Undiagnosed severe pulmonic regurgitation in a carcinoid patient for tricuspid valve replacement and patent foramen ovale closure

摘要

Preoperative transthoracic echocardiogram (TTE) revealed normal left ventricular function, enlarged RV with severely decreased function, and severe TR. Preoperative transesophageal echocardiogram (TEE) showed a moderately dilated RV, thickened anterior tricuspid leaflet with frozen posterior leaflet resulting in malcoaptation and severe TR, and PFO. Although not well vizualized, the pulmonic valve (PV) was reported to be grossly normal. Pulmonary artery pressures were reported as normal (24/10 mm Hg).