Tricuspid valve (TV) atresia
- Sowmya Balasubramanian, MD, MSc
Sowmya Balasubramanian, MD, MSc
- Clinical Assistant Professor
- Lucile Packard Children’s Hospital and Stanford Medical School
- Theresa Tacy, MD
Theresa Tacy, MD
- Associate Professor of Pediatrics
- Stanford University Medical Center
Tricuspid valve (TV) atresia is a cyanotic congenital heart lesion that is characterized by congenital agenesis or absence of the tricuspid valve, resulting in no direct communication between the right atrium and ventricle . If untreated, TV atresia has a high mortality rate with a survival rate as low as 10 percent at one year of age, depending on the type of TV atresia and the presence of other cardiac lesions [2,3].
The constellation of anatomic variants, physiology, clinical presentation, diagnosis, and management of TV atresia will be reviewed here.
TV atresia is the third most common cyanotic heart lesion with an estimated prevalence of 0.5 to 1.2 per 10,000 live births [4-7]. There is no difference in the incidence based on gender.
Although TV atresia is characterized by the absence of the TV, there is a spectrum of anatomic variants based on the morphology of the atresia and the presence of other cardiac structural lesions.
Morphology of TV atresia — Morphologic variation of TV atresia includes the following [8,9]:
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- Morphology of TV atresia
- Associated cardiac lesions
- CLINICAL PRESENTATION
- Fetal presentation
- Postnatal presentation
- - Physical examination
- - Initial tests
- Pulse oximetry
- - Chest radiography
- - Electrocardiogram
- Natural course
- Fetal diagnosis
- Postnatal diagnosis
- - Echocardiography
- - Other imaging tests
- DIFFERENTIAL DIAGNOSIS
- Initial medical management
- Surgical management
- - First stage
- - Second stage
- - Interstage management
- - Third stage
- LONG-TERM MANAGEMENT
- SUMMARY AND RECOMMENDATIONS