Triscupid atresia

Triscupid Atresia. It is characterized by an imperforated right atrioventricular duct, leaving simply a membranous vault. Tricuspid arthresia presents:

  • An interatrial communication that ensures circulation.
  • A small right ventricular cavity.
  • A large mitral orifice, with the VI enlarged.
  • A ventricular defect.

Summary

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  • 1 Causes
  • 2 Diagnosis
    • 1 Electrocardiography
    • 2 Radiography
  • 3 Treatment
    • 1 Operative indications
    • 2 Operational technique
    • 3 Fontana operation
  • 4 Possible complications
  • 5 Sources

Causes

Tricuspid atresia is a rare form of congenital heart disease that affects about 5 in 100,000 live births. 20% of patients with this condition will also have other heart problems.

Normally, blood flows from the body to the right atrium, then through the tricuspid valve to the right ventricle, and then continues to the lungs . If the tricuspid valve does not open, blood cannot flow from the right atrium into the right ventricle. Due to the problem with the tricuspid valve, blood cannot finally enter the lungs, where it has to go to collect oxygen (get oxygenated).

Instead, blood passes through a hole between the left and right atrium. In the left atrium , it mixes with oxygenated blood that returns from the lungs. This mix of oxygenated and deoxygenated blood is then pumped into the body, causing the oxygen levels in the blood to be lower than normal.

The lungs receive blood either through a hole between the right and left ventricles or through a fetal vessel called the arterial duct that connects the pulmonary artery (the artery to the lungs) to the aorta (the main artery in the body). . The arterial duct occurs when a baby is born, but it closes on its own soon after birth.

Diagnosis

  • Early cyanosis.
  • Drum stick fingers.
  • Dyspnea on exertion.
  • Right heart failure.
  • Upon auscultation there may be no murmur or a systolic murmur can be heard throughout the precordium.

Electrocardiograph

  • Deviation of the electrical axis to the left.
  • Left ventricular hypertrophy.
  • Pathological P waves, very high and indented, with predominance of the 1st. Peak over the 2nd.

Bone scan

Telecardiogram:

  • Large, globular heart area.
  • Half excavated arch.
  • Decreased pulmonary flow.

Angiocardiogram:

  • Dilated right atrium.
  • Pass the contrast from right to left: inter -icular route.
  • Fill early in the aorta.
  • Absence of the RV.

Right heart catheterization.

  • The catheter passes from AD to AI, and does not pass into the tricudpid orifice.
  • Ad pressure is increased.
  • Giant A waves in the pressure curves of the AD.
  • Signs of atrial shunt, right to left.
  • Low arterial oxygen saturation.

Treatment

Operative indications

It refers to medical treatment and, in the event of heart failure, surgical intervention of the appeliative type is recommended.

Operative technique

  • Left or right subclavian-pulmonary anastomosis (Blalock-Taussig operation) in children older than 2 years.
  • Right intrapercardial aortopulmonary anastomosis (Waterston’s operation), or anastomosis between the superior vena cava and the right pulmonary artery, in children younger than 2 years of age.

Fontana operation

  • Longitudinal medial stereotomy.
  • Placement of valve prosthesis at the mouth of the inferior vena cava.
  • Placing the graft that carries blood from the AD to the pulmonary artery.

Possible complications

  • Fast and irregular heart rhythms (arrhythmias).
  • Chronic diarrhea (from a disease called protein-losing enteropathy).
  • Heart failure.
  • Fluid in the abdomen ( ascites) and in the lungs ( pleural effusion ).
  • Obstruction of artificial communication.
  • Accidentscerebrovascular]] is and other complications of the nervous system .
  • Sudden death.

 

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