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      Tricuspid Regurgitation Causing a Right to Left Interatrial Shunt with Normal Pulmonary Pressures

      a , b

      Cardiology

      S. Karger AG

      Foramen ovale, patent, Tricuspid regurgitation, Interatrial shunt

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          Abstract

          We describe a patient who presented with asymptomatic hypoxia refractory to supplemental oxygen. Transthoracic echocardiography and angiography demonstrated a tricuspid valve with a large regurgitant jet oriented directly at a patent foramen ovale, producing a right to left shunt with systemic hypoxia. The patient was found to have normal right-sided cardiac pressures as well as normal pulmonary arterial pressures, demonstrating the shunt was secondary to the tricuspid regurgitant jet and not a result of a pressure gradient between atria. Surgical correction of the tricuspid valve and closure of the patent foramen ovale resulted in resolution of the patient’s hypoxemia.

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          Most cited references 5

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          Right-to-left shunt across atrial septal defect related to tricuspid regurgitation: assessment by transesophageal Doppler echocardiography.

          The purpose of this study was to assess the factors involved in the development of the right-to-left (R-L) shunt in patients with atrial septal defect (ASD), especially the role of tricuspid regurgitation (TR). Thirty-one consecutive patients with ASD underwent transesophageal Doppler echocardiography to determine the size of ASD, the shunt flow, and the TR flow, and they were compared with hemodynamics examined by cardiac catheterization. Sixteen patients with the R-L shunt were older (53 +/- 11 vs 34 +/- 9 years; p 2.5 cm and the maximal TR flow area > 4 cm2 were significantly higher in the six patients as compared with patients with TR not related to the R-L shunt (p < 0.05 and p < 0.05), despite the pulmonary arterial pressure being similar in the two groups. Reversal of pressure gradient between the left and right atrium was not observed during the cardiac cycle in all patients. In conclusion, TR is a determinant of the R-L shunt in patients with ASD even in the absence of the reversal of pressure gradient between the left and right atrium.
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            Platypnea-Orthodeoxia in a Patient With Ostium Primum Atrial Septal Defect With Normal Right Heart Pressures

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              • Abstract: not found
              • Article: not found

              Right-to-Left Interatrial Shunt After Pneumonectomy

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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2007
                May 2007
                19 February 2007
                : 107
                : 4
                : 429-432
                Affiliations
                aDepartment of Internal Medicine and bSection of Cardiology, Department of Internal Medicine, University of Illinois Medical Center, University of Illinois at Chicago, Chicago, Ill., USA
                Article
                99654 Cardiology 2007;107:429–432
                10.1159/000099654
                17310117
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 7, Tables: 1, References: 10, Pages: 4
                Categories
                Case Report

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