Echocardiography in the Diagnosis and Management of Tricuspid Atresia

Abstract

This review focuses on the utility of echocardiographic studies in the diagnosis of tricuspid atresia (TA) and in its management. Tricuspid atresia is a cyanotic congenital heart defect (CHD) accounting for nearly 1.5% of all CHDs. It is generally classified according to the morphology of the atretic tricuspid valve and associated heart defects. Following the description of the anatomic features of TA, echocardiographic features characteristic for TA were illustrated. Subsequent to a review of palliative and corrective procedures to treat TA, echocardiographic evaluation at each stage of Fontan was detailed. The role of echocardiography in the assessment of cardiac defects responsible for interstage mortality was also addressed. It was concluded that echo-Doppler studies are useful in the diagnosis and management of TA.

Double-Inlet Left Ventricle

“…In another transducer angulation ( B ), the Doppler flow from the distal portion of the shunt (DS) into both the right (RPA) and left (LPA) pulmonary arteries is imaged. Reproduced from Reference [ 26 ].…”

“…Continuous wave Doppler reveals a significant gradient (81 mmHg) across the PAB ( C ). Reproduced from Reference [ 26 ].…”

“…Low Doppler flow velocities through the bidirectional Glenn shunt ( B ) indicate that the shunt is not obstructed. Reproduced from Reference [ 26 ].…”

Mitral Atresia with Normal Aortic Root

“…In a slightly different view ( B ), the flow from the distal shunt (DS) into right (RPA) and left (LPA) pulmonary arteries is shown. Reproduced from [ 38 ].…”

“… Selected echo–Doppler images demonstrating pulmonary artery band (PAB) which is narrow (2.9 mm) by two–dimensional imaging ( A ) and by color flow Doppler ( B ) and a substantial gradient (81 mmHg) by continuous wave Doppler interrogation ( C ). Reproduced from reference [ 38 ]. …”