Original ArticlesAnterior Tricuspid Leaflet Cleft in an Adult Male An Autopsy Case ReportYamasaki, Gentaro MD∗; Kondo, Takeshi MD, PhD∗; Kuse, Azumi∗; Sugimoto, Marie MD∗; Takahashi, Motonori MD, PhD∗; Morichika, Mai BS∗; Nakagawa, Kanako PhD∗; Sakurada, Makoto PhD†; Asano, Migiwa MD, PhD‡; Ueno, Yasuhiro MD, PhD∗Author Information From the ∗Division of Legal Medicine, Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine †Forensic Science Laboratory, Hyogo Prefectural Police Headquarters, Kobe ‡Department of Legal Medicine, Ehime University Graduate School of Medicine, Ehime, Japan. Manuscript received July 2, 2019; accepted October 5, 2019. The authors report no conflict of interest. Reprints: Gentaro Yamasaki, MD, Division of Legal Medicine, Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: March 2020 - Volume 41 - Issue 1 - p 40-41 doi: 10.1097/PAF.0000000000000525 Buy Metrics Abstract The deceased was a 44-year-old male who was treated for a suspected Ebstein's anomaly observed using transthoracic echocardiogram. He was found dead in his bed at home. Autopsy revealed that the septal tricuspid leaflet was intact; however, a large anterior tricuspid leaflet cleft and right atrioventricular cavity dilation were observed. Pathological examination revealed a normal tricuspid valve, except for the presence of a cleft with local fibrosis of the left ventricle papillary muscle and hemosiderin-containing macrophages at both lungs. There were no other abnormalities that may have led to death. It was concluded that he died a cardiac death based on the right heart overload associated with the anterior tricuspid leaflet cleft. This case indicates the possibility that the anterior tricuspid leaflet cleft can cause death and also highlights the necessity of a detailed autopsy to accurately diagnose the cause of death. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.