How is CTR used in Ebstein anomaly?

CTR is the cardiac silhouette width divided by thoracic width on PA CXR. CTR >0.65 in Ebstein indicates massive cardiomegaly from RA and atrialized RV enlargement, correlating with severity and functional status.

What other imaging features assess Ebstein severity?

Echo-based Great Ormond Street Ebstein (GOSE) score uses apical displacement of tricuspid valve >=8mm/m2, tethering severity, TR grade, and RV size to grade severity from mild to severe.

When is surgery indicated in Ebstein anomaly?

Surgery is indicated for symptomatic heart failure (NYHA III-IV), significant TR with cyanosis, paradoxical embolism, or atrial arrhythmias refractory to medical therapy or ablation.

Ebstein Anomaly CTR Ratio

Assess Ebstein anomaly severity using cardiothoracic ratio (CTR) on chest X-ray. CTR >0.65 indicates severe cardiomegaly from massive RA/atrialized RV enlargement.

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