Surgical palliation of tricuspid atresia

In the 20-year period ending December 31, 1973 we operated on 105 patients for palliation of tricuspid atresia (TA) with reduced pulmonary blood flow. Pott's anastomosis (85), Blalock-Taussig anastomosis (19), intrapericardial aorta (Ao)-to-right pulmonary artery (RPA) (18), Glenn procedure (3)...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1975-10, Vol.52 (4), p.685-690
Main Authors: Kyger, 3rd, E R, Reul, Jr, G J, Sandiford, F M, Wukasch, D C, Hallman, G L, Cooley, D A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aorta - surgery
Child
Child, Preschool
Female
Heart Atria - surgery
Heart Defects, Congenital - mortality
Heart Defects, Congenital - surgery
Heart Septum - surgery
Humans
Infant
Infant, Newborn
Male
Methods
Pulmonary Artery - surgery
Pulmonary Circulation
Subclavian Artery - surgery
Transposition of Great Vessels - surgery
Tricuspid Valve - abnormalities
Tricuspid Valve - surgery
Vena Cava, Superior - surgery
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Summary:In the 20-year period ending December 31, 1973 we operated on 105 patients for palliation of tricuspid atresia (TA) with reduced pulmonary blood flow. Pott's anastomosis (85), Blalock-Taussig anastomosis (19), intrapericardial aorta (Ao)-to-right pulmonary artery (RPA) (18), Glenn procedure (3) and miscellaneous shunts (2) have been used. Of patients undergoing operation more than 15 years ago, 45% (9/20) are still alive. The over-all operative mortality was 9%. It was highest in patients less than one month of age (7/23, 30%). There were no operative deaths in patients older than 12 months. The median age at first operation for the entire series was five months. Our results indicate the Pott's anastomosis and Ao-to-RPA anastomosis are superior to the Blalock-Taussig anastomosis (BT) for palliation of TA. Of patients surviving BT, 69% (11/16) required reoperation, compared to 22% (17/78) surviving Pott's anastomosis and 13% (2/16) surviving Ao-to-RPA shunts. All three patients undergoing Glenn procedures (superior vena cava-to-RPA anastomosis) required reoperation or died without significant benefit. Ballon atrial septosomy and Pott's anastomosis appear to be indicated for infants less than six months of age, and Ao-to-RPA shunt with simultaneous atrial septectomy (if indicated) for older children.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.52.4.685