A case is reported in which acute tricuspid regurgitation developed in a child with a ventricular septal defect resulting in a left ventricular-right atrial shunt. This was successfully treated by closure of the defect and tricuspid valve replacement. The anterior leaflet of the tricuspid valve was almost completely destroyed by endocarditis, though in previous reports of tricuspid valve endocarditis in association with ventricular septal defect in children, it has beem invariably the septal leaflet which is damaged.
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