Journal of Postgraduate Medicine
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CASE REPORT
 
 
Year : 1979  |  Volume : 25  |  Issue : 4  |  Page : 253-254  

Tricuspid atresia

Lilam S Shah, AS Vengsarkar 
 Department of Cardiology, Seth G. S. Medical College and K.E.M. Hospital, Parel, Bombay-400 012, India

Correspondence Address:
Lilam S Shah
Department of Cardiology, Seth G. S. Medical College and K.E.M. Hospital, Parel, Bombay-400 012
India

Abstract

Echocardiographic features o f a proven case o f tricuspid atresia type 1B are discribed. An interesting finding of mitral valve pro­lapse in tricuspid atresia is reported.



How to cite this article:
Shah LS, Vengsarkar A S. Tricuspid atresia.J Postgrad Med 1979;25:253-254


How to cite this URL:
Shah LS, Vengsarkar A S. Tricuspid atresia. J Postgrad Med [serial online] 1979 [cited 2020 Nov 30 ];25:253-254
Available from: https://www.jpgmonline.com/text.asp?1979/25/4/253/42236


Full Text

 Introduction



Echocardiography has been proved use­ful in diagnosing many of the congenital anomalies non-invasively. Our case had type 1B tricuspid atresia diagnosed on an­giocardiography. Echocardiography re­vealed highly suggestive features of tri­cuspid atresia.

 Case report



L. B., a 4 year old female child presented to us with the complaints of repeated attacks of anoxic spells and respiratory tract infection. The child was born of full term normal deli­very of non-consanguinous parents. Cyanosis was noticed since birth. Clinical examination revealed central cyanosis and clubbing of all the four limbs, normal situs and no skeletal deformities. Cardiovascular system examination revealed prominent `a' waves in neck veins, apex beat in the 5th LICS 1 cm. outside MCL suggesting left ventricular volume overload. There was a striking absence of the left para­sternal pulsations. On auscultation she had a pansystolic murmur along the left sternal edge in the 3rd and 4th LICS, left ventricular S 3 and single second sound. ECG showed left axis deviation (axis QRS in frontal plane -60°) and left ventricular hypertrophy. X-ray chest confirmed situs solitus, levocardia, left ventri­cular hypertrophy, prominent right atrium and pulmonary bay with pulmonary oligemia. Clinical diagnosis of tricuspid atresia was made. Catheter and angiocardiography revealed type 1B tricuspid atresia.

The child was subjected to echocardiographic studies. Echocardiogram revealed large left ventricle (LVIDd = 5.0 cm) LVIDs = 4.5 cm) and brisk excursion of anterior mitral leaflet reaching upto the anterior chest wall. Tricuspid valve could not be obtained inspite of repeated attempts, and right ventricular cavity was absent; interventricular septum merged with anterior chest wall echoes. Mitral valve echo showed significant prolapse of the anterior mitral leaflet. (See [Figure 1] on page 254).

 Discussion



Echocardiography in congenital heart disease has been reported by various in­vestigators. [1],[2],[3],[4],[5] Highly suggestive echo­cardiographic feature of tricuspid atresia are (1) visualization of single AV valve echo. (2) diminutive or absent right ven­tricular cavity (3) large left ventricular chamber and (4) brisk excursion of an­terior mitral valve in early diastole tou­ching the interventricular septum due to increased left ventricular volume over­load. An interesting finding of prolapse of mitral leaflet is described. [6] This has been reported as being very common ii this malformation. All these features were observed in our case.

References

1Chesler, E., Joffe, H. S., Vecht, R., Beck W. and Schrire, V.: Ultrasound echography in single ventricle and the hypo plastic left and right heart syndromes Circulation. 42: 123-139, 1970.
2Chesler, E., Joffe, H. S., Back, W. et al Echocardiography in the diagnosis of con. genital heart disease. Pediatr. Clin North Amer,, 18: 1163-1190, 1.971.
3Godmann, M. J., Tham, P, and Langford­Kidd, B. S.: Echocardiography in the evaluation of the cyanotic newborn infant. Brit. Heart J., 36: 154-166, 1974.
4Meyer, R. A. and Kaplan, S.: Echo­cardiography in the diagnosis of hypopla­sia of the left or right ventricle in the neonate. Circulation, 46: 55-64, 1972.
5Meyer, R. A. and Kaplan, S.: Non-in­vasive techniques in pediatric cardiovas­cular disease. Progr. Cardiovasc. Disease, 15: 341-367, 1973.
6Seward, J. B., Tajik, A. J., Hagler, D. J. and Ritter, D. G.: Echocardiographie spectrum of tricuspid atresia. Mayo Clin. Proc.. 53: 100-112, 1978.

 
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