The association between atrial septal defect and prolapse of the tricuspid valve. An echocardiographic study.

The echocardiograms of 52 patients with atrial septal defects were reviewed. Six patients were noted to have prolapse of the tricuspid valve. Three of these subjects had associated prolapse of the mitral valve. The diagnosis of tricuspid valvular prolapse was confirmed by angiograms in one patient. Four patients had midsystolic tricuspid valvular prolapse, and holosystolic prolapse of the tricuspid valve was observed in two. In one patient a striking increase in the degree of tricuspid valvular prolapse was noted after closure of the atrial septal defect. A concomitant increase in the degree of tricuspid regurgitation was noted after surgery. Aggravation of tricuspid valvular prolapse should be considered as one of the causes of clinical and hemodynamic deterioration in the condition of a patient following repair of an atrial septal defect.