• Atresia means closed or absent.
• Tricuspid Atresia results in a number of
• ♥ The tricuspid valve is closed or absent.
• ♥ The right ventricle is small.
• ♥ The pulmonary artery is narrow.
• ♥ The pulmonary valve may be blocked.
• Defined as congenital absence or
agenesis of the tricuspid valve, with no
direct communication between the right
atrium and right ventricle.
• Incidence : 0.06 per 1000 live births
• Prevalence :in clinical series of congenital
heart disease is 1- 2.4 %.
To survive your baby will
• ASD OR VSD
• First reported by Kreysig in 1817.
• Clinical features reported by Bellet and
Stewart in 1933.
• Also by Taussig and Brown in 1936.
Formation of the atrioventricular
Days 34 to 36
• 1.Formed from endocardial cushion tissue
• 2. Tricuspid valve, papillary muscles and
chordate tendineae formed largely from
the conus septum.
• The clinical features of tricuspid
atresia largely depend on the quantity of
pulmonary blood flow
, and acidosis
LV apical impulse
Waves in jugular
• pulmonary oligemia
• may have central cyanosis,
• tachypnea or hyperpnea,
INCREASED PULM FLOW
• Diff to diagnose
• may not appear cyanotic but may present
with signs of heart failure later in infancy
• pulmonary plethora present with
symptoms of dyspnea, fatigue, difficulty
feeding, and perspiration, which are
suggestive of congestive heart failure.
• Cyanosis is minimal
• holosystolic type of murmur at the lower
sternal border, suggestive of VSD,
• Problems related to chronic cyanosis,
• polycythemia, relative anemia,
• stroke, brain abscess,
• coagulation abnormalities,
• History and PE
• Pulse oximetry
• Hb and hematocrit
• Surgical options for Fontan operation
• a. Lateral tunnel: Gortex graft placed
inside RA to direct IVC flow through
RA/SVC junction and into MPA
• b. Extracardiac (As Illustrated): Gortex or
Dacron circumferential tube graft from IVC
• ablation, pacemaker, ICD, medications,
conversion to lateral tunnel
• B. Ventricular dysfunction:
• rhythm and transplant
• C. Atrioventricular valve regurgitation
(AVVR): Valve repair/replacement
• D. Fontan pathway obstruction:
reoperation for relief of conduit stenosis
• G. Thromboembolic events:
• anticoagulation varies from center to
center but minimally life long aspirin (ASA