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Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report

A 75-year-old man (Asian, Japanese) was readmitted for examination of a heart murmur and haemolytic anemia 3 months after mitral valve and tricuspid annuloplasties and coronary artery bypass. A new systolic murmur was heard, and echocardiography showed a high-velocity jet originating from the left v...

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Autores principales: Tayama, Eiki, Tomita, Yukihiro, Imasaka, Ken-ichi, Kono, Takanori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075505/
https://www.ncbi.nlm.nih.gov/pubmed/24942072
http://dx.doi.org/10.1186/1749-8090-9-104
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author Tayama, Eiki
Tomita, Yukihiro
Imasaka, Ken-ichi
Kono, Takanori
author_facet Tayama, Eiki
Tomita, Yukihiro
Imasaka, Ken-ichi
Kono, Takanori
author_sort Tayama, Eiki
collection PubMed
description A 75-year-old man (Asian, Japanese) was readmitted for examination of a heart murmur and haemolytic anemia 3 months after mitral valve and tricuspid annuloplasties and coronary artery bypass. A new systolic murmur was heard, and echocardiography showed a high-velocity jet originating from the left ventricular outflow tract and extending to the right atrium, a small defect between the left ventricle and the right atrium. No periprosthetic leaks were found in the mitral position. We judged that surgical repair of the defect was essential to treat mechanical haemolysis. At operation, we found a communication (3 mm in diameter) just beneath the detached prosthetic ring at the anteroseptal commissure of the tricuspid valve. After partially removing the tricuspid ring from the anteroseptal commissure area, the defect was closed using a single mattress suture with pledget. In this case, the tricuspid annuloplasty stitch in the atrioventricular region was probably placed on the membranous septum rather than on the tricuspid annulus. A tear then occurred in the atrioventricular membranous septum, leading to left ventricular–right atrial communication.
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spelling pubmed-40755052014-07-01 Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report Tayama, Eiki Tomita, Yukihiro Imasaka, Ken-ichi Kono, Takanori J Cardiothorac Surg Case Report A 75-year-old man (Asian, Japanese) was readmitted for examination of a heart murmur and haemolytic anemia 3 months after mitral valve and tricuspid annuloplasties and coronary artery bypass. A new systolic murmur was heard, and echocardiography showed a high-velocity jet originating from the left ventricular outflow tract and extending to the right atrium, a small defect between the left ventricle and the right atrium. No periprosthetic leaks were found in the mitral position. We judged that surgical repair of the defect was essential to treat mechanical haemolysis. At operation, we found a communication (3 mm in diameter) just beneath the detached prosthetic ring at the anteroseptal commissure of the tricuspid valve. After partially removing the tricuspid ring from the anteroseptal commissure area, the defect was closed using a single mattress suture with pledget. In this case, the tricuspid annuloplasty stitch in the atrioventricular region was probably placed on the membranous septum rather than on the tricuspid annulus. A tear then occurred in the atrioventricular membranous septum, leading to left ventricular–right atrial communication. BioMed Central 2014-06-18 /pmc/articles/PMC4075505/ /pubmed/24942072 http://dx.doi.org/10.1186/1749-8090-9-104 Text en Copyright © 2014 Tayama et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Tayama, Eiki
Tomita, Yukihiro
Imasaka, Ken-ichi
Kono, Takanori
Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
title Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
title_full Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
title_fullStr Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
title_full_unstemmed Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
title_short Iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
title_sort iatrogenic left ventricular-right atrial communication after tricuspid annuloplasty; a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075505/
https://www.ncbi.nlm.nih.gov/pubmed/24942072
http://dx.doi.org/10.1186/1749-8090-9-104
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