To summarize the ultrasonic characteristics and diagnostic points of Ebstein's anomaly before and after surgery, and to discuss the application value of echocardiography in preoperative diagnosis and postoperative follow-up of this malformation.

The clinical characteristics and echocardiographic data of 68 patients with Ebstein's anomaly before and 6 months after surgery at Beijing Anzhen Hospital from January 2018 to July 2023 were retrospectively analyzed and compared. The combined malformations and surgical methods were summarized, tricuspid regurgitation was compared between before and after surgery, and tricuspid valve annular diameter, right atrium area, functional right ventricular area, atrialized portion of the right ventricle area, right ventricular anterior-posterior diameter, left ventricular end-diastolic diameter, pulmonary artery diameter, tricuspid annular plane systolic execution, left ventricular eccentricity index, and right ventricle fractional area change were measured. The t-test was used to compare chamber size, valve condition, and cardiac function between before and after surgery. The χ² test was used to compare preoperative and intraoperative valve displacement, dysplasia, and absence conditions.

Postoperative right ventricular anteroposterior diameter [(19.03±2.73) mm vs (29.99±3.80) mm], right atrial area [(14.67±3.76) cm² vs (22.39±5.25) cm²], atrialized portion of the right ventricle [(13.08±3.19) cm² vs (17.10±3.95) cm²], tricuspid annular diameter [(25.92±5.38) mm vs (33.64±6.21) mm], and left ventricular eccentricity index [(0.93±0.08)% vs (1.45±0.07)%] were significantly lower than the preoperative values (t=55.982, 32.530, 29.612, 36.870, and 1.420, respectively, P<0.001 for all). The functional right ventricular area [(18.59±2.99) cm² vs (14.70±3.05) cm²] and left ventricular end-diastolic diameter [(38.06±4.178) mm vs (29.75±3.73) mm] were significantly increased after operation (t=-32.055 and -34.607, respectively, P<0.001 for both). The degree of tricuspid regurgitation was significantly reduced after operation. Tricuspid annular plane systolic excution had no significant change after operation (P>0.05). Displacement of the posterior part of the anterior valve was the only diagnosed anomaly (one patient) before operation, but six patients were found to have anterior valve displacement during the operation. There was a statistically significant difference in the detected anterior valve displacement between before and during operation (χ²=5.731, P=0.018), while there were no significant differences in displacement, dysplasia, or absence of the other valves (P>0.05).

Echocardiography can provide an important basis for the details of the tricuspid valve. It is the first choice for the preoperative diagnosis of Ebstein's anomaly, the evaluation of the anatomical structure of the valve, and the postoperative follow-up of patients.