A case of isolated bicuspid pulmonary valve

Abstract

Our case highlights the finding of an abnormal pulmonary valve on 2D echocardiography, confirmed to be of bicuspid morphology with 3D imaging. The use of biplane imaging both in transthoracic and transoesophageal echocardiography and routine use of three-dimensional views particularly in transoesophageal echocardiography are of incremental value in better delineating pulmonary valve anatomy.Learning points:Bicuspid pulmonary valve as an isolated clinical entity is a rare finding in clinical practice with an incidence of about 0.1%.The true prevalence of the condition may be underestimated because of difficulty in visualising the pulmonary valve en-face on standard two-dimensional echocardiography.Trans-oesophageal echocardiography may provide better visualization of the pulmonary valve when transthoracic images are affected by interference from the left lung.Routine use of 3D echocardiography with biplane and zoomed views should be advocated for a full morphological assessment of the pulmonary valve, whether imaging via the transthoracic or transoesophageal approach.

Absent Single Pulmonary Cusp Causing Isolated Pulmonary Valvae Regurgitation

“…With newer investigations, the indications of surgery also change. 2D TTE with colour flow Doppler would be the recommended first line investigation for establishing diagnosis and severity of the PR [8]. Manivarmane et al recommended routine use of biplane and 3D imaging in both TTE and transoesophageal echocardiography to delineate PV anatomy in IPVR [8].…”

“…2D TTE with colour flow Doppler would be the recommended first line investigation for establishing diagnosis and severity of the PR [8]. Manivarmane et al recommended routine use of biplane and 3D imaging in both TTE and transoesophageal echocardiography to delineate PV anatomy in IPVR [8]. The use of 3D transesophageal echocardiography is currently limited to older patients because of technical limitations.…”

Double whammy: A case of bilateral bicuspid arterial valves in transposition, with a review of the literature

“…[1] Bicuspid pulmonary valves, in contrast, are very rare, having an incidence of only 0.1%. [2] The bicuspid aortic valve is commonly seen in association with left-sided heart disease but has rarely been reported in the setting of transposition,[3] defined on the basis of concordant atrioventricular and discordant ventriculoarterial connections. The presence of both arterial valves with two leaflets is exceedingly rare.…”

Absent Single Pulmonary Cusp Causing Isolated Pulmonary Valvar Regurgitation

“…With newer investigations, the indications of surgery also change. 2D TTE with color flow Doppler would be the recommended first line investigation for establishing diagnosis and severity of the PR[6]. Manivarmane et al recommended routine use of biplane and 3D imaging in both TTE and transesophageal echocardiography to delineate PV anatomy in IPVR[6].…”

“…2D TTE with color flow Doppler would be the recommended first line investigation for establishing diagnosis and severity of the PR[6]. Manivarmane et al recommended routine use of biplane and 3D imaging in both TTE and transesophageal echocardiography to delineate PV anatomy in IPVR[6]. The use of 3D transesophageal echocardiography is currently limited to older patients because of technical limitations.Cardiac MRI would be essential in planning management.…”