Follow-Up Evaluation of Right Ventricular Function with Strain Imaging in Postoperative Ebstein’s Anomaly Patients

Objective: To assess right ventricular (RV) systolic function in patients following surgical repair of Ebstein’s anomaly (EA) using echocardiographic strain analysis, and to investigate its correlation with cardiac magnetic resonance (CMR) parameters. Methods: A Retrospective study was performed in 46 patients who received biventricular repair of EA between May 2014 and December 2023, with ≥2 qualified echocardiographic studies and >6-month follow-up. Patients were grouped (A, B, C) based on postoperative cardiac function and echo reports. Conventional echocardiographic parameters and RV strain indices were compared among groups. In 13 reoperated patients, parameters were compared before, early post-operation, and one month after reoperation. Correlation analysis between echocardiographic indices and CMR measurements were performed in 20 patients with simultaneous CMR data. Results: (1) Fractional area change (FAC) and strain parameters (RVFLS, RVSLS, and RVGLS) were superior to other echocardiographic indices in distinguishing between groups (p<0.05; group A > B > C). (2) FAC, RVGLS, and RVFLS were more sensitive in detecting early postoperative changes after reoperation, displaying an initial decline but returning to preoperative levels within one month. (3) RVEF showed moderate correlation with FAC, RVGLS, and RVFLS, while RVEDV and RVESV were most strongly correlated with RVFLS and RVGLS. Strain indices exhibited better correlation with CMR-derived parameters than conventional echocardiographic measures. Conclusion: In patients with Ebstein’s anomaly after biventricular repair, echocardiographic strain analysis—especially RVFLS and RVGLS—provides valuable assessment of RV function and shows strong correlation with CMR parameters.