Accessory Tricuspid Valve Research Articles

Tetralogy of Fallot with restrictive ventricular septal defect by accessory tricuspid valve: repair with accessory valve preservation

BackgroundRestrictive ventricular septal defect resulting in suprasystemic right ventricular pressure is a rare entity in tetralogy of Fallot patients. It is often caused by accessory tricuspid valve tissue protruding through the defect. Surgical resection of the accessory tricuspid valve has been recommended, but the risk of tricuspid regurgitation caused by the resection has not been widely discussed.Case presentationA 5-month-old male who had been diagnosed with tetralogy of Fallot was referred for progressive decline in oxygen saturation. Preoperative echocardiogram revealed restrictive ventricular septal defect and severe pulmonary stenosis, suggesting suprasystemic right ventricular pressure (> 160 mmHg). Intraoperatively, accessory tricuspid valve tissue was found to be attached to the superior edge of the ventricular septal defect and partially occlude the aortic valve. The risk of tricuspid regurgitation caused by accessory tricuspid valve resection was high due to the complicated relationship between the true tricuspid valve and the accessory tricuspid valve. Therefore, the accessory tricuspid valve was preserved on the right ventricular side of the ventricular septum to avoid the risk of tricuspid regurgitation. Postoperative echocardiogram did not show tricuspid regurgitation or left ventricular outflow tract obstruction, and the patient was discharged to home on postoperative day 35 without major complications.ConclusionsWe herein reported a high-risk patient of tetralogy of Fallot with restrictive ventricular septal defect caused by accessory tricuspid valve who successfully underwent definitive repair with accessory tricuspid valve preservation considering the risk of tricuspid regurgitation.

Accessory tricuspid valve tissue: masquerading as right ventricular outflow tract obstruction in a case of tetralogy of Fallot.

Accessory tricuspid valve tissue: masquerading as right ventricular outflow tract obstruction in a case of tetralogy of Fallot.

A Rare Case of Prolapsing Accessory Tricuspid Valve Tissue into the Ventricular Septal Defect in Patient Undergoing Tetralogy of Fallot Repair: Role of Transesophageal Echocardiography

A Rare Case of Prolapsing Accessory Tricuspid Valve Tissue into the Ventricular Septal Defect in Patient Undergoing Tetralogy of Fallot Repair: Role of Transesophageal Echocardiography

Cryptogenic stroke caused by patent foramen ovale with thrombophilia and accessory tricuspid valve in a teenager.

Accessory tricuspid valve is rare congenital abnormality. We describe a case of cryptogenic stroke in teenager boy caused by patent foramen ovale with thrombophilia and accessory tricuspid valve.

Concordant location of accessory pathways and tricuspid valve in AV discordance

Concordant location of accessory pathways and tricuspid valve in AV discordance

Accessory tricuspid leaflet associated with persistent left superior vena cava

Right atrioventricular valve is historically named as tricuspid valve. However, cases depicting multi-leaflet morphology of the right atrioventricular valve were reported. Accessory leaflet of the tricuspid valve is a rare entity and associated with congenital cardiac anomalies. We present an accessory tricuspid valve in a patient with isolated persistent left superior vena cava.

Accessory Leaflet of Tricuspid Valve Masquerading as Infective Endocarditis Preoperatively and Causing RVOT Obstruction Postoperatively

Accessory tricuspid valve tissue is a rare congenital anomaly. We report a case where preoperative echocardiogram was suggestive of infective vegetations over the tricuspid valve but intra-operatively it was found to be accessory tricuspid valve leaflets which were causing right ventricular outflow tract obstruction.

Intermittent' restrictive ventricular septal defect in Tetralogy of Fallot.

Ventricular septal defect (VSD) in Tetralogy of Fallot (TOF) is usually large and non-restrictive with equalization of right and left ventricular pressures. Restrictive VSD in TOF is rare. We present an unusual case of TOF with restriction to VSD caused by accessory tricuspid valve tissue that varied with respiration.

Accessory Tricuspid Valve Leaflet and an Anomalous Muscle Bundle in the Right Ventricular Outflow Tract in a Patient with Double‐Outlet Right Ventricle: A Rare Case Report

Double-outlet right ventricle (DORV), a clinically important congenital heart disease, occurs in 1-3% of persons with congenital heart disease. It may occur as an isolated cardiac defect, together with other cardiac lesions, or in association with extracardiac anomalies. Other rare cardiac anomalies include an anomalous muscle bundle (AMB) in the right ventricular outflow tract (RVOT) and an accessory tricuspid valve leaflet. We report a very rare case of concomitant DORV, AMB in the RVOT and accessory tricuspid valve leaflet in a 17-year-old male patient. The patient eventually died from severe decompensated heart failure. To the best of our knowledge, such a case has not been previously reported in the literature.

Accessory Tricuspid Valve Leaflet in an Asymptomatic Adult

Accessory tricuspid valve is a rare congenital cardiac anomaly that it most frequently seen in children with complex congenital heart disease. Symptoms depend mostly on coexisting cardiac defects. We present an accessory tricuspid valve in an asymptomatic adult.

Congenital choanal atresia and pyriform aperture stenosis

Abstract Background : Choanal (CA) has a reported incidence of 1 in 5000–8000 live births since its first description by Johann George Roederer in 1755. Nasal aperture (NPAS) was described more recently in 1989 by Brown et al. but its true incidence remained unknown. We describe a case of a term male infant with a unilateral left CA and bilateral NPAS that was managed successfully with surgical intervention. Methods : We performed a literature search with the keywords choanal atresia and pyriform aperture stenosis from Medline, Embase and PubMed databases. To our knowledge, there is no report where CA co-exists with NPAS in a term infant. Case : We present a case of a term male infant who presented with respiratory distress due to bilateral NPAS and inferior turbinates hypertrophy, and a left sided CA. He had none of the typical craniofacial abnormalities or syndromes. His only other associated condition is a peri-membranous ventricular septal defect and accessory tricuspid valve tissue. He was successfully treated with a midface degloving approach for NPAS repair and transoral endoscopic repair of CA. Conclusion : CA and NPAS may present with similar clinical signs and symptoms. The management of both conditions is dictated by the degree of and severity of symptoms, with the goal of establishing a normal nasal airway, as infants are obligate nasal breathers.

Isolated Accessory Tricuspid Valve Causing Right Ventricular Outflow Tract Obstruction

Accessory tricuspid valve (TV) tissue is a rare congenital cardiac anomaly with varying clinical and hemodynamic features. We report a rare case of accessory TV tissue causing severe right ventricular outflow tract obstruction (RVOT) in a patient without associated cardiac anomaly. Surgical resection of the isolated accessory TV tissue resulted in complete relief of the RVOT without compromising TV function.

Restrictive ventricular septal defect and critical subaortic stenosis in tetralogy of Fallot

Tetralogy of Fallot is characterized by a non-restrictive malalignment ventricular septal defect (VSD), an overriding aorta and right ventricular outflow tract obstruction resulting from anterior deviation of the infundibular septum. Due to the large VSD, systolic pressures are equal in both ventricles. In rare cases, redundant tricuspid valve tissue may prolapse into the VSD resulting in restriction of the defect size and causing suprasystemic pressure in the right ventricle. Subaortic obstruction by prolapse of the redundant tricuspid tissue into the left ventricular outflow tract, although theoretically possible in this situation, has not been described yet in the literature. We report on a newborn with tetralogy of Fallot presenting with cyanosis and severe arterial hypotension a few hours after birth. Echocardiography revealed redundant hammock-like accessory tricuspid valve tissue almost completely occluding the originally large VSD. Suprasystemic pressure in the right ventricle resulted in protrusion of tricuspid valve tissue across the VSD and thereby caused severe left ventricular outflow tract obstruction. Emergency pulmonary balloon valvuloplasty performed for decompression of the right ventricle, reduced prolapse of tricuspid tissue into the left ventricular outflow tract and resulted in significant improvement of pulmonary and systemic blood flow. In tetralogy of Fallot, accessory tricuspid valve tissue may obstruct the VSD as well as the left ventricular outflow tract resulting in a life threatening condition in newborns shortly after birth.

Accessory Tricuspid Valve Tissue in Tetralogy of Fallot Causes Hemodynamic Changes During Intermittent Positive-Pressure Ventilation

c a i fl i s m S m t RESENCE OF ACCESSORY tricuspid valve (ATV) tissue is a rare phenomenon. The association of tetralogy of allot (TOF) with ATV is even rarer but has been described ith a restrictive ventricular septal defect (VSD).1 An ATV has ven been found to be associated with complete obstruction of VSD in a human heart.2 The diagnosis of ATV by 2-dimenional echocardiography may be missed due to greater emphais being placed on the associated major anomaly.3 If missed, n ATV may cause problems during weaning from cardiopulonary bypass (CPB).4 The authors describe a child with TOF resenting with severe hemodynamic changes in the operating oom. The cause of this unusual presentation could not be scertained until the ATV was found perioperatively.

Clinical and pathological features of accessory valve tissue

Background. Accessory valve tissue is a rare congenital cardiac malformation causing a variety of clinical features. We describe our experience with the surgical treatment of accessory valve tissue to clarify clinical and pathological features of this anomaly.Methods. Between December 1990 and February 1999, 11 children underwent resection of accessory valve tissue together with repair of coexisting intracardiac malformations. Eight patients had accessory tricuspid valve, while 3 had accessory mitral valve tissue. Associated intracardiac malformations included tetralogy of Fallot in 6 patients, transposition of the great arteries in 3, coarctation complex in 1, and ventricular septal defect in 1.Results. Accessory valve tissue was completely resected in all but 1 patient with accessory mitral valve and transposition of the great arteries. As total resection of the accessory valve tissue through the pulmonary artery was unsuccessful, partial resection and bidirectional Glenn shunt operation was performed instead of arterial switch operation in this patient.Conclusions. The clinical signs and symptoms of accessory valve tissue vary according to its location and coexisting cardiac malformations. Congenital heart surgeons should be familiar with the clinical and pathological features of accessory valve tissue, so as not to overlook it during operation.

Familial Sudden Death: Report of a Case and Review of the Literature

A 15 1/2-year-old boy died suddenly while swimming. He had a family history of sudden death involving three consecutive generations, including a brother. The patient had a history of exercise-related syncope, for which he was being treated with nadolol. Autopsy showed enlarged heart, normal coronary arteries, right ventricular septal hypertrophy, quadricuspid pulmonary valve, accessory tricuspid valve, and a moderately elongated and thickened mitral valve. Conduction system revealed that the penetrating bundle was pushed to the left side of the summit of the ventricular septum by the right ventricular septal hypertrophy; it was lobulated and showed fatty-fibrous changes. These findings extended throughout the beginning of the bundle branches. We conclude that in this patient with familial sudden death and normal QT interval, the abnormal right ventricular septal hypertrophy altered the course and produced degenerative changes in the conduction system, which may have caused sudden death.

Echocardiographic features of tetralogy of Fallot with an accessory tricuspid valve leaflet

Echocardiographic features of tetralogy of Fallot with an accessory tricuspid valve leaflet

Accessory tricuspid valve tissue causing obstruction of the ventricular septal defect in tetralogy of Fallot.

Among 61 heart specimens of tetralogy of Fallot with or without pulmonary atresia, four presented with an accessory tricuspid valve leaflet. This structure caused partial or almost complete obstruction of the ventricular septal defect. Depending on the morphology, the accessory tissue was classified into "mobile" or "fixed" types. The "mobile" variety was tethered by long chordae tendineae which permitted a wide excursion of the leaflet through the ventricular septal defect into the left ventricular outflow tract where it represented a potential cause of obstruction. The "fixed" variety was attached to the edges of the defect by short chordae which reduced considerably its movements. This type created a fixed obstruction of the ventricular septal defect without involving the subaortic left ventricular outflow tract. The precise morphology of the accessory tricuspid valve tissue is of considerable surgical significance. When mobile, the tissue must be resected at the time of surgical repair. When fixed it can be used as a suture anchorage during closure of the ventricular septal defect.