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Eur J Cardiothorac Surg 2005;27:728-729
© 2005 Elsevier Science NL

Letter to the Editor

Is congenital tricuspid insufficiency (CTI) as rare as it seems to be?

Andrew C. Chatzis*, Nicolas M. Giannopoulos, George E. Sarris

Department of Paediatric and Congenital Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece

Received 25 November 2004; accepted 23 December 2004.

* Corresponding author. Address: 356 Sygrou Ave, 17674 Kallithea, Athens, Greece. Tel: +30 310 9493855; fax: +30 210 9607462. (E-mail: achatzis{at}otenet.gr).

Key Words: Congenital • Tricuspid insufficiency • Absent pericardium

We read with interest the report of severe tricuspid insufficiency in a case of partial absence of the left pericardium presented by Goetz et al. [1]. We have recently reported a rare similar case of a 37-year-old male yet with absence of the right pericardium [2]. In spite the fact that right pericardial defects do not affect cardiac position in any way, our patient had severe tricuspid regurgitation which we felt was congenital tricuspid insufficiency (CTI) due not only to significant annular dilatation (a chief feature of CTI), but also to dysplastic, deficient leaflet tissue [3–5].

In the case reported by Goetz et al. [1], the leaflets appeared normal and disruption of the valve was attributed to heart displacement and stretching alone. However, we believe that one should also consider the contribution of a congenital element to the dilatation of the tricuspid annulus, unrelated to cardiac displacement.

References

  1. Goetz WA, Liebold A, Vogt F, Birnbaum DE. Tricuspid valve repair in a case with congenital absence of left thoracic pericardium. Eur J Cardiothorac Surg 2004;26:848-849.[Abstract/Free Full Text]
  2. Chatzis AC, Giannopoulos NM, Sarris GE. Isolated congenital tricuspid insufficiency associated with right-sided congenital partial absence of the pericardium. J Heart Valve Dis 2004;13(5):790-791.[Medline]
  3. Aaron BL, Mills M, Lower RR. Congenital tricuspid insufficiency: definition and review. Chest 1976;69:637-641.[Abstract/Free Full Text]
  4. Katogi T, Aeba R, Ito T, Goto T, Cho Y, Ueda T, Kawada S. Surgical management of isolated congenital tricuspid regurgitation. Ann Thorac Surg 1998;66:1571-1574.[Abstract/Free Full Text]
  5. Marui A, Mochizuki T, Mitsui N, Koyama T, Horibe M. Isolated tricuspid regurgitation caused by a dilated tricuspid annulus. Ann Thorac Surg 1998;66:560-562.[Abstract/Free Full Text]




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