Parachute deformity of both atrioventricular valves with congenitally corrected transposition in an adult

Abstract

A 23-year-young female presented with mild exertional dyspnoea and palpitation since early childhood. By deploying 2D- and 3D echocardiography, she was detected to have situs solitus, atrioventricular and ventriculoarterial discordance with L-malposition of great vessels, valvular pulmonary stenosis, large secundum atrial septal defect, bicuspid aortic valve, right-sided aortic arch, and moderately severe mitral and tricuspid valve regurgitation. Typical parachute deformities of the morphologically mitral and tricuspid valves were observed. 3D echocardiography revealed a single papillary muscle in the morphologically left ventricle placed anteriorly and providing insertion to tendinous cords and only a moderator band with no other muscle bundles in the morphologically right ventricle placed posteriorly and providing attachment to two strings of cords. Considering the minimal symptoms, conservative treatment was pursued.

Parachute tricuspid valve: a systematic review

“…In one of the patients, an additional diastolic murmur was heard at the apex [ 4 ]. A fixed split of the second heart sound was heard in 3 (27.3%) patients [ 5 , 13 , 14 ].…”

“…The electrocardiographical results were described for 7 patients: 2 (28.6%) patients had a normal sinus rhythm [ 5 , 7 ], and 5 (71.4%) patients had an abnormal electrocardiogram including right bundle branch block ( n = 1) [ 8 ], conduction defects ( n = 1) [ 6 ], left ventricular hypertrophy ( n = 1) [ 9 ], ST-T changes ( n = 1) [ 5 ], and north-west axis (+ 150°), right atrial enlargement and prominent R wave in the V 1 lead ( n = 1) [ 14 ].…”

“…The diagnostic methods of PTV were described in 12 patients: it was diagnosed by transthoracic echocardiography ( n = 5, 41.7%) [ 9 – 11 , 14 , 16 ], by both transthoracic and three-dimensional transesophageal echocardiography ( n = 2, 16.7%) [ 5 ], by transthoracic and transesophageal echocardiography, three-dimensional transthoracic and transesophageal echocardiography and computed tomographic angiography ( n = 2, 16.7%) [ 7 , 8 ], by transthoracic echocardiography and multislice cardiac computed tomography ( n = 1, 8.3%) [ 7 ], and by autopsy ( n = 2, 16.7%) [ 4 , 12 ].…”

“…The chordae tendineae were narrated for 4 patients: they were with normal length and thickness ( n = 1) [ 14 ], elongated ( n = 1) [ 8 ], shorter ( n = 1) [ 15 ] and shortened and thickened ( n = 1) [ 4 ].…”

“…This case was excluded from the statistical analysis of tricuspid valve function. In the remaining 10 patients, 6 (60%) patients had tricuspid regurgitation (it was trivial ( n = 2, 33.3%) [ 7 , 8 ], mild ( n = 1, 16.7%) [ 14 ], mild-to-moderate ( n = 1, 16.7%) [ 5 ] and moderate-to-severe [ 5 ] ( n = 1, 16.7%)), 3 (30%) had tricuspid stenosis [ 6 , 9 , 10 ] and 1 (10%) had a normally functioning tricuspid valve [ 11 ]. The systolic tricuspid pressure gradient was 8.3 ± 4.2 mmHg and the mean tricuspid pressure gradient was 4.3 ± 1.9 mmHg [ 7 , 8 , 10 , 15 ].…”