PMC6875343_01
Transesophageal echocardiogram at the midesophageal four chamber view showing rupture of the papillary muscle (red arrow) resulting in protrusion of the tricuspid valve and subvalvular apparatus into the right ventricle, and detached anterior leaflet from the annulus (blue arrow). Significant dilatation of right atrium, with increased pressure as demonstrated by the bowing of the interatrial septum into the left atrium.
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fig1
TEE was performed. The intraoperative TEE demonstrated poor biventricular function with severe tricuspid regurgitation and papillary rupture (Figure 1).
Photograph of the pathology specimen of the excised ruptured tricuspid valve.
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fig2
On cardiopulmonary bypass, the right atrium was opened and the valvular anatomy was inspected (Figure 2).