Tricuspid Atresia: Corrective Operation without a Bioprosthetic Valve

Murray, Gordon F.; Herrington, Robert T.; Delany, David J.

doi:10.1016/s0003-4975(10)64109-4

Cited by 20 publications

(5 citation statements)

References 19 publications

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“…However, the cardiac index is often markedly decreased whereas the right atrial mean pressure is increased with an "a" wave of sometimes more than 30 mmHg (37,43,49,50) . An improvement in sys temic oxy gen saturation is not always evident (24 , 37,38) which made some auth ors believe that the superiority of the "corrective" operation is no t demo nstrated (31). Other publications, however, report better results (19), and particularly an average gain of systemic 0 , saturation of about 13 % (43 , 49) appears comparable with our results attained by enlargement of the VSD.…”

Section: Discussionsupporting

confidence: 75%

“…Clinically, a 30 mmHg decrease of systemic pressure and a 20 % decrease of cardiac index were measure d in a patient who developed nodal rhythm after corrective operation (24).Surgical enlargement of the VSD is an easy and short procedure allow ing for precise evaluatio n of the intracardiac lesion. Like others(22,38), we observed that angiography often underestimates the true dimensions of the right ventricle and of the pulmonary artery, which both are important determinants fo r an eventual "corrective"…”

supporting

confidence: 83%

“…Surgical enlargement of the VSD in tricuspid atresia has been performed in only a few cases without transposition of the great vessels (3, II , 14, 35 arterio-venous shunts ( 14,34,38) , absent left pulmonary artery flow if the VSD is small (40), occasionally leading to microt hrombotic vascular pulmonary disease (4), increase of pulmonary vascular resistance (20), and deterioration of gas exchange because of absent pulsatile flow (10 , 38, 55). (19,37,42,48) and dura mater valve (14 ).…”

Section: Discussionmentioning

confidence: 99%

“…(19,37,42,48) and dura mater valve (14 ). There is controversy about the need fo r a caval inflow valve : by avoiding back pressure (43 , 49, 55) it is thought to limit the loss of energy of the right atrium , but it was found more traumatic to the right atrium including the risk of weakening its primordial pump function (38).…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Tricuspid Atresia with Small Pulmonary Flow (Type Ib) by Surgical Enlargement of the Ventricular Septum Defect

Gersbach¹,

Friedli²,

Hahn³

1981

Thorac cardiovasc Surg

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We re cently treated 7 pa tients wit h tricuspid at resia type lb. and o ne patient wit h type IIl b by en largeme nt o f t he ven t ricular septu m defect (VS DI , co mbined w ith pulmonary valvotomy o r infundibular resectio n in 3 cases. Th e res ult was good o r excellent in t he 7 cases with type lb, white t he patie nt wit h type l Hb , suffering f rom associated cardiovascular malformati ons and operated upon in a very poor hemody nam ic state, d ied d uring operati on. Th e procedure is simple and represents no part icu lar risks if one avoids excessive enlarge me nt of the VSD and does not resect in the area of the cardiac co nd uction system. Review of the literature leads us to believe that thi s operation shou ld have a place amo ng t he different for ms of surg ical trea tme nt for tricusp id atresia .

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Section: Discussionsupporting

confidence: 75%

supporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Treatment of Tricuspid Atresia with Small Pulmonary Flow (Type Ib) by Surgical Enlargement of the Ventricular Septum Defect

Gersbach¹,

Friedli²,

Hahn³

1981

Thorac cardiovasc Surg

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“…The Fontan procedure and its modificat ions are applied in many pediatric cardiovascular centers to treat certain forms of complex congenital cyanotic cardiac defects such as tricuspid atresia, common ventricle, single vent ricle and univentricular heart (7,12,14,IS,18,19,20 ,21,22). In the past the prognosis for these patients has been poor in spite of all attem pts with palliative operations such as systemicopulmonary anastomoses and pulmonary artery banding in those patients with increased lung perfu sion (2, 4 , 5).…”

Section: Introductionmentioning

confidence: 99%

Fontan Procedure - Indication and Clinical Results*,**

Vivie¹,

Ruschewski²,

Köveker³

et al. 1981

Thorac cardiovasc Surg

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Twenty-six patients with tricuspid atresia (15), univentricular heart (7), and single ventricle (4) underwent 27 Fontan or modified Fontan procedures between 1975 and 1981. The age of the patients varied between 4 and 26 years. Twenty patients had had a total of 33 palliative operations prior to correction. The original Fontan procedure was performed in 10 patients from 1975 to 1977. According to the various anatomical findings modifications of the Fontan procedure, such as direct anastomosis or implantation of a valveless conduit, were introduced in 1977. Early mortality among all the patients was 22% (6 patients died). Three deaths occurred in the initial period 1975 to 1977. Among the last 20 patients (1978 to 1981) there were 3 early deaths. Three patients with single ventricle survived, one died due to pulmonary failure. There were 2 late deaths (sepsis, sudden cardiac death). Postoperative cardiac catheterization performed in 17 patients revealed excellent results in 13 patients; the remaining 4 displayed diminished arterial oxygen saturation, three of them had Glenn palliation prior to corrective surgery. Postoperative right atrial mean pressure varied from 10 to 23 mmHg. The left ventricular parameters were within the normal range.

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