and adolescence. An international co-operative study of 505 cases. Br Heart J. 1974 May;36(5):417–427. doi: 10.1136/hrt.36.5.417. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whittemore R., Hobbins J. C., Engle M. A. Pregnancy and its outcome in women with and without surgical treatment of congenital heart disease. Am J Cardiol. 1982 Sep;50(3):641–651. doi: 10.1016/0002-9149(82)90334-4. [DOI] [PubMed] [Google Scholar]




