Ebstein’s anomaly is an abnorma lity of the tricuspid valve in which there is a failure of
delamination, resulting in tethering of septal and posterior leaflets, apical displacement of the
functional annulus and atrialization of the RV. TTE complemented by 3DE is used to diagnose
and evaluate for surgical repair. Several congenital heart defects also concomitantly have
anomalous origin of their coronary arteries. Some anomalous coronaries, such as an anomalous
coronary arising from the opposite sinus, are associated with sudden cardiac death, making their
detection imperative. TTE often fails to visualize the coronary arteries. TEE has increased
sensitivity, but MRI and MR and CT angiography is the standard to detect anomalous coronaries
and elucidate their course.
