ISOLATED TRICUSPID-VALVE STENOSIS CAUSED BY INFECTIVE ENDOCARDITIS INAN ADULT - REPORT OF A CASE

We report herein the case of a 42-year-otd man in whom dyspnea on exer tion was found to be caused by isolated tricuspid stenosis. Two-dimens ional echocardiogram showed thickening of the tricuspid valve with a m arkedly enlarged right atrium. A color-flow Doppler examination-reveal ed severe tricuspid stenosis without regurgitation and a Doppler-deriv ed tricuspid diastolic pressure gradient of 23 mmHg. At the time of su rgery, the patient was noted to have a stenotic tricuspid valve with t hickened leaflets, fused commissures, and almost normal chorda tendine ae. The valve leaflets were teased apart to the scattered specimen, an d tricuspid valve replacement was successfully performed. Microscopic examination of the specimen demonstrated infective endocarditis. Isola ted acquired tricuspid stenosis is extremely rare and, to our knowledg e, this is the first case of infective endocarditis being involved as the primary cause.