Of parachutes and tricuspid valves

Abstract

We would like to congratulate Purvis et al. on their marvellous images of a dysplastic tricuspid valve apparatus1 and thank them for their interest in our own case report on an unusual anterior papillary muscle of the tricuspid valve.2 Before discussing their proposed label ‘parachute-like asymmetric tricuspid valve’ for both our cases, it is worth reflecting on the normal anatomy of the tricuspid valve apparatus. As the name implies, the tricuspid valve consists of three leaflets, named according to their location: septal, posterior (often the smallest), and anterior (mostly the largest) leaflet. From an anatomical study published in 1971, we know the anterior leaflet often shows a notch close to the anteroseptal commissure, which in three-dimensional …