Tricuspid atresia. Results of treatment in 115 children

J Thorac Cardiovasc Surg. 1983 Mar;85(3):440-6.

Abstract

We present our experience in the management of tricuspid atresia in 115 children. The anatomic data are categorized as follows: type I, 83.5%, type II, 16.5%. Type IB is the most frequent, representing 63.5% of all the cases. Each patient was operated upon one to four times. The age at first operation ranged from 10 days to 20 years. The first operation was a shunt in 94 children, a Fontan operation in four, and banding of the pulmonary artery in 17. Hospital mortality for the first operation was 12.2%, significantly higher in children under 6 months and in those having Waterston shunts. Potts and Blalock-Taussig operations give low long-term mortality; although few (six) have been done, Potts shunts also seem to give good long-term palliation in this series. The Glenn anastomosis is a good operation when performed after a systemic-pulmonary arterial shunt. The Fontan operation was performed in 24 children (hospital mortality 16.6%). There have been no late deaths after the third month postoperatively. Mean follow-up for this operation is only 2 years, but 88% of the survivors lead a normal life, two thirds of them receiving no treatment. There has been one reoperation for stenosis of a Dacron conduit with a good result. Late arrhythmias are well tolerated. In conclusion, the Fontan procedure is a good operation, but palliative procedures still allow good long-term survival.

MeSH terms

  • Actuarial Analysis
  • Adolescent
  • Adult
  • Arrhythmias, Cardiac / etiology
  • Ascites / etiology
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Cardiac Surgical Procedures / mortality
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Ventricular / etiology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pulmonary Circulation
  • Tricuspid Valve / abnormalities*
  • Tricuspid Valve / surgery