Cross-Sectional Echocardiographic Features of Ebstein’s Malformation

Abstract

Diagnostic criteria were defined for Ebstein’s malformation of the tricuspid valve (TV) using the multiple crystal echo approach (Bom) that provides real time studies of cross-section cardiac anatomv. In 6 patients using a single crystal technique nonspecific findings of tricuspid regurgitation (TR) were observed. In contrast, multicrystal studies in all patients revealed increased right ventricular (RV) dimensions and consistently abnormal TV echoes. In sagittal view the septal leaflet of the TV was displaced inferiorly within the RV cavity and its diastolic excursion was anterosuperiorly oriented. Additional findings in this view included multiple TV echoes, elongation and increased leaflet excursion of the TV and a “whipping” pattern of motion. In transverse views the TV was displaced leftward when mitral valve position was used as a reference landmark. True, paradoxical systolic anterior motion of the entire ventricular septum was observed in 5/5 patients and was seen even when only minimal TR was present.