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  • Title: [Transposition of the great arteries associated with the straddling tricuspid valve diagnosed preoperatively by two-dimensional echocardiography: report of a case].
    Author: Kitoh N, Takao A, Satomi G, Iwasa M, Narai S, Nakamura K.
    Journal: J Cardiogr; 1982 Sep; 12(3):753-62. PubMed ID: 7184984.
    Abstract:
    A case of transposition of the great arteries associated with the straddling tricuspid valve and the hypoplastic right ventricle was presented, who was diagnosed by two-dimensional echocardiography and finally confirmed by operation. The patient, a 2-year-old girl, had cyanosis, clubbed fingers, effort dyspnea and poor growth. The electrocardiogram revealed both atrial and left ventricular hypertrophy. In the M-mode echocardiogram, the interventricular septal echo was recorded at the level of the midportion of the tricuspid valve and posterior tricuspid leaflet opened behind the interventricular septum during diastole. Two-dimensional echocardiography demonstrated a small right ventricle with the tricuspid valve and its orifice which were straddling over the interventricular septum. Contrast echocardiography disclosed that in early diastole the bolus of contrast echoes passed through the tricuspid orifice into the right and left ventricles simultaneously. Left ventricular angiocardiography in the left anterior oblique projection revealed the negative diastolic silhouette of the tricuspid valve straddling the interventricular septum. Operative findings were as follows; the tricuspid orifice was normal in size, but the crest of the interventricular septum traversed the medial 1/3 of the orifice, the posterior 2/3 of the septal leaflet was supported by an anomalous papillary muscle originated from the left ventricular cavity adjacent to the posterior papillary muscle of the mitral valve and the posterior leaflet of the tricuspid valve was supported with the short chordae from the crest of the septum. The diagnosis of the straddling tricuspid valve was accurately made with the use of two-dimensional echocardiography.
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