Severe heart failure in child with ventricular septal defect and acute tricuspid regurgitation

Area of Science:

• Pediatric Cardiology
• Cardiac Surgery
• Infective Endocarditis

Background:

• Ventricular septal defect (VSD) can lead to complex hemodynamic alterations.
• Infective endocarditis in children with VSD is rare but serious.
• Tricuspid valve involvement in VSD-associated endocarditis typically affects the septal leaflet.

Observation:

• A child with a VSD developed acute tricuspid regurgitation.
• Endocarditis caused near-complete destruction of the anterior tricuspid valve leaflet.
• This presentation contrasts with typical septal leaflet involvement in similar cases.

Findings:

• Successful surgical treatment involved VSD closure and tricuspid valve replacement.
• The anterior leaflet, not the usual septal leaflet, was primarily destroyed by endocarditis.
• This case demonstrates an atypical pattern of tricuspid valve endocarditis in pediatric VSD.

Implications:

• Highlights the potential for varied leaflet destruction in pediatric VSD endocarditis.
• Emphasizes the importance of thorough echocardiographic and surgical assessment of the tricuspid valve.
• Informs surgical strategies for complex VSD and tricuspid valve pathology in children.