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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Right ventricular obstruction by tricuspid pouch in simple ventricular septal defect
1Department of Thoracic and Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan.
The Annals of Thoracic Surgery
|March 4, 1998
Summary
Tricuspid pouches can cause dynamic subpulmonary obstruction, even in isolated ventricular septal defects. Surgical closure of the defect resolved the obstruction and tricuspid pouches.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Tricuspid pouches are a rare cause of subpulmonary obstruction, typically associated with Transposition of the Great Arteries.
- Isolated Ventricular Septal Defect (VSD) rarely presents with dynamic right ventricular outflow tract obstruction due to tricuspid valve abnormalities.
Observation:
- A 5-year-old female presented with symptoms suggestive of dynamic right ventricular outflow tract obstruction.
- Echocardiography revealed the presence of tricuspid pouches, specifically involving the anterior and septal tricuspid leaflets, causing the obstruction.
- The obstruction was dynamic, meaning it varied with heart function and was exacerbated by the VSD.
Findings:
- The study successfully identified and characterized tricuspid pouches as the cause of dynamic subpulmonary obstruction in a patient with an isolated VSD.
- Echocardiographic imaging provided clear visualization of the tricuspid pouches and their obstructive effect on the right ventricular outflow tract.
Implications:
- This case highlights that tricuspid pouches can cause significant subpulmonary obstruction even in the absence of Transposition of the Great Arteries.
- Surgical closure of the Ventricular Septal Defect led to the resolution of both the tricuspid pouches and the subpulmonary obstruction.
- These findings suggest that early diagnosis and intervention, such as VSD closure, can effectively manage this rare cause of pediatric cardiac obstruction.
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