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Mitral value anomalies in tricuspid atresia: an autopsy study of 54 hearts

Published online by Cambridge University Press:  19 August 2008

Robin J. Pinto ,
Jaya Deshpande  and
Bharat V Dalvi
Robin J. Pinto
Affiliation:
Department of Cardiology, King Edward VII Memorial Hospital, Parel, Bombay 400 012, India.
Jaya Deshpande
Affiliation:
Department of Cardiac Pathology, King Edward VII Memorial Hospital, Parel, Bombay 400 012, India.
Bharat V Dalvi*
Affiliation:
Department of Cardiology, King Edward VII Memorial Hospital, Parel, Bombay 400 012, India.
*
Dr Bharat Dalvi Associate Professor, Department of Cardiology, King Edwards VI Memorial Hospital, Parel Bombay 400 012, India. Tel: 91 022 413 6051 ext:2135. Fax: 91 022 414 3435.
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Abstract

Anatomic study of 54 autopsied cases of tricuspid atresia revealed mitral valvar anomalies in 9 (16.7%). The morphologic findings in these 9 cases are presented and compared with 45 cases having a normal mitral valvar apparatus. The anomalies included a cleft valve in 2, parachute valve in 2, straddling valve in 3, and a valve with dual orifice in 2.Two of these cases had more than one anomaly. Data from echocardiography and cardiac catheterisation, when available, had failed to diagnose the anomalies during life. The anomalies were more commonly associated with discordant ventriculo-arterial connections (33.3% versus 13.3%, p < 0.01), were associated significantly with a large ventricular septal defect (33.3% versus 4.4%, p < 0.01), and with pulmonary hypertension (33.3% versus 2.2%, p < 0.01). Two of 3 post operative deaths among the 9 were due to hemodynamic consequences arising from the uncorrected mitral valvar anomaly (parachute valve in both ). Diagnosis of these anomalies prior to surgical correction is imperative, as their presence may necessitate repair or replacement of the mitral valve. Failure to do so may result in increased perioperative mortality, congestive cardiac failure and arrhythmias at a later date. Mitral valvar anomalies may be a contributory factor to the early onset of cardiac failure seen in patients with tricuspid atresia undergoing palliative shunts.

Keywords

Tricuspid atresiamitral valvepapillary musclesstraddling valvedouble orifice mitral valvecleft mitral valve
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 2 , April 1997 , pp. 163 - 171
Copyright
Copyright © Cambridge University Press 1997

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