Apex and subxiphoid approaches to Ebstein's anomaly using cross-sectional echocardiography

Apex and subxiphoid cross-sectional echocardiography was performed with an electronic sector scan on 11 patients having Ebstein's anomaly, isolated or associated with other cardiac diseases. For control study, 10 normal subjects and 10 ASD patients were similarly examined.In the apical four-chamber view, the displacement of the STL was measured in end-diastole using 8 mm. cinematography. It ranged from 1.4 to 3.2 cm., with an average of 2.1 ± 0.5 cm. in eight out of the 11 patients, whereas in control subjects, there was no displacement of the STL.From the apical three-chamber view of the right side of the heart, the downward displacement of the STL into the right ventricular cavity was also clearly visualized, as well as the tricuspid valve ring. Thus, the right-sided heart was seen to be divided into the functional and atrialized right ventricles and the right atrium by the displacement of the STL.In addition, the CT inserting into the ATL was observed in five cases from the three-chamber view and in four instances from the four-chamber view.The interpretable subxiphoid cross-sectional images were obtained in nine of the 11 patients. The right and left sides of the heart were widely visualized and the elongated ATL was fully observed from the tip to the thickened root. Moreover, the CT inserting into the ATL was visualized in six out of the nine patients.