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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Tricuspid Atresia

Rao1

  • 1Division of Pediatric Cardiology, Saint Louis University School of Medicine, 1465 South Grand Boulevard, St. Louis, MO 63104, USA. raops@slu.edu

Current Treatment Options in Cardiovascular Medicine
|November 30, 2000
PubMed

Insights

Tricuspid atresia (TA) treatment has improved significantly with the Fontan principle. Staged total cavopulmonary connection is the preferred surgical approach for children with TA, offering a better outlook.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery
  • Cardiovascular Physiology

Background:

  • Tricuspid atresia (TA) historically has a poor prognosis.
  • Advances in surgical techniques, including the Fontan principle, have improved outcomes for children with TA.
  • Prompt palliative procedures are crucial for managing pulmonary blood flow and obstructions in TA.

Purpose of the Study:

  • To review the current surgical management of tricuspid atresia (TA).
  • To highlight the efficacy of staged total cavopulmonary connection in improving long-term outlook for TA patients.
  • To compare the outcomes of total cavopulmonary diversion with conventional Fontan-Kreutzer operations.

Main Methods:

  • Review of palliative procedures for tricuspid atresia.
  • Description of staged total cavopulmonary connection, including bidirectional Glenn procedure and extracardiac conduit diversion.
  • Comparison of total cavopulmonary diversion with conventional Fontan-Kreutzer operations.

Main Results:

  • Staged total cavopulmonary connection is the current procedure of choice for surgical management of TA.
  • This approach bypasses the right atrium and right ventricle.
  • Total cavopulmonary diversion shows potential superiority over conventional Fontan-Kreutzer operations.

Conclusions:

  • The long-term outlook for children with tricuspid atresia has markedly improved with modern surgical therapies.
  • Staged total cavopulmonary connection represents a significant advancement in TA management.
  • Further long-term follow-up studies are necessary to definitively confirm the superiority of total cavopulmonary diversion.

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