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.
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.
Abrams
Dominic J R
DJ
Department of Paediatric Cardiology, The Royal Brompton & Harefield NHS Trust, London, United Kingdom.
Kilner
Philip
P
Till
Janice A
JA
Shore
Darryl F
DF
Sethia
Babulal
B
Franklin
Rodney C G
RC
Magee
Alan G
AG
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*