Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-19T13:24:24.906Z Has data issue: false hasContentIssue false
  • English
  • Français

Anatomy and echocardiography of the normal and abnormal tricuspid valve

Published online by Cambridge University Press:  13 October 2006

Richard M. Martinez ,
Patrick W. O'Leary  and
Robert H. Anderson
Richard M. Martinez
Affiliation:
The Congenital Heart Institute of Florida, University of South Florida, St Petersburg, Florida, United States of America
Patrick W. O'Leary
Affiliation:
Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, United States of America
Robert H. Anderson
Affiliation:
Cardiac Unit, Institute of Child Health, University College, London, United Kingdom
Get access Rights & Permissions [Opens in a new window]

Abstract

Perhaps because it guards the inlet to the lesser circulation, the morphologically tricuspid valve has received less attention in terms of its anatomy than the well-explored mitral valve, which will receive attention in a subsequent review in this supplement.1 As we will show in our initial review, nonetheless, the approach to morphological analysis is the same for both valves, irrespective of whether the specific morphology is displayed in the autopsy room or the echocardiographic laboratory. It is essential that the valve be analysed so as to reveal the precise structure of each if its components – the so-called valvar complex.2 Equally important, in the current era, with the burgeoning use of three-dimensional displays that place the heart firmly within the context of the body, it is essential that the components of the valve be described as seen relative to the bodily axis,3 rather than following the present custom of describing the heart as though it is removed from the body and positioned on its own apex.

Keywords

Atrioventricular valvesEbstein's malformationcongenital cardiac malformations
Type
The Atrioventricular Valves
Information
Cardiology in the Young , Volume 16 , Supplement S3: Controversies and Challenges of the Atrioventricular Junctions and Other Challenges Facing Paediatric Cardiovascular Practitioners and their Patients , September 2006 , pp. 4 - 11
Copyright
© 2006 Cambridge University Press

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

Asante-Korang A, O'Leary PW, Anderson RH. Anatomy and echocardiography of the normal and abnormal mitral valve. Cardiol Young 2006; 16: this Suppl.Google Scholar
Perloff JK, Robert WC. The mitral apparatus. Functional anatomy of mitral regurgitation. Circulation 1972; 46: 227–239.Google Scholar
Cook AC, Anderson RH. Editorial. Attitudinally correct nomenclature. Heart 2002; 87: 503–506.Google Scholar
Hauck AJ, Freeman DP, Ackermann DM, Danielson GK, Edwards WD. Surgical pathology of the tricuspid valve: a study of 363 cases spanning 25 years. Mayo Clin Proc 1988; 63: 851–863.Google Scholar
Ebstein W. Ueber einen sehr seltenen Fall von Insufficienz der Valvula tricuspidalis, bedingt durch eine angeborene hochgradige Missbildung derselben. Arch Anat Physiol 1866; 33: 238–254.Google Scholar
Becker AE, Becker MJ, Edwards JE. Pathologic spectrum of dysplasia of the tricuspid valve, features in common with Ebstein's malformation. Arch Pathol 1971; 91: 167–178.Google Scholar
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: 167–173.Google Scholar
Kanani M, Moorman AFM, Cook AC, et al. Development of the atrioventricular valves: clinicomorphologic correlations. Ann Thorac Surg 2005; 79: 1797–1804.Google Scholar
Schreiber C, Cook A, Ho SY, Augustin N, Anderson RH. Morphologic spectrum of Ebstein's malformation: revisitation relative to surgical repair. J Thorac Cardiovasc Surg 1999: 117: 148–155.Google Scholar
Leung MP, Baker EJ, Anderson RH, Zuberbuhler JR. Cineangiographic spectrum of Ebstein's malformation: its relevance to clinical presentation and outcome. J Am Coll Cardiol 1988; 11: 154–161.Google Scholar
Ng R, Somerville J, Ross D. Ebstein's anomaly: Late results of surgical correction. Eur J Cardiol 1979; 9: 39–52.Google Scholar
Celermajer D, Cullen S, Sullivan I. Outcome in neonates with Ebstein's anomaly. J Am Coll Cardiol 1992; 19: 1041–1046.Google Scholar
Hurwitz R. Left ventricular function in infants and children with symptomatic Ebstein's anomaly. J Am Coll Cardiol 1994; 73: 716–718.Google Scholar
Jost C, Connolly H, O'Leary P, Warnes C, Tajik A, Seward J. Left heart lesions in patients with Ebstein anomaly. Mayo Clinic Proceedings 2005; 80: 361–368.Google Scholar
Van Mierop L, Gessner I. Pathogenetic Mechanisms in Congenital Cardiovascular Malformations. Prog Cardiovasc Dis 1972; 15: 67–85.Google Scholar
Snider AR, Serwer A, Ritter SB. Echocardiography in Pediatric Heart Disease, 2nd Edition. Mosby-Year Book, Inc., St. Louis, Missouri 1997; Chapter 3, pp 29, 36.
Ayres NA, Miller-Hance W, Fyfe DA, et al. Indications and guidelines for performance of transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease. J Am Soc Echocardiogr, 2005; 18: 91–98.Google Scholar
Maxted W, Nanda N, Kim KS, Roychoudhury D, Pinherio L. Transesophageal echocardiographic identification and validation of individual tricuspid valve leaflets. Echocardiography 1994; 11: 585–596.Google Scholar
Silverman NH, McElhinney DB. Atrioventricular valve dysfunction: evaluation by Doppler and cross-sectional ultrasound. Ann Thorac Surg 1998; 66: 653–658.Google Scholar
Huhta JC. Fetal congestive heart failure. Semin Fetal Neonatal Med 2005; 10: 542–552.Google Scholar
McElhinney DB, Silverman N, Brook M, Hanley F, Stanger P. Asymmetrically short tendinous cords causing congenital tricuspid regurgitation: improved understanding tricuspid valvar dysplasia in the era of color flow echocardiography. Cardiol Young 1999; 9: 300–304.Google Scholar
Ports TA. Silverman NH. Schiller NB. Two-dimensional echocardiographic assessment of Ebstein's anomaly. Circulation 1978; 58: 336–343.Google Scholar
Shiina A, Seward J, Edwards W. Two-dimensional echocardiographic spectrum of Ebstein's anomaly: Detailed anatomic assessment. J Am Coll Cardiol 1984; 3: 356–370.Google Scholar
Gussenhoven E, Stewart P, Becker A. “Offsetting” of the septal tricuspid leaflet in normal hearts and in hearts with Ebstein anomaly: Anatomic and echographic correlation. Am J Cardiol 1984; 54: 172–176.Google Scholar
Dearani JA, O'Leary PW, Danielson GK. Surgical treatment of Ebstein's malformation – state of the art in 2006. Cardiol Young 2006; 16: this suppl.Google Scholar
Seward J. Ebstein's anomaly: Ultrasound imaging and hemodynamic evaluation. Echocardiography 1993; 10: 641–664.Google Scholar
Shiina A, Seward J, Tajik A, Hagler D, Danielson G. Two-dimensional echocardiographic-surgical correlation in Ebstein's anomaly: Preoperative determination of patients requiring tricuspid valve plication vs. replacement. Circulation 1983; 68: 534–544.Google Scholar
Gussenhoven W, de Villeneuve V, Hugenholtz P. The role of echocardiography in assessing the functional class of the patient with Ebstein's anomaly. Eur Heart J 1984; 5: 490–493.Google Scholar
Eidem BW, Tei C, O'Leary PW, Cetta F, Seward JB. Nongeometric quantitative assessment of right and left ventricular function: Myocardial performance index in normal children and patients with Ebstein anomaly. J Am Soc Echocardiogr 1998; 11: 849–56.Google Scholar
Dearani JA, Danielson GK. Surgical Management of Ebstein's Anomaly in the adult. Semin Thorac Cardiovasc Surg 2005; 17: 148–154.Google Scholar
Oh J, Seward JB, Tajik AJ. Valvular heart disease. In: The Echo Manual, 2nd edition. Lippincott-Raven Publishers, Philadelphia PA, 1999.
Randolph GR, Hagler DJ, Connolly HM, et al. Intraoperative transesophageal echocardiography during surgery for congenital heart defects. J Thorac Cardiovasc Surg 2002; 124: 1176–1182.Google Scholar