An uncommon and challenging finding regarding the tricuspid valve: case report, clinical considerations, and practical management

TL;DR

A rare case of a tricuspid valve aneurysm was identified in an asymptomatic patient, leading to a decision against surgical intervention.

Contribution

The paper presents a unique case of a tricuspid valve aneurysm with distinct morphological features and management considerations.

Findings

The lesion exhibited 'finger-in-glove' and 'garland-like' morphology consistent with a tricuspid valve aneurysm.

The patient's asymptomatic status and lack of precipitating events led to the conclusion of an aseptic tricuspid valve aneurysm.

Surgical intervention was not recommended following multidisciplinary evaluation.

Abstract

The differential diagnosis of tricuspid masses remains challenging.

This case involves the incidental detection of a lesion with a non-solid appearance, exhibiting the characteristic ‘finger-in-glove’ and ‘garland-like’ morphology, resembling a blind-ended protrusion of the tricuspid leaflet. This presentation is consistent with a tricuspid valve aneurysm, without significant associated stenosis or regurgitation.

Given the lesion’s morphological features, the patient’s asymptomatic status, and the absence of a precipitating event suggestive of an alternative diagnosis, we concluded that the most likely diagnosis is aseptic tricuspid valve aneurysm. Following a multidisciplinary heart team discussion, surgical intervention was deemed unnecessary.

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