Document Detail

Surgical pathology of 104 tricuspid valves (2000-2005) with classic right-sided Ebstein's malformation.
MedLine Citation:
PMID:  18402795     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ebstein's anomaly has been described extensively in autopsy material. However, there have been no large surgical pathology series of this malformation. OBJECTIVE: To review clinical and surgical pathologic features of a large number of cases of Ebstein's anomaly from a single institution. METHODS: Review of medical histories, surgical reports, and surgical pathology reports at the Mayo Clinic (2000-2005). RESULTS: Among 104 patients, the mean age was 31 years (2 months-79 years), and 57% were female. Common ECG abnormalities included right bundle branch block (58%), first-degree heart block (31%), preexcitation (18%), and nonspecific intraventricular conduction delay/block (15%). Moreover, 74% had inter-atrial communication, 13% mitral valve prolapse, and 5% bicuspid aortic valve. Clinically, all had tricuspid regurgitation (severe in 74%), and 17% of anterior leaflets were fenestrated. No tricuspid valve was calcified. Surgically, tricuspid tissue was removed during replacement in 99% and repair in 1%. The anterior tricuspid leaflet was resected in 98%, and its length was 0.81-9.3 cm/m2 body surface area (mean, 3.3). Characteristically, leaflets were large and had irregular shapes and numerous short cordal or direct myocardial insertions. One tricuspid valve had two papillary fibroelastomas. None had clinical or pathologic evidence of active or healed endocarditis. CONCLUSIONS: Among patients with Ebstein's malformation, tricuspid valve tissue almost exclusively was removed during valve replacement and represented the anterior leaflet. Valve tissue was generally large, irregularly shaped, and associated with insertion of short cords or myocardial stumps. Interestingly, although appreciably deformed, Ebstein valves were not associated with infective endocarditis.
David W Barbara; William D Edwards; Heidi M Connolly; Joseph A Dearani
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Publication Detail:
Type:  Journal Article     Date:  2007-10-24
Journal Detail:
Title:  Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology     Volume:  17     ISSN:  1054-8807     ISO Abbreviation:  Cardiovasc. Pathol.     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9212060     Medline TA:  Cardiovasc Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  166-71     Citation Subset:  IM    
Mayo Medical School, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Child, Preschool
Ebstein Anomaly / complications,  pathology*,  physiopathology
Heart Block / congenital
Heart Valve Prosthesis Implantation
Middle Aged
Tricuspid Valve / abnormalities*,  surgery
Tricuspid Valve Insufficiency / congenital*,  physiopathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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