**1. Introduction**

Ebstein's anomaly of the tricuspid valve is a rare congenital heart malformation that accounts for about 0.5% of all congenital heart defects and 0.005% of all live births [1, 2]. In a report from the Society of Thoracic Surgery (STS) Congenital Heart Surgery Database from 2010 to 2016, there were 494 patients with Ebstein's anomaly who received index operations in 95 centers [3]. Given the low incidence of this defect, some centers will have limited experience managing patients with Ebstein's anomaly, suggesting the potential importance of regionalizing care in patients with more complex physiology. Ebstein's anomaly was first described by Wilhelm Ebstein with the autopsy findings of abnormal tricuspid valves in 1866 [4]. The patient, Joseph Prescher, was a 19-year-old worker who presented with cyanosis, dyspnea, palpitations, cardiomegaly, and distended jugular veins [4]. Ebstein's anomaly is more than an issue with inferior displacement and rotation of the tricuspid valve, as this anomaly may also involve abnormalities of the right ventricular myocardium and in some cases the left ventricle [5]. This malformation is thought to be due to the defects in the process of "delamination from the underlying myocardium" [6] during the development of the tricuspid valve. Presentation of this malformation varies widely from neonates in extremes to an incidental finding during physical examination in an otherwise asymptomatic adult secondary to the anatomic severity of the tricuspid valve and the associated heart malformations [7].
