Key result
Bioprosthetic TVR relieves symptoms and partially restores RV function in tricuspid valve agenesis.
Why the study?
Tricuspid valve agenesis is an exceptionally rare congenital anomaly that is usually diagnosed during childhood, making diagnosis in adulthood uniquely uncommon.
Case Report (n=1)
No
Surgical bioprosthetic valve replacement can be successfully performed in adults with severe tricuspid regurgitation due to congenital tricuspid valve agenesis, with 3D echocardiography playing a crucial role in pre-operative planning.
May support surgical correction for symptom relief in rare adult tricuspid agenesis; hypothesis-generating and requires larger studies before practice change.
Background: Tricuspid valve agenesis is an exceptionally rare congenital cardiac disease characterized by the incomplete formation or complete absence of one or more tricuspid leaflets. It is commonly diagnosed during childhood due to the development of heart failure symptoms. Case summary: We report the case of a 62-year-old woman admitted for a worsening of heart failure symptoms (New York Heart Association functional Class IV at admission). A standard transthoracic echocardiogram was performed, which showed severe right heart dilatation and severe tricuspid regurgitation. A three-dimensional echocardiogram revealed the absence of the posterior tricuspid leaflet. The patient underwent an uncomplicated surgical bioprosthetic valve replacement with a favourable outcome and partial recovery of right ventricular function. In our patient, valve repair was not favoured due to the additional mild hypoplasia of the anterior leaflet. The 3-month post-operative evolution of the patient was favourable, with significant symptom relief. Discussion: The diagnosis of tricuspid agenesis during adulthood is uniquely uncommon. A three-dimensional echocardiography can provide accurate pre-procedural insight into the valve anatomy, allowing surgeons to plan for either valve repair when the anatomy is suitable or valve replacement.
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Raicea et al. (2024) conducted a case report in Tricuspid valve agenesis with severe tricuspid regurgitation (n=1). Surgical bioprosthetic valve replacement was evaluated on Symptom relief and right ventricular function recovery. Surgical bioprosthetic valve replacement successfully treated severe tricuspid regurgitation caused by tricuspid valve agenesis, leading to significant symptom relief and partial recovery of right ventricular function at 3 months.
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