Congenital cleft of the anterior tricuspid leaflet with severe tricuspid regurgitation in adults

Abstract

Tricuspid valve anomalies can be accurately identified by Doppler echocardiography. Surgical repair is the treatment of choice in patients with severe tricuspid regurgitation due to a congenital cleft of the anterior leaflet of the tricuspid valve.

Congenital Cleft of Anterior Tricuspid Leaflet in Adolescent

“…5 A cleft of the TV is a rare Doppler echocardiographic finding. 1 In adolescents and adults examined routinely by Doppler echocardiography, the incidence of cleft was 1:161 patients (0.6%). 6 In another study, this anomaly was found in 5 of 28,091 Doppler echocardiograms In previous cases, the reason for TR was dysplasia of the TV.…”

“…6 In another study, this anomaly was found in 5 of 28,091 Doppler echocardiograms In previous cases, the reason for TR was dysplasia of the TV. 1 In contrast, clefts of the mitral valve are well known and associated with atrioventricular canal defects. 1 Eichhorn and colleagues 1 postulated two explanations for the occurrence of a cleft: in all of their cases, the cleft was located in the anterior leaflet close to where the lateral endocardial cushion meets the right dorsal conus swelling, thus the cleft might be the result of anomalous fusion; another possible explanation is the great variability in anatomic structure of the TV.…”

“…Congenital tricuspid insufficiency due to a cleft in the anterior tricuspid leaflet is a rare congenital anomaly. [1][2][3] Most reported cases were associated with a perimembranous ventricular septal defect, pulmonary stenosis, or atrial septal defect (ASD).…”

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

“…These include tricuspid valve prolapse, Ebstein's anomaly, isolated dysplasia of the tricuspid valve, cleft tricuspid leaflet, unguarded tricuspid valve orifice, dysplasia of the left sided tricuspid valve in congenitally corrected transposition of the great arteries (atrioventricular and ventriculo-arterial discordance), atrioventricular septal defect (common atrioventricular junction), or pulmonary atresia with intact ventricular septum. 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.…”

Transesophageal Three‐Dimensional Echocardiographic Demonstration of Clefts in the Anterior Tricuspid Valve Leaflet

“…Isolated clefts in the tricuspid valve (TV) are rare, but they can cause severe tricuspid regurgitation requiring surgery 1 . They may result from the anomalous fusion of the lateral endocardial cushion with the right dorsal conus swelling or accessory TV leaflets may be misdiagnosed as clefts 1,2 .…”