Bharucha Tara, Anderson Robert H, Lim Zek S, Vettukattil Joseph J
From Congenital Cardiac Centre (TB, ZSL, JJV), Southampton University NHS Trust, Southampton, United Kingdom.
Cardiol Young. 2010 Feb;20(1):49-53. doi: 10.1017/S1047951109991971. Epub 2010 Jan 19.
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.
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.
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.
Three-dimensional multiplanar review permits accurate definition of the dynamic morphology of Ebstein's malformation, permitting clear differentiation from tricuspid valvar dysplasia.
我们旨在评估三维超声心动图的多平面观察模式检查先前确诊为埃布斯坦畸形患者中畸形三尖瓣的动态形态和功能特征的能力。基于这些特征，我们试图将埃布斯坦畸形与三尖瓣发育异常区分开来。
我们使用三维多平面观察，通过Qlab 6.0或Tomtech Image Arena 3.0进行分析，研究了23例年龄从1天至70岁的患者，这些患者先前经横断面超声心动图诊断为埃布斯坦畸形。
利用旋转异常特征以及有效三尖瓣口的方位作为埃布斯坦畸形的诊断特征，我们将11例患者（48%）重新分类为表现为三尖瓣发育异常。此外，我们研究了三尖瓣的动态形态和功能。10例患者接受了手术治疗，结果显示与三维多平面观察的结果具有良好的相关性。在埃布斯坦畸形患者中，我们发现了不同程度的旋转，有效瓣口总是指向右心室流出道。相比之下，发育异常的三尖瓣口的开放方向是朝向右心室心尖。两组的分层程度和腱索下装置异常情况相似。
三维多平面观察能够准确界定埃布斯坦畸形的动态形态，从而能够与三尖瓣发育异常清晰区分开来。
