title: Comparison of the offset distance of the tricuspid septal leaflet in neonates with Ebstein's anomaly and neonates with pulmonary atresia with intact ventricular septum.
abstract: An indexed offset distance of the tricuspid septal leaflet ⩾8 mm/m2 is a quantitative criterion for the diagnosis of Ebstein's anomaly. The purpose of this study was to investigate the validity of this criterion for the discrimination of Ebstein's anomaly from pulmonary atresia with intact ventricular septum in neonatal patients. A total of 122 neonatal patients, 56 with Ebstein's anomaly and 66 with pulmonary atresia with intact ventricular septum, were enrolled. Diagnosis of each anomaly was based on typical morphologic features. Echocardiographic variables, including the offset distance of the tricuspid septal leaflet, were measured via an offline analysis of images recorded before 1 month of age. The offset distance of the tricuspid septal leaflet was indexed by the body surface area, and the indexed offset distances in the Ebstein's anomaly and pulmonary atresia with intact ventricular septum groups were 34.2 mm/m2 (7.1-119.1 mm/m2) and 7.2 mm/m2 (0.0-25.6 mm/m2), respectively. The indexed offset distance was ⩾8 mm/m2 in 29 (43.9%) of the patients with pulmonary atresia with intact ventricular septum; clinical and echocardiographic characteristics were comparable between these 29 patients and the remaining 37 patients with pulmonary atresia with intact ventricular septum. When an indexed offset distance ⩾8 mm/m2 was applied as a cut-off for the diagnosis of Ebstein's anomaly, the sensitivity was 0.963 and the specificity was 0.561. In conclusion, indexed offset distance ⩾8 mm/m2 cannot be used as a cut-off for the diagnosis of complicated Ebstein's anomaly in neonatal patients with pulmonary atresia with intact ventricular septum.
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Yu
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Kang
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: Chang Deok
authors.initials: CD
authors.lastname: Seo
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: Jae Suk
authors.initials: JS
authors.lastname: Baek
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: Young-Hwue
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Pediatric Cardiology,College of Medicine,University of Ulsan,Songpa-gu,Seoul,South Korea.
authors.forename: Jae-Kon
authors.initials: JK
authors.lastname: Ko
mesh_terms: D000015:Abnormalities, Multiple; D004437:Ebstein Anomaly / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014261:Tricuspid Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging; D054088:Ventricular Septum / Q000000981:diagnostic imaging*