Surgical repair of tricuspid atresia

TLDR

The authors describe a novel surgical technique that redirects all vena caval blood to the lungs via a cava‑pulmonary anastomosis, with oxygenated blood returning to the left heart, a method suitable only for children with adequately sized, low‑pressure pulmonary arteries and otherwise requiring palliative surgery. Three tricuspid‑atresia repairs were performed, with two successful outcomes.

Abstract

Surgical repair of tricuspid atresia has been carried out in three patients; two of these operations have been successful. A new surgical procedure has been used which transmits the whole vena caval blood to the lungs, while only oxygenated blood returns to the left heart. The right atrium is, in this way, `ventriclized9, to direct the inferior vena caval blood to the left lung, the right pulmonary artery receiving the superior vena caval blood through a cava-pulmonary anastomosis. This technique depends on the size of the pulmonary arteries, which must be large enough and at sufficiently low pressure to allow a cava-pulmonary anastomosis. The indications for this procedure apply only to children sufficiently well developed. Younger children or those whose pulmonary arteries are too small should be treated by palliative surgical procedures.