title: Prolapse of the antero-superior leaflet of the tricuspid valve secondary to congenital anomalies of the valvar and sub-valvar apparatus: a rare cause of severe tricuspid regurgitation.
abstract: Congenital anomalies of the tricuspid valve, and/or its supporting apparatus, leading to severe tricuspid regurgitation are rare. Although well tolerated in early childhood, long-standing and progressive volume loading of the right heart leads to symptoms of decreased exercise tolerance, and may predispose to arrhythmias in the long term. We report three cases of severe tricuspid regurgitation related to anomalies of the cords supporting the antero-superior leaflet of the tricuspid valve. Shortened cords leading to tethering of the leaflet were seen in two cases, and hypoplasia of the leaflet in the other. In all cases, the regurgitant jet was directed posteriorly towards the coronary sinus and atrial septum. Surgical repair was possible in one case, while it proved necessary to replace the valve in a second. The third child is asymptomatic and under regular review.
authors: Department of Paediatric Cardiology, The Royal Brompton & Harefield NHS Trust, London, United Kingdom.
authors: Dominic J R
authors: DJ
authors: Abrams
authors: Philip
authors: P
authors: Kilner
authors: Janice A
authors: JA
authors: Till
authors: Darryl F
authors: DF
authors: Shore
authors: Babulal
authors: B
authors: Sethia
authors: Rodney C G
authors: RC
authors: Franklin
authors: Alan G
authors: AG
authors: Magee
mesh_terms: D002648:Child; D002815:Chordae Tendineae / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D018450:Disease Progression; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D012720:Severity of Illness Index; D014261:Tricuspid Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000209:etiology*