Mitral and Tricuspid Valve Anomalies

Abstract

As with all of the many facets of congenital heart disease, there is a wide diversity of congenital pathologies affecting both the mitral and tricuspid valves. Abnormalities of an atrioventricular (AV) valve can result in stenosis, regurgitation, or some combination of the two, and accurate anatomic and functional assessment is critical for their management. Transesophageal echocardiography (TEE)—with its ability to image valvar anatomy, motion, and function with superior real-time temporal and spatial resolution—is considered the primary imaging tool for AV valve assessment in the intraoperative setting, where it plays an indispensable role for the monitoring of mitral and tricuspid valve surgery. However, it is also integral to a number of other clinical settings, such as the diagnostic evaluation of AV valve disease in older patients with poor transthoracic echocardiographic windows, or for the assessment of possible endocarditis. The emergence of three-dimensional imaging capabilities has further augmented the utility of TEE, by significantly enhancing the ability to display and understand complex AV valve disease. This chapter reviews the diverse and complex mitral and tricuspid abnormalities commonly found in children and young adults, and the important role that TEE plays in their evaluation and management.