A 14-month-old male presented electively for repair of double-chambered right ventricle and ventricular septal defect after remote repair of aortic coarctation. Pre-operative echocardiogram showed a restrictive ventricular septal defect with inlet extension and partial occlusion by transformational tricuspid valve tissue. Upon visualization of the tricuspid valve intraoperatively, a clear yellow, fluid-filled cyst was found on the septal leaflet which was partially occluding the ventricular septal defect. Pathology examination showed that the cyst was contained within fibrous valve tissue and lined by endothelial cells which has not, to our knowledge, been described before in the literature.
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