Document Type : Case Report
Authors
1 Assistant Professor, Cardiovascular Research Center AND Department of Cardiology, School of Medicine, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
2 Professor, Cardiovascular Research Center AND Department of Cardiology, School of Medicine, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
BACKGROUND: Parachute tricuspid valve is a rare congenital malformations explained in the literature. In most cases, this malformation coexists with other congenital defects. The importance of this condition depends on its functional consequences. CASE REPORT: First case was a 52-year-old female patient presented with palpitation. She had a history of paroxysmal supraventricular tachycardia. Transthoracic echocardiography revealed large secundum type atrial septal defect and all the tricuspid valve leaflets appeared to be connected to a single calcified papillary muscle in right ventricle suggestive of parachute tricuspid valve. Echocardiography showed severe right ventricle and right atrial enlargement, and moderate to severe tricuspid regurgitation without significant tricuspid stenosis. Another case was a 30-year-old female patient referred for echocardiography prior to her breast cancer chemotherapy. Transthoracic echocardiography revealed a right ventricle with an unusual fusion of papillary muscles resulting in a single calcified head for the attachment of all tricuspid leaflets. These findings were suggestive of a parachute-like tricuspid valve. Other data were mild to moderate tricuspid regurgitation without any stenosis, and normal right ventricle size and function. In both cases, parachute tricuspid valve was confirmed by three dimensional echocardiograph. CONCLUSION: In our first case, parachute tricuspid valve was associated with atrial septal defect, although in the second case, no associated anomaly was detected, a condition not previously reported in the literature. In both cases, parachute tricuspid valve was not associated with tricuspid stenosis. Based on other published cases, parachute involvement of the tricuspid valve is less often reported than cases involving the mitral valve. Additionally, the associated consequences in tricuspid valve position such as tricuspid stenosis seem to be less significant than cases involving mitral valve. It is recommended that in patients with tricuspid valve involvement, parachute anomaly should be considered as a possible rare cause.
Keywords
- Milo S, Stark J, Macartney FJ, Anderson RH. Parachute deformity of the tricuspid valve. Thorax 1979; 34(4): 543-6.
- Ariza S, Cintado C, Castillo JA, Descalzo A, Canadas M, Santos J, et al. Parachute tricuspid valve associated with Fallot's tetralogy. Arch Mal Coeur Vaiss 1979; 72(3): 317-20.
- Marwah A, Suresh PV, Shah S, Misri A, Maheshwari S. Parachute tricuspid valve. Eur J Echocardiogr 2006; 7(3): 226-7.
- Mohan JC, Shekhar C, Mohan V, Kaur B, Singh SK. Parachute tricuspid valve in an asymptomatic adult. Indian Heart J 2012; 64(1): 93-4.
- Kurtul A, Duran M, Akkaya E, Ornek E. Parachute mitral and tricuspid valves together with ventricular septal defect. Turk Kardiyol Dern Ars 2013; 41(3): 264.
- Mohan JC, Shukla M, Sethi A. Parachute deformity of both atrioventricular valves with congenitally corrected transposition in an adult. Indian Heart J 2015; 67(6): 565-9.
)