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Radiology
Tricuspid Atresia
Built from Obstetric Imaging
What’s inside
9 sections · 52 slides
Overview
- What this covers
What the defect is
A door that never formed, and the detour blood has to take
- Start with the normal right heart
- Tricuspid atresia, defined
- The second hole in the heart
- Right atrium walled off from the right ventricle
- Blood flow paths in tricuspid atresia
- How blood still reaches the lungs
- 1 in 25,000
- Rare, but rarely alone
The two doors that decide the outcome
Foramen ovale and ventricular septal defect - size is everything
- Two holes carry all the traffic
- What each door size means
- When the foramen ovale is too tight
- When the VSD is generous, and when it is not
- A hole in the wall between the ventricles
The newborn at the bedside
What the anatomy predicts about the first hours of life
- What sets the baby's oxygen level
- No VSD versus a large VSD
- When transposition is also present
Finding it on ultrasound
One view makes the diagnosis; colour Doppler proves it
- The view that makes the diagnosis
- What follows from a valve that never opens
- Still, bright tricuspid valve with a small right ventricle
- Close-up of the sealed valve and the septal defect
- Three things colour Doppler adds
- Flow through the defect, none through the valve
- The five-chamber view: how the arteries leave
- The three-vessel and trachea view
- Working through the views in order
- The classic signs, view by view
What else it could be
Three defects that can look the same on the four-chamber view
- Pulmonary atresia with an intact septum
- The other two look-alikes
- One discriminator each
Looking after the pregnancy
What to check at diagnosis, and what to re-check every visit
- The first job after the diagnosis
- Why follow-up every 2 to 4 weeks
- The four things each scan re-measures
- A Doppler finding that looks alarming
- Reversed flow at atrial contraction in the ductus venosus
- Reading the ductus venosus trace
- Counselling and delivery planning
Surgery after birth
Three stages that work around the defect rather than repair it
- Why the surgery cannot be a repair
- The name for that plan
- The three stages
- Stage one: the newborn
- Stage two: the Glenn operation
- Stage three: closing the circuit
- 90%
- Why survival falls with time
Take home
What the referring physician needs, and the points to keep
- What the referring physician needs to know
- What the referring physician needs to know
- Key points
- References
- References (continued)
- Suggested reading
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition