European Journal of Echocardiography 2006 7(3):226-227; doi:10.1016/j.euje.2005.10.002
Copyright © 2005, The European Society of Cardiology
Parachute tricuspid valve
A. Marwah*,
P.V. Suresh,
S. Shah,
A. Misri and
S. Maheshwari
Narayana Hrudalaya Institute of Cardiac Sciences, No 258/A, Bommasandra Industrial Area, Anekal Taluk, Bangalore, Karnataka 560099, India
Received 5 September 2005; accepted after revision 5 October 2005.
* Corresponding author. Tel.: +91 080 51309321. ashu_marwah{at}yahoo.com
 |
Abstract
|
|---|
Parachute abnormality of mitral valve frequently occurs with
left sided obstructive lesions though occasionally may occur
as an isolated lesion. Symptoms depend upon the severity of
stenosis and associated lesions. Parachute abnormality of the
tricuspid valve has rarely been reported and its association
with left to right shunts has not been described so far.
Keywords: ASD; atrial septal defect; VSD; ventricular septal defect; LA; left atrium; RA; right atrium; LV; left ventricle; RV; right ventricle
|
Case report
|
|---|
A 21-year old lady was evaluated for class II dyspnoea (NYHA).
She had history of poor weight gain and congestive cardiac failure
in infancy and early childhood, which improved with passage
of time. On examination she was 166cm tall, with a weight of
47kg. Cardiovascular examination revealed a wide fixed split
of second heart sound and a grade 3/6 pan-systolic murmur in
the left lower parasternal area.
Echocardiography revealed normal segmental analysis. There was a large (35mm) secundum atrial septal defect (ASD) and a restrictive (6mm) perimembranous ventricular septal defect with left to right shunt. There was a gradient of 120mm Hg across the ventricular septal defect. The right ventricle was mildly dilated. The tricuspid valve annulus (22mm) was smaller than the mitral valve annulus (24mm). The right ventricle had a single papillary muscle on the septum and all the tricuspid valve leaflets were attached to it. There was mild prolapse of septal leaflet of the tricuspid valve. The tricuspid valve was functionally normal. The other valves were normal with normal ventricular function. The patient is waiting to undergo surgery (Figs. 1–3
).
|
Discussion
|
|---|
Parachute abnormality of mitral valve is a known entity, and
is usually associated with left sided obstructive lesions. There
has been only one report of parachute abnormality of tricuspid
valve in association with right sided obstructive lesions. Ariza
et al.
1 described presence of parachute abnormality of the tricuspid
valve in association with Fallot's tetralogy. The tricuspid
valve in this case was stenosed and manifested with congestive
cardiac failure. Milo et al.
2 have reported parachute abnormality
of tricuspid valve in a patient with double outlet right ventricle.
Here the presence of abnormal valve was of no consequence in
the final management of the patient.
To the best of our knowledge presence of parachute abnormality of tricuspid valve in association with left to right shunts has not been described. In our patient, the presence of parachute abnormality of tricuspid valve was seen in a functionally intact valve despite the presence of increased flow due to a large ASD. The atrial shunt was left to right and there was presence of right ventricular volume overload.
|
References
|
|---|
- Ariza S., Cintado C., Castillo J.A., Descalzo A., Canadas M., Santos J., et al. Parachute tricuspid valve associated with Fallot's tetralogy. Arch Mal Coeur Vaiss (1979 Mar) 72(3):317–320.[Web of Science][Medline]
- Milo S., Stark J., Macartney F.J., Anderson R.H. Parachute deformity of the tricuspid valve. Thorax (1979 Aug) 34(4):543–546.[Abstract/Free Full Text]
CiteULike 
Connotea 
Del.icio.us What's this?
Top
Abstract
Case report
