Tricuspid atresia medical therapy

Tricuspid atresia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Keri Shafer, M.D. [2] Priyamvada Singh, MBBS [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

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Medical Therapy

• The mainstay of therapy for the cyanotic neonate with severepulmonary stenosis and small sized VSD is usingprostaglandin E1 (PGE1) for keeping patency of ductus arteriosis.
• The mainstay of therapy for heart failure symptoms is using diuretic for reduction of congestion and then starting ACEI.

Surgery Surgery is the mainstay of therapy for tricuspid atresia.

       In the first 8 weeks of life if there is severe cyanosis and pulmonary obstruction and normal positioning aorta and pulmonary artery, making a shunt between systemic subclavian artery to thepulmonary artery is necessary which is called Blalock -Taussig(BT shunt).
       If the pulmonary artery comes from the left ventricle and is overflowed, pulmonary artery banding is useful for lowering the pulmonary blood flow.
       In older children, bi-direction Glenn shunt which is the connection between superior vena cava to thepulmonary artery will be done for transferring the blood to the pulmonary system.

Fontan procedure is a conduit between the inferior vena cava and the pulmonary artery and transfers the systemic venous blood to pulmonary circulation in the age of 2-3 years old. Endocarditis prophylaxis before every procedure is recommended.