Makindo Medical Notes"One small step for man, one large step for Makindo" |
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๐ Tricuspid Atresia is a rare congenital heart defect where the tricuspid valve fails to develop, blocking blood flow from the right atrium to the right ventricle. โก๏ธ This results in an underdeveloped (hypoplastic) right ventricle and reduced pulmonary blood flow. โ Without intervention, survival is not possible, as oxygenated and deoxygenated blood cannot mix effectively.
| Management Option | Description | Comments |
|---|---|---|
| ๐ Prostaglandin Infusion | Keeps ductus arteriosus open (PGE1). | Immediate emergency stabilisation to allow pulmonary blood flow. |
| ๐ณ๏ธ Atrial Septostomy | Enlarges ASD for atrial mixing. | Improves systemic oxygenation in neonates. |
| ๐ BlalockโTaussig Shunt | Shunt from subclavian artery โ pulmonary artery. | Palliative, improves pulmonary flow until definitive repair. |
| โ๏ธ Bidirectional Glenn | SVC connected to pulmonary arteries (blood from upper body flows directly to lungs). | Usually performed at 4โ6 months; step towards Fontan. |
| ๐ Fontan Procedure | IVC connected to pulmonary arteries โ systemic venous blood bypasses heart. | Final stage palliation (18 monthsโ4 years). Provides long-term survival pathway. |
| ๐ Long-term Follow-up | Monitoring for arrhythmias, heart failure, protein-losing enteropathy. | Lifelong cardiology follow-up is essential post-Fontan. |
๐ก Teaching Pearl: Unlike TGA, where circulation is parallel, in tricuspid atresia the LV handles both systemic and pulmonary flow. ๐ ECG clue: left ventricular hypertrophy is typical (unlike most cyanotic CHDs which show RVH).