Circulation, Vol 54, 795-800, Copyright © 1976 by American Heart Association
RJ Boucek Jr, TP Graham Jr, JP Morgan, GF Atwood and RC Boerth
Four cases of congenital tricuspid insufficiency (CTI) are presented in
whom spontaneous improvement occured. There was no evidence of Ebstein's
disease in three of the four. All presented with similar clinical and
laboratory findings including massive cardiomegaly, mild to moderate
congestive heart failure, and moderate to severe desaturation.
Catheterization data demonstrated severe TI and right-to- left atrial
shunting. During the period of follow-up, up to 3.5 years, all symptoms
have spontaneously disappeared. Clinical and angiocardiographic evidence
for minimal residual TI have remained. Right atrial and right ventricular
volume measurements were markedly abnormal initially and returned to normal
or near normal. These measurements may be a useful method for quantitating
the severity of tricuspid insufficiency. The course of the three infants
with massive CTI (without Ebstein's disease) differs from previous reports
and may be important both in formulating future management plans and in
defining the etiology of the disorder.
ARTICLES
Spontaneous resolution of massive congenital tricuspid insufficiency
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