Asymmetrically short tendinous cords causing congenital tricuspid regurgitation: improved understanding of tricuspid valvar dysplasia in the era of color flow echocardiography

McElhinney, Doff B.; Silverman, Norman H.; Brook, Michael M.; Hanley, Frank L.; Stanger, Paul

doi:10.1017/s1047951100004972

Cited by 21 publications

(22 citation statements)

References 10 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Progression of RV dysfunction and pulmonary hypertension can be resolved after proper and timely surgery 7 . Therefore, optimal timing of TV surgery is recommended before advanced RV dysfunction develops, even if a patient does not complain of any symptoms 3,6,8 . This is because the event‐free survival rate after surgery with preoperative severe RV dysfunction is poor, and is estimated to be 57% in two years 6 .…”

Section: Discussionmentioning

confidence: 99%

Repair of Congenitally Absent Chordae in a Tricuspid Valve Leaflet with Hypoplastic Papillary Muscle Using Artificial Chordae

Shikata

Nagashima

Nishimura

et al. 2010

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Isolated congenital tricuspid regurgitation without downward displacement of the leaflet is uncommon in adults, and repair of such valves often requires a procedure that is more complex than simple tricuspid annuloplasty. We describe a technique of tricuspid valvoplasty using the neo-papillary loop technique to reconstruct multiple artificial chords for isolated congenital tricuspid regurgitation associated with a dysplastic anterior leaflet with agenesis of the chordae tendineae and a hypoplastic anterior papillary muscle. This technique provides a simple and valuable option for the repair of dysplastic valves lacking chordae, even those with a hypoplastic papillary muscle.

show abstract

Section: Discussionmentioning

confidence: 99%

Repair of Congenitally Absent Chordae in a Tricuspid Valve Leaflet with Hypoplastic Papillary Muscle Using Artificial Chordae

Shikata

Nagashima

Nishimura

et al. 2010

Journal of Cardiac Surgery

View full text Add to dashboard Cite

show abstract

“…All three tricuspid valve leaflets were thoroughly inspected for the presence of aberrant tendinous chords and short non-aberrant tendinous chords. 5 The normal anatomical distribution of tendinous chords in the tricuspid valve is summarised in table 1.…”

Section: Methodsmentioning

confidence: 99%

“…4 Asymmetrically short tendinous chords to the septal leaflet have also been reported to cause congenital tricuspid regurgitation. 5 Here we report 10 patients in whom a diagnosis of severe tricuspid regurgitation caused by tethering by aberrant tendinous chords was made by echocardiography. Although tethering of the tricuspid valve has been found in tricuspid regurgitation from other causes, 6 7 we are unaware of any previous reports describing this malformation as the sole mechanism of regurgitation.…”

mentioning

confidence: 98%

Aberrant tendinous chords with tethering of the tricuspid leaflets: a congenital anomaly causing severe tricuspid regurgitation

Kobza

Kurz

Oechslin

et al. 2004

Heart

View full text Add to dashboard Cite

Objective: To define the entity of tricuspid regurgitation caused by tethering of the tricuspid valve leaflets by aberrant tendinous chords. Design: Retrospective study. Setting: Tertiary care centre (university teaching hospital). Patients: 10 patients with unexplained severe tricuspid regurgitation. Methods: The last 13 500 echocardiographic studies from our facility were reviewed to identify patients with severe unexplained tricuspid regurgitation. Tethering was defined by the presence of aberrant tendinous chords to the tricuspid valve leaflets limiting the mobility of the tricuspid leaflet and resulting in incomplete coaptation and apical displacement of the regurgitant jet origin. Aberrant tendinous chords were defined as those inserting at the clear zone of the tricuspid leaflet and not originating from the papillary muscle. Patients fulfilling the diagnostic criteria for Ebstein's anomaly were excluded. Results: 10 patients with aberrant tendinous chords tethering one or more tricuspid valve leaflets were identified. There were short non-aberrant tendinous chords in seven patients, five of whom also had right ventricular or tricuspid annulus dilatation. Conclusions: Tethering of the tricuspid valve leaflets by aberrant tendinous chords can be the sole mechanism of congenital tricuspid regurgitation. It is often associated with short non-aberrant tendinous chords, which may develop secondary to right ventricular or tricuspid annulus dilatation. Awareness of tethering as a cause of tricuspid regurgitation may be important in planning reconstructive surgery.

show abstract

“…Developmental disorders of the chordae and papillary muscles, such as thickening and partial or total agenesis of valvular tissue are primarily responsible for dysplasia, atresias, and mitral and tricuspid valve defects of varying degrees as well as other important disorders [1].…”

Section: Introductionmentioning

confidence: 99%

Comparison between multiplanar and rendering modes in the assessment of fetal atrioventricular valve areas by 3D/4D ultrasonography

Júnior

Rôlo

Nardozza

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

Comparação entre os modos multiplanar e renderizado na avaliação da área das valvas atrioventriculares fetais por meio da ultrassonografia 3D/4DComparison between multiplanar and rendering modes in the assessment of fetal atrioventricular valve areas by 3D/4D ultrasonography Abstract Objective: To compare the agreement of multiplanar and rendering modes in the assessment fetal atrioventricular valves (mitral and tricuspid) areas by three-dimensional (3D) ultrasonography using the software spatio-temporal image correlation (STIC).Methods: We conducted a prospective cross-sectional study with normal pregnant women, with single fetuses, between 18-33 weeks. To measure the areas, we used the plan of fourchamber view. In the case of multiplanar, the plane was rotated on the axis "Z" form the heart to position at 9h. For rendering, the green line (region of interest -ROI) was placed from the atria of the heart perpendicular to the crux. The agreement was assessed by a Bland-Altman (limits of agreement) using the relative difference between the measures: ((rendering mode) -(multiplanar mode)) / (average).Results: 328 fetuses were evaluated. We have not identified the occurrence of systematic error between methods: the average relative difference was 1.62% (-2.07% to 5.32%, confidence interval 95%) in the mitral and 1.77% (-1.08% to 4.62%) in the tricuspid valve. The limits of agreement between methods were -65.26% to 68.51% for the mitral and -49.91% to 53.45% for the tricuspid.Conclusions: There was no systematic error between modes and thus the observed values for the area of fetal atrioventricular valves can be used for comparisons needs to be corrected. However, relatively large variations may be observed when repeating the measurement area by different modes.

show abstract

Asymmetrically short tendinous cords causing congenital tricuspid regurgitation: improved understanding of tricuspid valvar dysplasia in the era of color flow echocardiography

Cited by 21 publications

References 10 publications

Repair of Congenitally Absent Chordae in a Tricuspid Valve Leaflet with Hypoplastic Papillary Muscle Using Artificial Chordae

Repair of Congenitally Absent Chordae in a Tricuspid Valve Leaflet with Hypoplastic Papillary Muscle Using Artificial Chordae

Aberrant tendinous chords with tethering of the tricuspid leaflets: a congenital anomaly causing severe tricuspid regurgitation

Comparison between multiplanar and rendering modes in the assessment of fetal atrioventricular valve areas by 3D/4D ultrasonography

Contact Info

Product

Resources

About