TRICUSPID ATRESIA. Dr Vivek pillai. 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 %.
Proposed by Kuhne and later modified
Type 1 : normally related great arteries (70 – 80%)
a. intact ventricular septum with pulmonary atresia( 9%)
b. small ventricular septal defect and pulmonary stenosis( 51%)
c. large ventricular septal defect without pulmonary stenosis ( 9%)
Type ii spontaneously/ decrease in size-”acquired pulmonary atresia” : D-transposition of great arteries (12 – 25%)
a. ventricular septal defect with pulmonary atresia( 2%)
b. ventricular septal defect with pulmonary stenosis( 8%)
c. ventricular septal defect without pulmonary stenosis(18%)
Type 3 spontaneously/ decrease in size-”acquired pulmonary atresia”:L- Transposition or malposition of great arteries (3-6%)
associated complex lesions, ie., truncus arteriosus, endocardial cushion defect
EARLY COMPLICATIONS OF FONTAN communication.
LATE COMPLICATIONS OF FONTAN
Hepatomegaly and ascites.
Progressive decrease in oxygen saturation( obstn. of venous pathways, leakage in intra- atrial baffle, dev of pulm av fistula.).
Protein losing enteropathy