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Tricuspid Valve: Congenital Abnormalities and Stenosis

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Abstract

Three-dimensional echocardiography (3DE) has incremental diagnostic value over two-dimensional echocardiography in the evaluation of the tricuspid valve. 3DE provides en face view of all leaflets of the tricuspid valve. The understanding of tricuspid valve leaflet morphology and mechanisms of valvular regurgitation from 3DE provides valuable insights into tricuspid valve function, and assists in the planning for surgical interventions. Congenital abnormalities of the tricuspid valve and illustrative clinical cases are presented in this chapter.

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References

  1. Silver MD, Lam JH, Ranganathan N, Wigle ED. Morphology of the human tricuspid valve. Circulation. 1971;43(3):333–48.

    Article  CAS  Google Scholar 

  2. Lamers WH, Viragh S, Wessels A, Moorman AF, Anderson RH. Formation of the tricuspid valve in the human heart. Circulation. 1995;91(1):111–21.

    Article  CAS  Google Scholar 

  3. Addetia K, Yamat M, Mediratta A, Medvedofsky D, Patel M, Ferrara P, et al. Comprehensive two-dimensional interrogation of the tricuspid valve using knowledge derived from three-dimensional echocardiography. J Am Soc Echocardiogr. 2016;29(1):74–82.

    Article  Google Scholar 

  4. Stankovic I, Daraban AM, Jasaityte R, Neskovic AN, Claus P, Voigt JU. Incremental value of the en face view of the tricuspid valve by two-dimensional and three-dimensional echocardiography for accurate identification of tricuspid valve leaflets. J Am Soc Echocardiogr. 2014;27(4):376–84.

    Article  Google Scholar 

  5. Ammash NM, Warnes CA, Connolly HM, Danielson GK, Seward JB. Mimics of Ebstein’s anomaly. Am Heart J. 1997;134(3):508–13.

    Article  CAS  Google Scholar 

  6. Attenhofer Jost CH, Connolly HM, Dearani JA, Edwards WD, Danielson GK. Ebstein’s anomaly. Circulation. 2007;115(2):277–85.

    Article  Google Scholar 

  7. Lev M, Liberthson RR, Joseph RH, Seten CE, Eckner FA, Kunske RD, et al. The pathologic anatomy of Ebstein’s disease. Arch Pathol. 1970;90(4):334–43.

    CAS  PubMed  Google Scholar 

  8. Ho SY, Goltz D, McCarthy K, Cook AC, Connell MG, Smith A, et al. The atrioventricular junctions in Ebstein malformation. Heart. 2000;83(4):444–9.

    Article  CAS  Google Scholar 

  9. Anderson KR, Zuberbuhler JR, Anderson RH, Becker AE, Lie JT. Morphologic spectrum of Ebstein’s anomaly of the heart: a review. Mayo Clin Proc. 1979;54(3):174–80.

    CAS  PubMed  Google Scholar 

  10. Celermajer DS, Bull C, Till JA, Cullen S, Vassillikos VP, Sullivan ID, et al. Ebstein’s anomaly: presentation and outcome from fetus to adult. J Am Coll Cardiol. 1994;23(1):170–6.

    Article  CAS  Google Scholar 

  11. Eichhorn P, Ritter M, Suetsch G, von Segesser LK, Turina M, Jenni R. Congenital cleft of the anterior tricuspid leaflet with severe tricuspid regurgitation in adults. J Am Coll Cardiol. 1992;20(5):1175–9.

    Article  CAS  Google Scholar 

  12. Song JM, Fukuda S, Lever HM, Daimon M, Agler DA, Smedira NG, et al. Asymmetry of systolic anterior motion of the mitral valve in patients with hypertrophic obstructive cardiomyopathy: a real-time three-dimensional echocardiographic study. J Am Soc Echocardiogr. 2006;19(9):1129–35.

    Article  Google Scholar 

  13. Sukmawan R, Watanabe N, Ogasawara Y, Yamaura Y, Yamamoto K, Wada N, et al. Geometric changes of tricuspid valve tenting in tricuspid regurgitation secondary to pulmonary hypertension quantified by novel system with transthoracic real-time 3-dimensional echocardiography. J Am Soc Echocardiogr. 2007;20(5):470–6.

    Article  Google Scholar 

  14. Ton-Nu TT, Levine RA, Handschumacher MD, Dorer DJ, Yosefy C, Fan D, et al. Geometric determinants of functional tricuspid regurgitation: insights from 3-dimensional echocardiography. Circulation. 2006;114(2):143–9.

    Article  Google Scholar 

  15. Park YH, Song JM, Lee EY, Kim YJ, Kang DH, Song JK. Geometric and hemodynamic determinants of functional tricuspid regurgitation: a real-time three-dimensional echocardiography study. Int J Cardiol. 2008;124(2):160–5.

    Article  Google Scholar 

  16. Ring L, Rana BS, Kydd A, Boyd J, Parker K, Rusk RA. Dynamics of the tricuspid valve annulus in normal and dilated right hearts: a three-dimensional transoesophageal echocardiography study. Eur Heart J Cardiovasc Imaging. 2012;13(9):756–62.

    Article  Google Scholar 

  17. Spinner EM, Buice D, Yap CH, Yoganathan AP. The effects of a three-dimensional, saddle-shaped annulus on anterior and posterior leaflet stretch and regurgitation of the tricuspid valve. Ann Biomed Eng. 2012;40(5):996–1005.

    Article  Google Scholar 

  18. Takahashi K, Inage A, Rebeyka IM, Ross DB, Thompson RB, Mackie AS, et al. Real-time 3-dimensional echocardiography provides new insight into mechanisms of tricuspid valve regurgitation in patients with hypoplastic left heart syndrome. Circulation. 2009;120(12):1091–8.

    Article  CAS  Google Scholar 

  19. Kutty S, Colen T, Thompson RB, Tham E, Li L, Vijarnsorn C, et al. Tricuspid regurgitation in hypoplastic left heart syndrome: mechanistic insights from 3-dimensional echocardiography and relationship with outcomes. Circ Cardiovasc Imaging. 2014;7(5):765–72.

    Article  Google Scholar 

  20. Kutty S, Graney BA, Khoo NS, Li L, Polak A, Gribben P, et al. Serial assessment of right ventricular volume and function in surgically palliated hypoplastic left heart syndrome using real-time transthoracic three-dimensional echocardiography. J Am Soc Echocardiogr. 2012;25(6):682–9.

    Article  Google Scholar 

  21. Khoo NS, Smallhorn JF. Mechanism of valvular regurgitation. Curr Opin Pediatr. 2011;23(5):512–7.

    Article  Google Scholar 

  22. Svane S. Congenital tricuspid stenosis. A report on six autopsied cases. Scand J Thorac Cardiovasc Surg. 1971;5(3):232–8.

    Article  CAS  Google Scholar 

  23. Lewis T. Congenital tricuspid stenosis. Clin Sci. 1945;5(3–4):261–73.

    CAS  PubMed  Google Scholar 

  24. Williams DB, Danielson GK, McGoon DC, Puga FJ, Mair DD, Edwards WD. Porcine heterograft valve replacement in children. J Thorac Cardiovasc Surg. 1982;84(3):446–50.

    CAS  PubMed  Google Scholar 

  25. Zoghbi WA, Chambers JB, Dumesnil JG, Foster E, Gottdiener JS, Grayburn PA, et al. Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography’s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2009;22(9):975–1014, quiz 1082–4

    Article  Google Scholar 

  26. Connolly HM, Miller FA Jr, Taylor CL, Naessens JM, Seward JB, Tajik AJ. Doppler hemodynamic profiles of 82 clinically and echocardiographically normal tricuspid valve prostheses. Circulation. 1993;88(6):2722–7.

    Article  CAS  Google Scholar 

  27. Kobayashi Y, Nagata S, Ohmori F, Eishi K, Nakano K, Miyatake K. Serial doppler echocardiographic evaluation of bioprosthetic valves in the tricuspid position. J Am Coll Cardiol. 1996;27(7):1693–7.

    Article  CAS  Google Scholar 

  28. Aoyagi S, Nishi Y, Kawara T, Oryoji A, Kosuga K, Ohishi K. Doppler echocardiographic evaluation of St. Jude Medical valves in the tricuspid position. J Heart Valve Dis. 1993;2(3):279–86.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA

    Pei-Ni Jone

  2. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD, USA

    Shelby Kutty

Authors
  1. Pei-Ni Jone
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  2. Shelby Kutty
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Corresponding author

Correspondence to Pei-Ni Jone .

Editor information

Editors and Affiliations

  1. University of Milano-Bicocca and Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milano, Italy

    Luigi P. Badano

  2. Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA

    Roberto M. Lang

  3. University of Milano-Bicocca and Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milano, Italy

    Denisa Muraru

Electronic Supplementary Material

Normal tricuspid valve imaged by transesophageal echocardiography from a right atrial perspective (AVI 325 kb)

Thickened and dysplastic tricuspid valve leaflets from the apical four chamber view, with the heart rotated and cropped from behind (AVI 4871 kb)

This illustrates evaluation of thickened dysplastic tricuspid valve leaflets from the right ventricle up after cropping from a transthoracic three-dimensional full volume (AVI 4042 kb)

The tricuspid valve in Ebstein anomaly from a right ventricular perspective. Note the anterior leaflet displacement anteriorly into the right ventricular outflow tract (AVI 1871 kb)

Parasternal short axis view in Ebstein anomaly demonstrating the failure of delamination of the septal leaflet and the inability of tricuspid valve to coapt (AVI 1486 kb)

Right atrial view of moderate to severe tricuspid regurgitation in Ebstein anomaly (AVI 3069 kb)

Right ventricular view of the Ebstein tricuspid valve and the inability of leaflets to coapt (AVI 11248 kb)

Right atrial view of the prolapsing cleft tricuspid valve into the right atrium (AVI 10802 kb)

Transesophageal echocardiogram in the midesophageal view demonstrates the prolapse of the tricuspid valve into the right atrium (AVI 1000 kb)

Severe tricuspid regurgitation of the cleft tricuspid valve with prolapse (AVI 868 kb)

This is prolapse of the anterior leaflet of the tricuspid valve demonstrated with three-dimensional transesophageal echocardiography in a patient with corrected transposition of the great arteries (AVI 2212 kb)

Straddling of the tricuspid valve shown by transthoracic subcostal three-dimensional echocardiography in a patient with corrected transposition of the great arteries (AVI 4420 kb)

Three-dimensional transesophageal echocardiography in a stenotic bioprosthetic valve from the right atrial perspective (AVI 75902 kb)

Three-dimensional transesophageal echocardiography of post-transcatheter tricuspid valve implant of a Melody valve within the Carpentier-Edwards valve (AVI 990 kb)

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Jone, PN., Kutty, S. (2019). Tricuspid Valve: Congenital Abnormalities and Stenosis. In: Badano, L., Lang, R., Muraru, D. (eds) Textbook of Three-Dimensional Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-030-14032-8_19

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  • DOI: https://doi.org/10.1007/978-3-030-14032-8_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14030-4

  • Online ISBN: 978-3-030-14032-8

  • eBook Packages: MedicineMedicine (R0)

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