Tricuspid atresia. Clinical course in 62 cases (1967--1974).

Open Access
Publisher Website
Google Scholar
Abstract
Patients (62) with tricuspid atresia admitted for cardiac catherization between 1967 and 1974 were classified by anatomical and radiological findings into those with normally related great arteries (type I: 39 cases) and those with transposition of the great arteries (type II: 23 cases). These types were further subdivided into Group A (reduced lung vascularity), group B (normal or increased vascularity) and group C (increased vascularity initially, becoming reduced). ECG showed superior and left axis deviation in 61.5% of patients with type I and in 22.7% of those with type II tricuspid atresia. P wave amplitude (> 0.25 mV) and atrial pressures showed better correlations with a wave gradient rather than with mean interatrial gradient. Palliative operations such as the Waterston shunt resulted in high mortality (44.4%) in neonates. A Blalock-Taussig shunt is preferred though another shunt is invariabily required later. Postoperative hemodynamic study never showed pulmonary hypertension after an arterial shunt procedure, and survivors are suitable for the Fontan operation, which was done in 2 cases. Because multiple operations with high mortality (30%) are required the Fontan procedure may be performed earlier. Pulmonary artery banding is recommended as the initial step for patients with type II tricuspid atresia and increased pulmonary blood flow (type II B).
Keywords