Parachute Tricuspid Valve in a Patient with Atrial Septal Defect Detected by Two‐ and Three‐Dimensional Echocardiography

Abstract

Atrioventricular valve parachute deformity was generally seen in the mitral position, which is called parachute mitral valve. Parachute deformity is also seen in the tricuspid position, but this has rarely been reported as sporadic cases. All of these cases were associated with other congenital defects, such as double outlet right ventricle, left to right shunt. We herein present two- and three-dimensional echocardiographic features of a parachute tricuspid valve in a patient with atrial septal defect and prominent eustachian valve.

Parachute tricuspid valve: a systematic review

“…Actually a systolic murmur was audible in all 11 patients. In 10 patients, the murmur was audible along the sternal border, and in 1 patient, it was heard in the left intercostal space [ 8 ]. In one of the patients, an additional diastolic murmur was heard at the apex [ 4 ].…”

“…The electrocardiographical results were described for 7 patients: 2 (28.6%) patients had a normal sinus rhythm [ 5 , 7 ], and 5 (71.4%) patients had an abnormal electrocardiogram including right bundle branch block ( n = 1) [ 8 ], conduction defects ( n = 1) [ 6 ], left ventricular hypertrophy ( n = 1) [ 9 ], ST-T changes ( n = 1) [ 5 ], and north-west axis (+ 150°), right atrial enlargement and prominent R wave in the V 1 lead ( n = 1) [ 14 ].…”

“…The diagnostic methods of PTV were described in 12 patients: it was diagnosed by transthoracic echocardiography ( n = 5, 41.7%) [ 9 – 11 , 14 , 16 ], by both transthoracic and three-dimensional transesophageal echocardiography ( n = 2, 16.7%) [ 5 ], by transthoracic and transesophageal echocardiography, three-dimensional transthoracic and transesophageal echocardiography and computed tomographic angiography ( n = 2, 16.7%) [ 7 , 8 ], by transthoracic echocardiography and multislice cardiac computed tomography ( n = 1, 8.3%) [ 7 ], and by autopsy ( n = 2, 16.7%) [ 4 , 12 ].…”

“…In 6 (42.9%, 6/14) patients, cardiac chamber enlargement was noted: 4 (66.6%) patients had one cardiac chamber enlargement (right ventricular enlargement ( n = 3) [ 4 , 8 , 13 ] and right atrial enlargement ( n = 1) [ 6 ]), and 2 (33.3%) patients had two cardiac chamber enlargement (right atrial and right ventricular enlargement ( n = 1) [ 5 ] and left atrial and right ventricular enlargement ( n = 1) [ 11 ]).…”

Parachute deformity of both atrioventricular valves with congenitally corrected transposition in an adult

“…Shortly after its description involving the mitral tensor apparatus, it was observed that often, the anomaly was associated with left-sided obstructive lesions and the syndrome was called the Shone complex. 4 Parachute tricuspid valve is a late discovery 5 with a single case each reported with tetralogy of Fallot, 6 double-outlet right ventricle, 7 two cases with atrial septal defect 8,9 and three in isolation. [10][11][12] Most of these cases were not symptomatic due to parachute tricuspid valve.…”