Zuberbuhler J R, Allwork S P, Anderson R H
J Thorac Cardiovasc Surg. 1979 Feb;77(2):202-11.
The structure of the tricuspid valve in 14 cases of Ebstein's malformation is described and compared with that in the normal heart. The anomalous hearts showed a spectrum of malformation, varying from minimal displacement of the adjacent parts of the septal and inferior leaflets of the tricuspid valve to presence of an imperforate membrane or muscle shelf between the inlet and trabecular zones of the right ventricle. In "typical" Ebstein's anomaly the anterosuperior leaflet was abnormally attached so as to partially obstruct the route from right atrium to distal right ventricle, the communication between these chambers being between the abnormally attached leaflet and its malformed neighbors. In two hearts, a muscular shelf produced stenosis between inlet and trabecular portions, but a competent valve was produced at this site, the atrialized part of the right ventricle being of normal thickness. The significance of these findings is considered with regard to possible methods of repair. Description of the anomaly is facilitated by considering the right ventricle as possessing inlet, trabecular, and outlet portions. The essence of the anomaly is displacement of the tricuspid orifice to the junction of the inlet and trabecular ventricular zones.
描述了14例埃布斯坦畸形患者三尖瓣的结构，并与正常心脏的三尖瓣结构进行了比较。异常心脏呈现出一系列畸形，从三尖瓣隔叶和下叶相邻部分的轻微移位到右心室流入道和小梁部之间存在无孔膜或肌性嵴。在“典型”的埃布斯坦畸形中，前上叶附着异常，部分阻塞了从右心房到右心室远端的通路，这些腔室之间的交通位于异常附着的瓣膜叶与其畸形的相邻叶之间。在两颗心脏中，肌性嵴在流入道和小梁部之间产生狭窄，但该部位形成了一个功能正常的瓣膜，右心室的心房化部分厚度正常。结合可能的修复方法对这些发现的意义进行了探讨。将右心室视为具有流入道、小梁部和流出道部分有助于对该畸形进行描述。该畸形的本质是三尖瓣口移位至心室流入道和小梁部的交界处。
