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Ebstein’s anomaly of the tricuspid valve

  • Congenital Heart Disease
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Abstract

Ebstein’s anomaly of the tricuspid valve is a rare lesion comprising less than 1% of patients with congenital heart disease. Among congenital heart lesions, Ebstein’s anomaly is one of the most diverse in presentation, severity, and management. In its most severe form, it is also one of the most lethal. In this article we present a case of a patient who developed cardiac symptoms in adulthood. We follow this with a review of the pathology, clinical presentation, evaluation, and management of Ebstein’s anomaly.

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References and Recommended Reading

  1. Fyler DC, Buckley LP, Hellenbrand WE, et al.:Report of the New England Regional Infant Cardiac Program.Pediatrics 1980,65(Suppl):453.

    Google Scholar 

  2. Arizmendi AF, Pineda LF, Jimenez CQ, et al.:The clinical profile of Ebstein’s malformation as seen from the fetus to adult in 52 patients.Cardiol Young 2004,14:55–63.

    Google Scholar 

  3. Botto LD, Correa A, Erickson JD:Racial and temporal variations in the prevalence of heart defects.Pediatrics 2001,107:E32.

    Article  PubMed  CAS  Google Scholar 

  4. Perloff JK:Survival patterns without cardiac surgery or interventional catheterization: a narrowing base. InCongenital Heart Disease in Adults, edn 2. Edited by Perloff JK, Child JS. Philadelphia: WB Saunders; 1998:15–53.

    Google Scholar 

  5. Attie F, Rosas M, Rijlaarsdam M, et al.:The adult patient with Ebstein’s anomaly: outcome in 72 unoperated patients.Medicine 2000,79:27–36.

    Article  PubMed  CAS  Google Scholar 

  6. Celermajer DS, Bull C, Till JA, et al.:Ebstein’s anomaly: presentation and outcome from fetus to adult.J Am Coll Cardiol 1994,23:170–176.

    Article  PubMed  CAS  Google Scholar 

  7. Giuliani ER, Fuster V, Brandenburg RO, et al.:Ebstein’s anomaly: the clinical features and natural history of Ebstein’s anomaly of the tricuspid valve.Mayo Clin Proc 1979,54:163–173.

    PubMed  CAS  Google Scholar 

  8. Zuberbuhler JR, Allwork SP, Anderson RH:The spectrum of Ebstein’s anomaly of the tricuspid valve.J Thorac Cardiovasc Surg 1979,77:202–211.

    PubMed  CAS  Google Scholar 

  9. Frescura C, Angelini A, Daliento L, et al.:Morphological aspects of Ebstein’s anomaly in adults.Thorac Cardiovasc Surg 2000,48:203–208.

    Article  PubMed  CAS  Google Scholar 

  10. Snider R, Serwer G, Ritter S, et al.:Abnormalities of ventricular inflow. InEchocardiography in Pediatric Heart Disease. Edited by Snider R, Serwer G, Ritter S. St. Louis: Mosby-Year Book; 1997;389–394.

    Google Scholar 

  11. Lamers WH, Viragh S, Wessels A, et al.:Formation of the tricuspid valve in the human heart.Circulation 1995,91:111–121.

    PubMed  CAS  Google Scholar 

  12. Chauvaud S:Ebstein’s malformation. surgical treatment and results.Thorac Cardiovasc Surg 2000,48:220–223.

    Article  PubMed  CAS  Google Scholar 

  13. Carpentier A, Chauvaud S, Mace L, et al.:A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve.J Thorac Cardiovasc Surg 1988,96:92–101.

    PubMed  CAS  Google Scholar 

  14. Celermajer DS, Cullen S, Sullivan ID, et al.:Outcome in neonates with Ebstein’s anomaly.J Am Coll, Cardiol 1992,19:1041–1046.

    CAS  Google Scholar 

  15. Brickner ME, Hillis LD, Lange RA:Congenital heart disease in adults: second of two parts.N Engl J Med 2000,342:334–342.

    Article  PubMed  CAS  Google Scholar 

  16. Of importance Attenhofer Jost C, Connolly H, O’Leary PW, et al.:Left heart lesions in patients with Ebstein anomaly.Mayo Clin Proc 2005,80:361–368. Recent and largest retrospective review of the presence of left-sided abnormalities in Ebstein’s anomaly.

    Article  PubMed  Google Scholar 

  17. Anderson KR, Danielson GK, McGoon DC, Lie JT:Ebstein’s anomaly of the left-sided tricuspid valve: pathologic anatomy of the valvular malformation.Circulation 1978,58:187–191.

    Google Scholar 

  18. Silverman NH, Gerlis LM, Horowitz ES, et al.:Pathologic elucidation of the echocardiographic features of Ebstein’s malformation of the morphologically tricuspid valve in discordant atrioventricular connections.Am J Cardiol 1995,76:1277–1283.

    Article  PubMed  CAS  Google Scholar 

  19. Jaiswal PK, Balakrishnan KG, Saha A, et al.:Clinical profile and natural history of Ebstein’s anomaly of tricuspid valve.Int J Cardiol 1994,46:113–119.

    Article  PubMed  CAS  Google Scholar 

  20. Jaiyesimi F:Electrocardiographic abnormalities in Ebstein’s anomaly. Deductions based on comparison with endomyocardial fibrosis.Cardiology 1982,69:61–69.

    PubMed  CAS  Google Scholar 

  21. Iturralde P, Nava S, Salica G, et al.:Electrocardiographic characteristics of patients with Ebstein’s anomaly before and after ablation of an accessory atrioventricular pathway.J Cardiovasc Electrophysiol 2006,17:1332–1336.

    Article  PubMed  Google Scholar 

  22. Of importance Khositseth A, Danielson GK, Dearani JA, et al.:Supraventricular tachycardia in Ebstein anomaly: management and outcome.J Thorac Cardiovasc Surg 2004,128:826–833. Informative retrospective study of mechanisms of supraventricular arrhythmias with the medical and surgical management.

    Article  PubMed  Google Scholar 

  23. Hebe J:Ebstein’s anomaly in adults. Arrhythmias: diagnosis and therapeutic approach.Thorac Cardiovasc Surg 2000,48:214–219.

    Article  PubMed  CAS  Google Scholar 

  24. Tede N, Shivkumar K, Perloff JK, et al.:Signal-averaged electrocardiogram in Ebstein’s anomaly.Am J Cardiol 2004,93:432–436.

    Article  PubMed  Google Scholar 

  25. Gentles TL, Calder AL, Clarkson PM, Neutze JM:Predictors of long-term survival with Ebstein’s anomaly of the tricuspid valve.Am J Cardiol 1992,69:377–381.

    Article  PubMed  CAS  Google Scholar 

  26. Choi YH, Park JH, Choe YH, et al.:MR imaging of Ebstein’s anomaly of the tricuspid valve.Am J Roentgenol 1994,163:539–543.

    CAS  Google Scholar 

  27. Trojnarska O, Szyszka A, Gwizdala A, et al.:Adults with Ebstein’s anomaly—cardiopulmonary exercise testing and BNP levels.Int J Cardiol 2006,111:92–97.

    Article  PubMed  Google Scholar 

  28. Atz AM, Munoz RA, Adatia I, et al.:Diagnostic and therapeutic uses of inhaled nitric oxide in neonatal Ebstein’s anomaly.Am J Cardiol 2003,91:906–908.

    Article  PubMed  CAS  Google Scholar 

  29. Bruckheimer E, Bulbul Z, Pinter E, et al.:Inhaled nitric oxide therapy in a critically ill neonate with Ebstein’s anomaly.Pediatr Cardiol 1998,19:477–479.

    Article  PubMed  CAS  Google Scholar 

  30. Pham P, Hoyer A, Shaughnessy R, et al.:A novel approach incorporating sildenafil in the management of symptomatic neonates with Ebstein’s anomaly.Pediatr Cardiol 2006,27:614–617.

    Article  PubMed  Google Scholar 

  31. Fontan F, Baudet E:Surgical repair of tricuspid atresia.Thorax 1971,26:240–248.

    PubMed  CAS  Google Scholar 

  32. Stellin G, Vida VL, Milanesi O, et al.:Surgical treatment of complex cardiac anomalies: the ‘one and one half ventricle repair’.Eur J Cardiothorac Surg 2002,22:1043–1049.

    Article  PubMed  CAS  Google Scholar 

  33. Marianeschi SM, McElhinney DB, Reddy VM, et al.:Alternative approach to the repair of Ebstein’s malformation: intracardiac repair with ventricular unloading.Ann Thorac Surg 1998,66:1546–1550.

    Article  PubMed  CAS  Google Scholar 

  34. Chowdhury UK, Airan B, Talwar S, et al.:One and one-half ventricle repair: results and concerns.Ann Thorac Surg 2005,80:2293–2300.

    Article  PubMed  Google Scholar 

  35. Chauvaud S, Fuzellier JF, Berrebi A, et al.:Bi-directional cavopulmonary shunt associated with ventriculo and valvuloplasty in Ebstein’s anomaly: benefits in high risk patients.Eur. J Cardiothorac Surg 1998,13:514–519.

    Article  PubMed  CAS  Google Scholar 

  36. Reemtsen BL, Fagan BT, Wells WJ, et al.:Current surgical therapy for Ebstein anomaly in neonates.J Thorac Cardiovasc Surg 2006,132:1285–1290.

    Article  PubMed  Google Scholar 

  37. McElhinney DB, Salvin JW, Colan SD, et al.:Improving outcomes in fetuses and neonates with congenital displacement (Ebstein’s malformation) or dysplasia of the tricuspid valve.Am J Cardiol 2005,96:582–586.

    Article  PubMed  Google Scholar 

  38. Of importance Boston US, Dearani JA, O’Leary PW, et al.:Tricuspid valve repair for Ebstein’s anomaly in young children: a 30-year experience.Ann Thorac Surg 2006,81:690–695; discussion 695–696. Recent large, long-term study from the Mayo Clinic.

    Article  PubMed  Google Scholar 

  39. Kiziltan HT, Theodoro DA, Warnes CA, et al.:Late results of bioprosthetic tricuspid valve replacement in Ebstein’s anomaly.Ann Thorac Surg 1998,66:1539–1545.

    Article  PubMed  CAS  Google Scholar 

  40. Of importance Agnoletti G, Boudjemline Y, Ou P, et al.:Right to left shunt through interatrial septal defects in patients with congenital heart disease: results of interventional closure.Heart 2006,92:827–831. Study of various lesions with concomitant right-to-left shunts and the results of device closure. Early data in what will be a growing experience.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Michelle Gurvitz MD.

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Gurvitz, M., Stout, K. Ebstein’s anomaly of the tricuspid valve. Curr Cardiol Rep 9, 336–342 (2007). https://doi.org/10.1007/BF02938383

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