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| CASE REPORT |
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| 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
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 529192 
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;25:253-4 |
| :: 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 | | |
| 1. | Chesler, 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.  |
| 2. | Chesler, 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. |
| 3. | Godmann, M. J., Tham, P, and LangfordKidd, B. S.: Echocardiography in the evaluation of the cyanotic newborn infant. Brit. Heart J., 36: 154-166, 1974. |
| 4. | Meyer, 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. |
| 5. | Meyer, R. A. and Kaplan, S.: Non-invasive techniques in pediatric cardiovascular disease. Progr. Cardiovasc. Disease, 15: 341-367, 1973. |
| 6. | Seward, J. B., Tajik, A. J., Hagler, D. J. and Ritter, D. G.: Echocardiographie spectrum of tricuspid atresia. Mayo Clin. Proc.. 53: 100-112, 1978. |
[Figure 1]
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