Echocardiography in the Diagnosis of Ebstein's Anomaly of the Tricuspid Valve

Nineteen patients aged between 4 days and 40 years with Ebstein's anomaly of the tricuspid valve have been examined with echocardiography. The diagnosis was verified with angiocardiography in all but one patient. The results at echocardiography are compared with those found in some other patients where an echo from the anterior tricuspid leaflet could be obtained (atrial septal defect, total anomalous pulmonary venous return, pulmonary hypertension, and one patient with congenital tricuspid stenosis). An echo from the anterior tricuspid leaflet could be obtained in all patients with Ebstein's anomaly. This echo had an abnormal pattern of movement with an abnormally anterior position during the entire diastole. A late tricuspid opening was found in most patients. A late tricuspid closure compared with the time of mitral closure was a constant finding. It is suggested that this late tricuspid closure is mainly caused by mechanical factors related to the abnormal, large anterior tricuspid leaflet. The abnormal pattern of movement of the echo from the anterior tricuspid leaflet with a late tricuspid closure has not been found in any other patient examined.