Ebstein's anomaly and other tricuspid valve anomalies

Ebstein's anomaly is a rare congenital heart disease that affects approximately 1 in 200,000 live births, and <1 % of all congenital heart diseases [1]. The anomaly was originally described in 1866 by Dr. Wilhelm Ebstein in a patient with progressive tricuspid insufficiency due to a congenital malformation [2]. Until 1950s, the diagnosis of Ebstein's anomaly was mainly based on autopsy findings. It was not until 1951 when Soloff et al. first described a method of diagnosing Ebstein's anomaly while the patient is still alive by invasive angiogram [3]. In the 1970s, with the development of M-mode, two-dimensional, and Doppler echocardiography, echocardiography became the primary modality in diagnosing Ebstein's anomaly [4]. However, echocardiography is highly dependent on operator experience, the availability of good acoustic windows, and spatial resolution distal to the probe. Due to the position of the right ventricle being directly behind the sternum and its complex geometry, imaging the right ventricle with echocardiogram is often difficult (Movie 8.1).