Complex Ebstein's malformation: defining preoperative cardiac anatomy and function

J Card Surg. 2013 Jan;28(1):70-81. doi: 10.1111/jocs.12032.

Abstract

Introduction: Ebstein's malformation is a congenital malformation of the tricuspid valve and right ventricle, with a highly variable morphology, and clinical presentation, accounting for less than 1% of all congenital heart diseases, and about 40% of congenital malformations of the tricuspid valve.

Method: Systematic review of English language literature regarding the morphogenesis and progress of imaging techniques, especially echocardiography and cardiac magnetic resonance imaging, in the preoperative planning of Ebstein's malformation, using the MEDLINE database with the PubMed Entre interface.

Results: Technological developments of the recent years, with 3D echocardiographic and cardiac magnetic resonance imaging evolution, have resulted in better understanding of the malformed tricuspid valve and right ventricle in vivo anatomy. Through a better understanding of Ebstein's malformation, there is a continuous trend of surgical techniques favoring tricuspid valve sparing procedures, with a constant decrease in early and late postoperative mortality.

Conclusions: Although imaging methods to investigate Ebstein's malformation have continuously evolved, standardization of assessment protocols by 3D echocardiographic imaging, speckle tracking imaging, and cardiac magnetic resonance imaging is required.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Ebstein Anomaly / diagnosis*
  • Ebstein Anomaly / pathology*
  • Ebstein Anomaly / physiopathology
  • Ebstein Anomaly / surgery
  • Echocardiography, Three-Dimensional*
  • Heart Ventricles / abnormalities
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Preoperative Period*
  • Tricuspid Valve / abnormalities
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / pathology