Perimembranous VSD with Severe TR on Echocardiography

 Perimembranous ventricular septal defect  (VSD) with severe Tricuspid regurgitation (TR).

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 Discussion: Mechanisms of tricuspid regurgitation in patient with perimembranous VSD:
1) Tricuspid valves clefts or dysplasia. 2) VSD jet pushing the tricuspid anterior leaflet to open tricuspid valves orifice. Mechanisms of spontaneous closure of membranous VSD: The tricuspid valve was responsible for most common mechanism of closure(85%) by either reduplication of leaflet tissue or adherence of septal leaflet to the margins of defect. Membranous VSD diminish in size or close spontaneously by aneurysm formation. So-call ventricular septal aneurysm is not a true aneurysm of the septaum membranaceum but rather a tissue out pouching from the tricuspid valve.Discussion: Mechanisms of tricuspid regurgitation in patient with perimembranous VSD:
1) Tricuspid valves clefts or dysplasia. 2) VSD jet pushing the tricuspid anterior leaflet to open tricuspid valves orifice. Mechanisms of spontaneous closure of membranous VSD: The tricuspid valve was responsible for most common mechanism of closure(85%) by either reduplication of leaflet tissue or adherence of septal leaflet to the margins of defect. Membranous VSD diminish in size or close spontaneously by aneurysm formation. So-call ventricular septal aneurysm is not a true aneurysm of the septaum membranaceum but rather a tissue out pouching from the tricuspid valve.

 

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