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[Tricuspid atresia. Clinical course in 120 children]
A A Rosado-Buzzo1, H Santamaría-Díaz, M Gómez-Gómez
1Hospital de Cardiología y Neumología Luis Méndez, Centro Médico Nacional del Instituto Mexicano del Seguro Social, D.F.
Insights
This study analyzes 120 children with tricuspid atresia (TA), finding hypoxic spells common. Management strategies and outcomes are detailed, offering insights for pediatric cardiology.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Echocardiography
Context:
- Tricuspid atresia (TA) is a critical congenital heart defect.
- Early diagnosis and management are crucial for infant survival.
- Understanding clinical presentation aids in timely intervention.
Purpose:
- To describe the clinical course of 120 children with tricuspid atresia.
- To analyze diagnostic findings, including chest X-ray and ECG.
- To review management strategies and outcomes in pediatric TA patients.
Summary:
- The study reviewed 120 pediatric tricuspid atresia (TA) cases.
- Common presentations included hypoxic spells (89%) and cardiomegaly (85%).
- Management involved medical therapy, systemic-pulmonary anastomosis (63), and Fontan procedures (13), with 21 deaths.
Impact:
- Provides a comprehensive overview of tricuspid atresia in a pediatric cohort.
- Highlights key diagnostic features and common clinical presentations.
- Offers data for refining management protocols and improving outcomes for congenital heart disease.
Abstract:
We describe the clinical course of 120 children with tricuspid atresia (TA) attended in the Hospital de Cardiología y Neumología, "Dr. Luis Méndez", del Centro Médico Nacional. There were 61 males and 59 females. The age of presentation was in 79 newborn babies, seventeen between one and six months old, 20 between six and 24 months old, and four with two or more years old. The clinical picture was hypoxic spells in 89% and congestive heart failure in the others. The chest film showed cardiomegaly in 85%, with diminished pulmonary flow in 48%, increased flow in 27.5%, and normal in 9%. The electrocardiogram with superior left axis deviation in 94%, right atrial hypertrophy in 58%, left atrial hypertrophy in 47.5% and left ventricular hypertrophy in 96%. TA was classified as type I in 103 children, type Ic in 70, Ib in 27 and Ia in six, and type II in seventeen children, with eight IIc, six IIb and three IIa. In 44 the management was medical, 63 underwent systemic-pulmonary anastomosis, 37 of them with Blalock-Taussig shunt and Fontan procedure in thirteen children. There were 21 deaths. This survey is compared with the literature and from this point we make management recommendations.