Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T09:15:50.409Z Has data issue: false hasContentIssue false

Prenatal diagnosis of tricuspid valvar dysplasia and regurgitation—always a poor outcome?

Published online by Cambridge University Press:  19 August 2008

Enrico Chiappa*
Affiliation:
From the Divisione di Cardiologia Pediatrica, Ospedale Infantile Regina Margherita Torino
Piero Gaglioti
Affiliation:
Divisione di Cardiologia Pediatrica, Istituto di Ginecologia e Ostetricia dell' Universitá di Torino, Torino
Tullia Todros
Affiliation:
Divisione di Cardiologia Pediatrica, Istituto di Ginecologia e Ostetricia dell' Universitá di Torino, Torino
*
Dr. Enrico Chiappa, Divisione di Cardiologia Pediatrica, Ospedale Infantile Regina Margherita, Piazza Polonia 94, 10126 Torino, Italy. Tel. 0039 11 673281 or 6927253; Fax. 6635168.

Abstract

The anatomic and pathophysiologic features of tricuspid valvar dysplasia are discussed in the light of two cases observed during fetal life which progressed with an unexpectedly favorable course. Some fetal echocardiographic features are proposed to explain this outcome. First, absence of associated cardiovascular abnormalities; second, clear separation between well represented right ventricular walls and the tricuspid valvar leaflets; third, normal proximal insertion of the tricuspid leaflets and, fourth, normal dimensions of the pulmonary trunk. We recommend karyotyping because of the possible association of this malformation with an aneuploid karyotype. We also describe transitory functional atresia of the pulmonary valve at birth, as far as we know for the first time, in a neonate that had normal forward flow of blood as seen on Doppler sampling in fetal life.

Type
Original Manuscripts
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hornberger, LK, Sahn, DJ, Kleinman, CS, Copel, JA, Reed, KL. Tricuspid valve disease with significant tricuspid insufficiency in the fetus: Diagnosis and outcome. J Am Coll Cardiol 1991; 17: 167173.CrossRefGoogle ScholarPubMed
2. Sharland, GK, Chita, SK, Allan, LD. Tricuspid valve dysplasia or displacement in intrauterine life. J Am Coll Cardiol 1991; 17: 944949.CrossRefGoogle ScholarPubMed
3. Paladini, D, Chita, SK, Allan, LD. Prenatal measurement of cardiothoracic ratio in evaluation of heart disease. Arch Dis Child 1990; 65: 2023.CrossRefGoogle ScholarPubMed
4. Roberson, DA, Silverman, NH. Ebstein’s anomaly: echocar- diographic and clinical features in the fetus and neonate. J Am Coll Cardiol 1989; 14: 13001307.CrossRefGoogle Scholar
5. Becker, AE, Becker, MJ, Edwards, JE. Pathologic spectrum of dysplasia of the tricuspid valve, features in common with Eb stein’s malformation. Arch Path 1971; 91: 167178.Google Scholar
6. Lang, D, Oberhoffer, R, Cook, A, Sharland, GK, Allan, LD, Fagg, NLK, Anderson, RH. Pathologic spectrum of malformations of the tricuspid valve in prenatal and neonatal life. J Am Coll Cardiol 1991; 17: 11611167.Google ScholarPubMed
7. Chaoui, R, Bollmann, R, Goldner, B, Heling, KS, Tennstedt, C. Fetal cardiomegaly: echocardiographic findings and outcome in 19 cases. Fetal Diagn Ther 1994; 9: 92104.CrossRefGoogle Scholar
8. Oberhoffer, R, Cook, AC, Lang, D, Sharland, G, Man, LD, Fagg, NLK, Anderson, RH. Correlation between echocardiographic and morphological investigations of lesions of the tricuspid valve diagnosed during fetal life. Br HeartJ 1992, 68: 580585.CrossRefGoogle ScholarPubMed
9. Berman, W Jr, Withman, V, Stanger, P, Rudolph, AM. Congen ital tricuspid incompetence simulating pulmonary atresia with intact ventricular septum: a report of two cases. Am Heart J 1978: 96: 655661.CrossRefGoogle Scholar
10. Bouceck, RJ Jr, Graham, TP Jr, Morgan, JP, Arwood, GF, Boerth, RC. Spontaneous resolution of massive congenital tricuspid insufficiency. Circulation 1976; 54: 795800.CrossRefGoogle Scholar
11. Gewillig, M, Dumoulin, M, Van der, Hauwaert L. Transient neonatal tricuspid regurgitation: a Doppler echocardiographic study of three cases. Br Heart J 1988; 60: 446451.CrossRefGoogle ScholarPubMed