Ebstein's anomaly of the tricuspid valve pathophysiology

and Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]

Associate Editor-In-Chief: }; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu] Priyamvada Singh, MBBS mailto:psingh@perfuse.org

Assistant Editor-In-Chief: Kristin Feeney, B.S. mailto:kfeeney@perfuse.org

Pathophysiology



The pathophysiology of Ebstein's anomaly depends on the morphology of tricuspid valve and right ventricle.

Tricuspid valve

 * The anterior leaflet of the tricuspid valve is malformed in this condition i.e. they are attached to tricuspid valve annulus or to the right ventricular endocardium
 * The septal and posterior leaflets are absent most of the times.
 * Due to these changes the tricuspid valve may becomes funnel-shaped and incompetent.

Right ventricle
The right ventricular changes are secondary to the malformed tricuspid valves. The right ventricle can thus be divided into two parts by the valve


 * The downward extension of the tricuspid valve causes 'atrialization' of the proximal part of the right ventricle
 * The small distal part, the right ventricle proper, thus is reduced in size and sometimes comprises only of the right outflow tract.