Subxiphoid two-dimensional echocardiographic identification of tricuspid valve abnormalities in transposition of the great arteries with ventricular septal defect

Barbara J. Deal, Alvin J. Chin, Stephen P. Sanders*, William I. Norwood, Aldo R. Castaneda

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Tricuspid valve morphology was examined using subxiphoid 2-dimensional echocardiography (2-D echo) in 39 infants aged 2 years or younger who had transposition of the great arteries (TGA) and ventricular septal defect (VSD) (group I). Age-matched control groups were 21 patients with simple TGA (group II), 30 patients with VSD and normally related great arteries (group III), and 15 normal patients (group IV). Valve abnormalities, consisting of chordal attachments to the infundibular septum or ventricular septal crest, straddling, overriding or some combination of these, were identified in 25 of 39 patients (64%) in group I, no patients in groups II or IV and 6 of 30 patients (20%) in group III. Intraatrial baffle repair was performed in 27 patients in group I (median age at surgery 3.5 months) and 19 patients in group II (median age 4 months). Preoperative right ventricular angiography, performed in all patients with TGA, demonstrated tricuspid regurgitation (TR) with biventricular dysfunction in 1 patient in group I. After surgery, TR was present in 9 of 17 group I patients and none of the 8 group II patients who underwent catheterization. All patients in whom TR was not present preoperatively had abnormal chordal attachments; 3 required valve replacement. These results demonstrate that tricuspid valve abnormalities are common in patients with TGA and VSD and may be identified preoperatively using 2-D echo. Patients with abnormal chordal attachments are at increased risk for TR after intraatrial baffle repair and should be considered for arterial switch repair.

Original languageEnglish (US)
Pages (from-to)1146-1151
Number of pages6
JournalThe American journal of cardiology
Volume55
Issue number9
DOIs
StatePublished - Apr 15 1985

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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