Ebsteins anomaly of the tricuspid valve echocardiography or ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] and Claudia P. Hochberg, M.D. [2]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]

Echocardiogram

See Echo in Ebstein's anomaly of the tricuspid valve for more info/images

a) Can be used to assess the severity of dilatation of the right atrium, and the functional status of the tricuspid valve as well as the right ventricle.

b) Normally the tricuspid valve closes within 30 msec of the mitral valve. In Ebstein's, the tricuspid valve closes 50 to 60 msec after the mitral valve.

c) The delayed tricuspid closure is not due to RBBB because it also occurs with preexcitation.

d) 2D ECHO allows you to assess whether the repair can be accomplished without a prosthetic valve, and detects whether an interatrial shunt is present.

Pathological specimen and ultrasound image of a heart with Ebstein's anomaly. Abbreviations: RA: Right atrium; ARV: Atrialized right ventricle; FRV: Functional right ventricle; AL: Anterior leaflet; SL: Septal leaflet; LA: Left atrium; LV: Left ventricle; asterisk: grade II tethering of the tricuspid septal leaflet.

Below is an apical 4-chamber transthoracic view, showing apically-displaced leaflets of the tricuspid valve. Note substantial tricuspid regurgitation, which originates close to the apex, where the abnormal leaflets actually coapt:

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