Tricuspid atresia is a type of heart disease that is present at birth (congenital heart disease), in which the tricuspid heart valve is missing or abnormally developed. The defect blocks blood flow from the right atrium to the right ventricle. Other heart or vessel defects are usually present at the same time.
Tri atresia; Valve disorder - tricuspid atresia; Congenital heart - tricuspid atresia; Cyanotic heart disease - tricuspid atresia
Tricuspid atresia is an uncommon form of congenital heart disease. It affects about 5 in every 100,000 live births. One in five people with this condition will also have other heart problems.
Normally, blood flows from the body into the right atrium, then through the tricuspid valve to the right ventricle and on to the lungs. If the tricuspid valve does not open, the blood cannot flow from the right atrium to the right ventricle. Because of the problem with the tricuspid valve, blood ultimately cannot enter the lungs. This is where it must go to pick up oxygen (becomes oxygenated).
Instead, the blood passes through a hole between the right and left atrium. In the left atrium, it mixes with oxygen-rich blood returning from the lungs. This mix of oxygen-rich and oxygen-poor blood is then pumped out into the body from the left ventricle. This causes the oxygen level in the blood to be lower than normal.
In people with tricuspid atresia, the lungs receive blood either through a hole between the right and left ventricles (described above), or through maintenance of a fetal vessel called the ductus arteriosus. The ductus arteriosus connects the pulmonary artery (artery to the lungs) to the aorta (main artery to the body). It is present when a baby is born, but normally closes by itself shortly after birth.
Once the diagnosis is made, the baby will often be admitted to the neonatal intensive care unit (NICU). A medicine called prostaglandin E1 may be used to keep the ductus arteriosis open (patent) so that blood can circulate to the lungs.
Generally, patients with this condition require surgery. If the heart is unable to pump enough blood out to the lungs and rest of the body, the first surgery most often takes place within the first few days of life. In this procedure, an artificial shunt is inserted to keep blood flowing to the lungs. In some cases, this first surgery is not needed.
Afterward, the baby goes home in most cases. The child will need to take one or more daily medicines and be closely followed by a pediatric cardiologist. This doctor will decide when the second stage of surgery should be done.
The next stage of surgery is called the Glenn shunt or hemi-Fontan procedure. This procedure connects half of the veins carrying oxygen-poor blood from the upper half of the body directly to the pulmonary artery. The surgery is most often done when the child is between 4 to 6 months old.
During stage I and II, the child may still look blue (cyanotic).
Stage III, the final step, is called the Fontan procedure. The rest of the veins carrying oxygen-poor blood from the body are connected directly to the pulmonary artery leading to the lungs. The left ventricle now only has to pump to the body, not the lungs. This surgery is usually performed when the child is 18 months to 3 years old. After this final step, the baby's skin is no longer blue.
Sachin Talwar practices in New Delhi, India. Talwar is rated as an Elite expert by MediFind in the treatment of Tricuspid Atresia. He is also highly rated in 41 other conditions, according to our data. His top areas of expertise are Transposition of the Great Arteries, Ventricular Septal Defects, Total Anomalous Pulmonary Venous Return, and Tetralogy of Fallot.
Harold Burkhart is a Thoracic Surgeon in Oklahoma City, Oklahoma. Burkhart has been practicing medicine for over 30 years and is rated as a Distinguished expert by MediFind in the treatment of Tricuspid Atresia. He is also highly rated in 31 other conditions, according to our data. His top areas of expertise are Hypoplastic Left Heart Syndrome, Congenital Heart Disease CHD, Atrioventricular Septal Defect, and Pulmonary Atresia. He is licensed to treat patients in Iowa, Oklahoma, Minnesota, and Wisconsin. Burkhart is currently accepting new patients.
Benjamin Frischhertz is a Cardiologist and a Pediatrics expert in Nashville, Tennessee. Frischhertz has been practicing medicine for over 16 years and is rated as a Distinguished expert by MediFind in the treatment of Tricuspid Atresia. He is also highly rated in 11 other conditions, according to our data. His top areas of expertise are Tricuspid Atresia, Atrioventricular Septal Defect, Endocardial Cushion Defect, and Partial Atrioventricular Canal. He is licensed to treat patients in Tennessee. Frischhertz is currently accepting new patients.
In most cases, surgery will improve the condition.
Complications may include:
Contact your health care provider right away if your infant has:
There is no known way to prevent tricuspid atresia.
Published Date: October 10, 2021
Published By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Well A, Fraser CD. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 59.