Anomalies of the Tricuspid Valve: Ebstein's Anomaly

Question 1

Ebstein’s Anomaly is caused by

Answer 1

1. Septal leaflet of the TV doesn’t separate from the RV wall during fetal development

Question 2

Ebstein’s Anomaly is described as a malformation of the ____ ____.

Answer 2

tricuspid valve

Question 3

Ebstein’s Anomaly is a ___ lesion.

Answer 3

cyanotic

Question 4

In Ebstein’s Anomaly, the TV is displaced ____ and to the ____, toward the ____.

Answer 4

inferiorly, right, apex

Question 5

In Ebstein’s Anomaly, the RV becomes ____.

Answer 5

atrialized

Question 6

Associated lesions with Ebstein’s:

Answer 6

1. PDA
2. ASD
3. VSD
4. PA Atresia (narrowed, stenotic or RVOT obstruction)
5. Tetralogy of Fallot

Question 7

Other associated problems with Ebstein’s:

Answer 7

1. RVH
2. PHTN
3. RA enlargement
4. Decreased RV function
5. TV regurge
6. Increased pulmonary vascular resistance
7. Volume overload to RA
8. Pressure overload to RA
9. LV is small and hyperdynamic

Question 8

Heart sounds associated with Ebstein’s:

Answer 8

• TR
• P2 is delayed
• Palpable thrill over RVOT & PA
• S4 is present

Question 9

Signs and Symptoms for Ebstein’s:

Answer 9

1. shortness of breath
2. dyspnea
3. respiratory distress
4. infection
5. arrhythmias (sinus tach, PACs, right sided arrhythmias)

Question 10

Surgical Repair for Ebstein’s:

Answer 10

1. Completely replace TV with a tissue valve
2. close ASD, VSD and any other associated lesions
3. If needed, shave leaflets away from myocardium