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Ann Thorac Surg 2007;83:680-682
© 2007 The Society of Thoracic Surgeons

Case Reports

Ruptured Tricuspid Valve Papillary Muscle: A Treatable Cause of Neonatal Cyanosis

Ritu Sachdeva, MDa,*, Richard T. Fiser, MDa, William R. Morrow, MDa, Joseph R. Cava, MD, PhDb, Nancy S. Ghanayem, MDc, Robert D.B. Jaquiss, MDd

a Pediatric Cardiology, Arkansas Children’s Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas
d Pediatric Cardiothoracic Surgery, Arkansas Children’s Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas
b Pediatric Cardiology, Children’s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, Wisconsin
c Pediatric Critical Care Medicine, Children’s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, Wisconsin

Accepted for publication June 23, 2006.

* Address correspondence to Dr Sachdeva, 800 Marshall St, Slot 512-3, Little Rock, AR 72202. (Email: sachdevaritu{at}uams.edu).

Severe tricuspid regurgitation resulting from a flail leaflet is a rare cause of neonatal cyanosis. We report two neonates with profound cyanosis and severe tricuspid regurgitation caused by rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. Ductal patency could not be established. Repair of the tricuspid valve was performed by reimplantation of the ruptured papillary muscle head, after initial stabilization using extracorporeal membrane oxygenation. Early recognition and treatment of this otherwise fatal condition can be lifesaving.






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