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TRICUSPID ATRESIA

Tricuspid atresia is the third common cyanotic congenital heart disease in which the non oxygenate blood can not flow from right artrium to right ventricle due to non development or agenesia of tricuspid valve. Right ventricle is small and pulmonary artery sometimes has stenosis.

Majority of infants with die in the first year of life without surgery. ASD or PFO,VSD,PDA are necessary for the blood flowing from right atrium to left system and with out them the infants will not survive.

historical perspective

Tricuspid atresia was first discovered by friedrich ludwig kreysig in 1817, a german physician who found the obstruction between right atrium and right ventricle in tricuspid valve. The classic term of tricuspid atresia was used firstly by schuberg in 1861.

pathophysiology

Inferior vena cava and superior vena cava collect venous non oxygenate blood into right atrium. Through ASD blood reach to left atrium and finally flow into left ventricle and via aorta artery goes into the rest of body. This blood is the mixture of saturated and unsaturated oxygen. If there is VSD, this mixed blood in left ventricle come into right ventricle via VSD , then via pulmonary artery flows into pulmonary bed and becomes oxygenate ,then returns back into left atrium with pulmonary venous oxygenate blood . In presence of PDA, the mixed blood in aora flow from this passage into pulmonary artery and pulmonary bed.

In presence of pulmonary stenosis and normal positioning of great arteries cyanosis will increase by increasing the right to left shunt in level of VSD. There are two types of great arterie positioning . In discordance VA connection or DTGA, pulmonary artery arises from left ventricle and aorta arises from right ventricle. The blood flows via ASD into right atrium and right ventricle and pulmonary artery and pulmonary bed . Aorta comes from the right ventricle and

In LTGA, the blood goes through ASD to

Classification[edit | edit source]

• [Disease name] may be classified according to [classification method] into [number] subtypes/groups:

• [group1]
• [group2]
• [group3]

• Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Differentiating tricuspid atresia from other Diseases

• Tricuspid atresia must be differentiated from other diseases that cause lung olygemia and cyanosis , such as

• TS
• PS
• ASD

Epidemiology and Demographics[edit | edit source]

• The prevalence of tricuspid atresia is approximately 5 per 100,000 individuals worldwide.
• In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

• Patients of all age groups may develop [disease name].

• is more commonly observed among patients aged [age range] years old.
• tricuspid atresia is more commonly observed among infant less than one year old.

Gender

• [Disease name] affects male and female equally.

Race

• There is no racial predilection for tricuspid atresia

Risk Factors[edit | edit source]

• Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis[edit | edit source]

• The majority of patients with [disease name] remain asymptomatic for [duration/years].
• Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
• If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
• Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
• Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis[edit | edit source]

Diagnostic Criteria[edit | edit source]

• The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:

• [criterion 1]
• [criterion 2]
• [criterion 3]
• [criterion 4]

Symptoms[edit | edit source]

• [Disease name] is usually asymptomatic.
• Symptoms of [disease name] may include the following:

• [symptom 1]
• [symptom 2]
• [symptom 3]
• [symptom 4]
• [symptom 5]
• [symptom 6]

Physical Examination[edit | edit source]

• Patients with [disease name] usually appear [general appearance].
• Physical examination may be remarkable for:

• [finding 1]
• [finding 2]
• [finding 3]
• [finding 4]
• [finding 5]
• [finding 6]

Laboratory Findings[edit | edit source]

• There are no specific laboratory findings associated with [disease name].

• A [positive/negative] [test name] is diagnostic of [disease name].
• An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
• Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings[edit | edit source]

• There are no [imaging study] findings associated with [disease name].

• [Imaging study 1] is the imaging modality of choice for [disease name].
• On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
• [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies[edit | edit source]

• [Disease name] may also be diagnosed using [diagnostic study name].
• Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment[edit | edit source]

Medical Therapy[edit | edit source]

• There is no treatment for [disease name]; the mainstay of therapy is supportive care.

• The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
• [Medical therapy 1] acts by [mechanism of action 1].
• Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery[edit | edit source]

• Surgery is the mainstay of therapy for [disease name].
• [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
• [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention[edit | edit source]

• There are no primary preventive measures available for [disease name].

• Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

• Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].