Mechanism of tricuspid regurgitation in paramembranous ventricular septal defect

Donald J. Hagler, Umberto Squarcia, Allison K. Cabalka, Heidi M. Connolly, Patrick W. O'Leary

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Literature has been limited in regard to the mechanisms of tricuspid regurgitation (TR) in patients with paramembranous (perimembranous) ventricular septal defect (VSD). Most observations have noted tricuspid valve clefts or dysplasia. We describe another mechanism for production of TR in association with paramembranous VSD. In 8 patients, we found significant TR produced by the VSD jet pushing the tricuspid anterior leaflet forward to open the tricuspid valve orifice. In these patients, a moderate paramembranous VSD extended slightly below the septal tricuspid leaflet with only partial obstruction of the VSD jet. All patients had restrictive VSD with low right ventricular pressure. This mechanism to produce TR was best defined by intraoperative transesophageal echocardiography, but current higher resolution imaging should allow correct diagnosis. We believe that when this mechanism for TR is found in association with a moderate VSD, surgical VSD closure is warranted.

Original languageEnglish (US)
Pages (from-to)364-368
Number of pages5
JournalJournal of the American Society of Echocardiography
Volume15
Issue number4
DOIs
StatePublished - Apr 2002

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Tricuspid Valve Insufficiency
Ventricular Heart Septal Defects
Tricuspid Valve
Transesophageal Echocardiography
Ventricular Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Mechanism of tricuspid regurgitation in paramembranous ventricular septal defect. / Hagler, Donald J.; Squarcia, Umberto; Cabalka, Allison K.; Connolly, Heidi M.; O'Leary, Patrick W.

In: Journal of the American Society of Echocardiography, Vol. 15, No. 4, 04.2002, p. 364-368.

Research output: Contribution to journalArticle

Hagler, Donald J. ; Squarcia, Umberto ; Cabalka, Allison K. ; Connolly, Heidi M. ; O'Leary, Patrick W. / Mechanism of tricuspid regurgitation in paramembranous ventricular septal defect. In: Journal of the American Society of Echocardiography. 2002 ; Vol. 15, No. 4. pp. 364-368.
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