Yale School of Medicine Congentital Heart Disease Contents Entities Cases References Echo Atlas Prev Next

Tricuspid Atresia with multiple surgeries in a 43 year old man

  Case radiograph


Echo studies

Echo LPLA Echo SA

Echo 4C Echo A2C

Patient Presentation

This 43-year old man, born with tricuspid atresia, was palliated in childhood with a Waterston -Cooley shunt (later taken down), a Glenn, a Blalock-Taussig, then a graft from descending aorta to left PA (B-T no longer functional). Hemoptysis required coil embolization of right lung AVMs.

At age 31 the aorta-PA graft was coil embolized in preparation for the Fontan: the PDA was ligated, the VSD closed, the ASD closed, a 6 mm fenestration was created, the RA appendage was connected by graft to the left PA, an opening between the RA and the SVC was slightly enlarged to allow some atrial return to the right lung. Due to cyanosis the ASD was closed with a clamshell occluder 2 months later (see transesophageal echo above).

Atrial arrhythmias began at age 25 and were medically treated. Atrial fibrillation recurred 6 years after the Fontan. Sinus rhythm was restored with amiodarone, digoxin, warfarin. An epicardial VVIR pacemaker was placed. VO2 was 14.5 ml/kg/min at baseline.

Clinical course...

Keys to clinical management...

SHORTCUTS: See the Contents page for complete listing of all pages and topics.


  YSMInfo Library Calendar Directories Search YSM Home

Copyright 2001, Yale University School of Medicine. All rights reserved.
February 12, 2000 (PL)