Clinical and echocardiographic assessment of a right-to-left shunt across an atrial septal defect secondary to tricuspid regurgitation

Kowalski, Mirosław; Hoffman, Piotr; Siudalska, Hanna; Jakubowska, Ewa; Rydlewska-Sadowska, W

doi:10.2143/ac.56.4.2005649

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“…Patients with similar presentations have been described before in the literature, but most patients with right to left shunting at the level of the atria in the setting of tricuspid regurgitation have also had at minimum some degree of pulmonary hypertension [1,2,3] or documented elevated right ventricular pressures [4]. A similar presentation of cyanosis attributed to shunting through an atrial septal defect was described in an isolated case report [5].…”

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confidence: 75%

Tricuspid Regurgitation Causing a Right to Left Interatrial Shunt with Normal Pulmonary Pressures

Gans¹,

Kao

2007

Cardiology

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We describe a patient who presented with asymptomatic hypoxia refractory to supplemental oxygen. Transthoracic echocardiography and angiography demonstrated a tricuspid valve with a large regurgitant jet oriented directly at a patent foramen ovale, producing a right to left shunt with systemic hypoxia. The patient was found to have normal right-sided cardiac pressures as well as normal pulmonary arterial pressures, demonstrating the shunt was secondary to the tricuspid regurgitant jet and not a result of a pressure gradient between atria. Surgical correction of the tricuspid valve and closure of the patent foramen ovale resulted in resolution of the patient’s hypoxemia.

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