Color Doppler flow pattern in antenatal diagnosis of unguarded tricuspid valve

Abstract

We describe an antenatally diagnosed case of unguarded tricuspid valve in a 15-week fetus. Because of its rarity, the differentiation of this anomaly from other tricuspid valve dysplasias is difficult. Tricuspid regurgitation is the hallmark of Ebstein's anomaly and other tricuspid valve abnormalities, whereas in unguarded tricuspid orifice there is total absence of the valve, resulting in 'to and fro' flow across the right-sided chambers. The color Doppler flow pattern helps in differentiating this anomaly from others. The antenatal diagnosis was confirmed on autopsy.

Isolated unguarded tricuspid valve: A rare cause of syncope and new-onset right cardiac failure in adult

“…Congenitally unguarded tricuspid orifice is a rare anomaly and antemortem diagnosis has been reported in the literature in only 19 cases [1][2][3][4][5][6][7][8][9][10][11][12]. An isolated unguarded tricuspid orifice with no other congenital abnormality has been reported in a few patients so far [1,5,[9][10][11].…”

“…Rarely, an unguarded tricuspid valve presents as an accidental finding in asymptomatic patient, who was evaluated by echocardiography for other reasons [11]. Or the diagnosis is made in uterus by fetal echocardiography [12].…”

“…An unguarded tricuspid valve is a rare congenital anomaly described in only a few antemortem case reports [1][2][3][4][5][6][7][8][9][10][11][12]. It is a variant of tricuspid valve dysplasia wherein there is partial or complete agenesis of tricuspid valve tissue [2].…”

Unguarded tricuspid orifice‐‐‐a rare cause of fetal right atrial dilatation with characteristic color doppler sign: Case report with review of literature

“…In gray‐scale sonography of unguarded TO, the tricuspid annulus appears patent with nonvisualization of the leaflet tissues . Myocardial thinning and redundant annular movements mimicking valvular cusps is noted, along with a characteristic to‐and‐fro motion of blood across the TO in color Doppler, pathognomonic of unguarded TO …”

“…A review of literature for prenatally diagnosed cases of unguarded TO is summarized in Table . It can be noted that the commonest association of unguarded TO was PA (n = 7/10, 70%).…”