Echocardiographic findings in isolated, surgically created tricuspid insufficiency.

The effects of surgically created tricuspid insufficiency on the right ventricular dimension and the motion of the interventricular septum were determined by serial echocardiography in a patient with a hemodynamically normal heart who underwent tricuspid valvulectomy and later tricuspid valve replacement for medically intractable bacterial endocarditis. Initially, both the right ventricular dimension (1.8 cm) and motion of the interventricular septum were normal. After valvulectomy interventricular septal motion became distinctly paradoxical (pattern A, later pattern B), and the right ventricular dimension progressively increased to 3.5 cm. After successful tricuspid valve replacement interventricular septal motion promptly returned toward normal as did the right ventricular dimension (2.2 cm). The rapid changes in these echocardiographic variables with creation and relief of acute right ventricular volume overload correspond well with results of previous work in experimental animals but differ from findings in man with chronic right ventricular volume overload.