\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[T2A]{fontenc}
\usepackage[ngerman,polish,english]{babel}



\usepackage{float}








\begin{document}

\title{3D TEE imaging in a patient with severe tricuspid regurgitation with
dextrocardia and tricuspid commussural prolapse}



\author[1]{Ayse  Demirtola}%
\author[1]{Duygu Inan}%
\author[1]{Özlem Pamuk}%
\author[1]{Sevil Tugrul Yavuz 1 MD}%
\author[2]{Anar Mammadli}%
\author[1]{alev kılıçgedik}%
\affil[1]{Basaksehir Cam ve Sakura Sehir Hastanesi}%
\affil[2]{Bayindir Hastanesi Sogutozu}%


\vspace{-1em}



  
  \date{May 27, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Dextrocardia is a cardiac positional anomaly in which the heart is
located in right hemithorax with base-to-apex axis directed to the right
and caudad. A number of congenital heart defects have been reported with
dextrocardia, including VSD, PDA, ASD, TOF, pentalogy of Fallot,
infundubular PS, transposition and pseudotruncus and total anomalous
pulmonary venous return. We will share a patient with severe TR due to
tricuspid valve commissural prolapse. A 42-year-old female patient was
admitted to our clinic with the complaint of dyspnea. Transthoracic
echocardiography revealed dextrocardia and severe TR consisting of two
separate regurgitation jets. Contrast echocardiography performed due to
dilatation of the coronary sin\selectlanguage{ngerman}üs, did not show persistent left superior
vena cava, and no right-to-left shunt was observed. Transesophageal
echocardiography showed a prolapse in the commissure where the tricuspid
anterior and septal leaflets meet, and a severe eccentric regurgitation
jet with an area of vena contracta 0.75cm2 in the 3D MPR was observed. A
moderate regurgitation jet was also seen from the coaptation line of all
three leaflets. Commussural prolapse and regurgitation jet revealed in
detail by 3D imaging. No significant pathology was detected in the other
valves except mild insufficiency. Right heart catheterization and
tricuspid valve surgery were planned for the patient with normal right
heart functions. Although it is known that there are many congenital
pathologies accompanying dextrocardia, we are happy to share our
experience with you as the first case to report the coexistence of
primary tricuspid valve disease and commusural prolapse with 3D detailed
imaging.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy


\textbf{3D TEE imaging in a patient with severe tricuspid regurgitation
with dextrocardia and tricuspid commussural prolapse}

Ay\selectlanguage{polish}ş\selectlanguage{english}e \selectlanguage{polish}İ\selectlanguage{english}rem Demirtola (1), Duygu \selectlanguage{polish}İ\selectlanguage{english}nan (1), \selectlanguage{ngerman}Özlem Pamuk (1), Sevil Tugrul
(1), Anar Mammadli (2), Alev K\selectlanguage{polish}ı\selectlanguage{english}l\selectlanguage{polish}ı\selectlanguage{ngerman}çgedik (1)

(1) Department of Cardiology, Basaksehir Cam \& Sakura City Hospital,
Istanbul, Turkey.

(2) Department of Cardiology, Bayindir Sogutozu Hospital, Ankara, Turkey

Corresponding author

Ay\selectlanguage{polish}ş\selectlanguage{english}e \selectlanguage{polish}İ\selectlanguage{english}rem Demirtola, MD

Department of Cardiology, Basaksehir Cam \& Sakura City Hospital, -
Olimpiyat Blv Rd, Ba\selectlanguage{polish}ş\selectlanguage{english}ak\selectlanguage{polish}ş\selectlanguage{english}ehir, Istanbul, Turkey

Telephone: +90 506 806 68 66

airem90@gmail.com

Dextrocardia is a cardiac positional anomaly in which the heart is
located in the right hemithorax with its base-to-apex axis directed to
the right and caudad. A number of congenital heart defects have been
reported with dextrocardia, including ventricular septal defect, patent
ductus arteriosus, atrial septal defect ,tetralogy of Fallot, pentalogy
of Fallot, infundubular pulmonary stenosis, transposition and
pseudotruncus and total anomalous pulmonary venous return. We will share
a patient with severe tricuspid regurgitation due to tricuspid valve
commissural prolapse.

A 42-year-old female patient was admitted to our clinic with the
complaint of dyspnea. Transthoracic echocardiography revealed
dextrocardia and severe tricuspid regurgitation consisting of two
separate regurgitation jets. Contrast echocardiography performed due to
dilatation of the coronary sin\selectlanguage{ngerman}üs, did not show persistent left superior
vena cava, and no right-to-left shunt was observed. Transesophageal
echocardiography showed a prolapse in the commissure where the tricuspid
anterior and septal leaflets meet, and a severe eccentric regurgitation
jet with an area of vena contracta 0.75cm2 in the 3D MPR was observed. A
moderate regurgitation jet was also seen from the coaptation line of all
three leaflets. Commussural prolapse and regurgitation jet revealed in
detail by 3D imaging. No significant pathology was detected in the other
valves except mild insufficiency. Right heart catheterization and
tricuspid valve surgery were planned for the patient with normal right
heart functions.

Although it is known that there are many congenital pathologies
accompanying dextrocardia, we are happy to share our experience with you
as the first case to report the coexistence of primary tricuspid valve
disease and commusural prolapse with 3D detailed imaging.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure1/Figure1}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure2/Figure2}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure3/Figure3}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

