title: Tricuspid pouch can cause systemic embolization in adulthood.
abstract: A 63-year-old-man with significant left hemiplegia was admitted to hospital. He had experienced a transient cerebral ischemic attack 10 years ago. Computed tomography revealed hypodensity along the right lateral ventricle, which corresponded to the left paralysis. Echocardiography and left ventricular angiography revealed an aneurysm of the membranous septum (AMS) without a ventricular septal defect (VSD). Therefore, the embolism was thought to be of cardiac origin, but surgery revealed that it was not caused by AMS. The aneurysm was created when the septal leaflet of tricupid valve formed a giant capsule during the process of natural closure of the VSD. It was a large pouch, 2.0 cm in diameter, adjacent to the septal leaflet. Anomalies of the tricuspid valve, including pouches, can resemble AMS.
authors.affiliation: Division of Cardiology, Tokuyama Central Hospital, Shunan, USA. atakaki@msf.biglobe.ne.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Takaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Wakeyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Iwami
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kimura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Uchinoumi
authors.forename: Shintarou
authors.initials: S
authors.lastname: Akashi
authors.forename: Susumu
authors.initials: S
authors.lastname: Matsuda
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Okada
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nishida
authors.forename: Masanori
authors.initials: M
authors.lastname: Murakami
mesh_terms: D002545:Brain Ischemia; D004452:Echocardiography; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006322:Heart Aneurysm / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014261:Tricuspid Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging