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Multiplanar review of three-dimensional echocardiography gives new insights into the morphology of Ebstein's malformation

Multiplanar review of three-dimensional echocardiography gives new insights into the morphology of Ebstein's malformation
Multiplanar review of three-dimensional echocardiography gives new insights into the morphology of Ebstein's malformation
Introduction: We aimed to assess the ability of the multiplanar review modality of three-dimensional echocardiography to examine the dynamic morphology and the functional characteristics of malformed tricuspid valves in patients previously identified as having Ebstein’s malformation. Based on these characteristics, we attempted to differentiate Ebstein’s malformation from tricuspid valvar dysplasia.

Methods: Using three-dimensional multiplanar review, analysed with either Qlab 6.0 or Tomtech Image Arena 3.0, we studied 23 patients, aged from 1 day to 70 years, previously diagnosed using cross-sectional echocardiography as having Ebstein’s malformation.

Results: Using the features of rotational abnormality, and the orientation, of the effective tricuspid valvar orifice as diagnostic features of Ebstein’s malformation, we reclassified 11 patients (48 per cent) as exhibiting tricuspid valvar dysplasia. In addition, we studied the dynamic morphology as well as the function of the tricuspid valve. Surgical treatment was undertaken on 10 patients, revealing good correlation with the findings obtained using three-dimensional multiplanar review. In those with Ebstein’s malformation, we found varying degrees of rotation, with the effective valvar orifice always directed towards the right ventricular outflow tract. The opening of the orifice of dysplastic tricuspid valves, in contrast, was towards the apex of the right ventricle. The degree of delamination, and abnormalities of subcordal apparatus, were similar in the two groups.

Discussion: Three-dimensional multiplanar review permits accurate definition of the dynamic morphology of Ebstein’s malformation, permitting clear differentiation from tricuspid valvar dysplasia.

congenital heart disease, tricuspid valve, anatomy
1047-9511
49-53
Bharucha, Tara
d8f5d152-31e0-49e7-99ac-5fdead9afef8
Anderson, Robert H.
0bfb7485-0146-471b-a3b0-ac63678b9778
Lim, Zek S.
1915b95f-7acf-43f2-b735-6fcfd3db44ba
Vettukattil, Joseph J.
6733316f-b576-4864-b41f-5da015f78887
Bharucha, Tara
d8f5d152-31e0-49e7-99ac-5fdead9afef8
Anderson, Robert H.
0bfb7485-0146-471b-a3b0-ac63678b9778
Lim, Zek S.
1915b95f-7acf-43f2-b735-6fcfd3db44ba
Vettukattil, Joseph J.
6733316f-b576-4864-b41f-5da015f78887

Bharucha, Tara, Anderson, Robert H., Lim, Zek S. and Vettukattil, Joseph J. (2010) Multiplanar review of three-dimensional echocardiography gives new insights into the morphology of Ebstein's malformation. Cardiology in the Young, 20 (1), 49-53. (doi:10.1017/S1047951109991971).

Record type: Article

Abstract

Introduction: We aimed to assess the ability of the multiplanar review modality of three-dimensional echocardiography to examine the dynamic morphology and the functional characteristics of malformed tricuspid valves in patients previously identified as having Ebstein’s malformation. Based on these characteristics, we attempted to differentiate Ebstein’s malformation from tricuspid valvar dysplasia.

Methods: Using three-dimensional multiplanar review, analysed with either Qlab 6.0 or Tomtech Image Arena 3.0, we studied 23 patients, aged from 1 day to 70 years, previously diagnosed using cross-sectional echocardiography as having Ebstein’s malformation.

Results: Using the features of rotational abnormality, and the orientation, of the effective tricuspid valvar orifice as diagnostic features of Ebstein’s malformation, we reclassified 11 patients (48 per cent) as exhibiting tricuspid valvar dysplasia. In addition, we studied the dynamic morphology as well as the function of the tricuspid valve. Surgical treatment was undertaken on 10 patients, revealing good correlation with the findings obtained using three-dimensional multiplanar review. In those with Ebstein’s malformation, we found varying degrees of rotation, with the effective valvar orifice always directed towards the right ventricular outflow tract. The opening of the orifice of dysplastic tricuspid valves, in contrast, was towards the apex of the right ventricle. The degree of delamination, and abnormalities of subcordal apparatus, were similar in the two groups.

Discussion: Three-dimensional multiplanar review permits accurate definition of the dynamic morphology of Ebstein’s malformation, permitting clear differentiation from tricuspid valvar dysplasia.

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More information

Published date: 2010
Keywords: congenital heart disease, tricuspid valve, anatomy

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Local EPrints ID: 152793
URI: http://eprints.soton.ac.uk/id/eprint/152793
ISSN: 1047-9511
PURE UUID: 0695c27c-da43-4687-95c6-37661cda657e

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Date deposited: 17 May 2010 09:12
Last modified: 16 Jul 2019 23:59

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Contributors

Author: Tara Bharucha
Author: Robert H. Anderson
Author: Zek S. Lim
Author: Joseph J. Vettukattil

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