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Ebstein's Anomaly. Purpose: To evaluate the value of MRT with spin echo (SE) and CINE gradient echo (GE) sequences for the pre- and postoperative assessment of patients with Ebstein's anomaly. Methods: Twelve patients within the ages of four to 49 years (mean 22 ± 12 years) were examined pre- (n = 5) or postoperatively (n = 7) after tricuspid valve reconstruction with a 1.5 T scanner. For the anatomical assessment, an ECG-gated transverse SE-sequence, for the assessment of valve morphology and function as well as for volumetry a CINE GE-sequence with retrospective gating was used. With the use of the multislice-multiphase technique, after summing up the manually outlined epi- and endocardial areas, endsystolic (ESV) and enddiastolic volumes (EDV), ejection fraction (EF), stroke volume (SV), and muscle mass (MM) were calculated for both ventricles. Results: The differentiation of the displaced parts of the tricuspid valve (TV) was insufficient with static SE, but was possible in all patients with CINE-MRT. Like in Doppler echocardiography, a qualitative assessment of tricuspid insufficiency was possible in CINE-MRT, the mean incompetence grade preoperative was 1.8 (± 0.8), postoperative 0.7 (± 0.5). The mean RV-EF in the preoperative group was 41.8% (± 6.4), in the post-operative group 47.9% (± 10.6), the mean LV-EF preoperative 47.4% (± 8.5%), postoperative 63.0% (± 9.4). Conclusion: CINE-MRT should rather be used than SE for the assessment of valve morphology. EF, muscle mass and tricuspid incompetence can also be calculated pre- and postoperative with CINE-MRT.

Between 1961 and 1972, 354 patients with atrial septal defect ware treated surgically. Of these 80 patients were aged over 40 years at the time of operation. The hospital mortality was 5%. 2 of these patients had a increased preoperative pulmonary artery systolic pressure (50-75 mmHg), the other 2 had a mitral or tricuspid incompetence. At late follow-up 82% of patients were symptomfree, 18% had slight clinical signs of breathlesness on exertion. The heart size decreased in 37 of 40 patients, the electrocardiographis signs of right ventricular hypertrophy in 23 patients. There was no influence on preexistant dysrhythmias by the operation. It is concluded that patients with atrial septal defect in this age group benefit from surgical closure of the defect.