Object: To evaluate the diagnostic ability and accuracy of echocardiography in Ebstein’s anomaly(EA).
Methods: 117 patients were diagnosed with EA from Mar. 2003 to Oct. 2008 in our hospital. Among them, 64 patients received cardiac surgery and all pathology was confirmed. We compare the main pathology finding intraoperatively with echocardiography reports.
Results: In 64 patients with surgery, the diagnosis of EA was confirmed in all. Concomitant defects reported by echo were ASD in 31 cases, PFO in 6, VSD in 3, LSVC in 1 and PS in 1. There were tricuspid regurgitation in all patients, 57 were severe, 6 were moderate and 1 was mild. All findings were confirmed during surgery. There were 62 septal, 35 anterior and 62 posterior leaflets of tricuspid valve involved in regarding of downward displacement. Echocardiography was able to identify all septal and posterior leaflet displacements, yet identified only 40% of anterior leaflet displacements. During surgery, septal leaflet was found absent in 19 patients, reported by echo in only 12(63.1%); posterior leaflet was absent in 18, reported by echo in 9 (50%). There was a big variety of leaflet hypoplasty. Echcardiography was able to identify moderate to severe cases, yet under evaluated mild cases, especially if the leaflet was partially involved.
Conclusion: In EA, all 3 leaflets of tricuspid valve can be involved. Though echocardiography is a very useful diagnostic tool,there is some limitation in accurate diagnosis, especially for hypoplasty of the leaflets and partial anterior leaflet displacement.It is easy to under evaluate the pathology.