The Surgical Management of Tricuspid Atresia

Abstract

Since Fontan in 1971 described a physiological correction for tricuspid atresia few successful operations have been reported. Two patients corrected 20 and 10 months ago at the Brompton Hospital are presented. These patients exhibit many of the problems in the management of tricuspid atresia. The first aged 20 having previously undergone three palliative operations, and therefore, presented a number of operative problems. The second, aged 8, had had no previous surgical treatment and was found at operation to have a partial atrial ventricular canal. The operative procedures, and the post operative course are described, the criteria for selection of patients for the Fontan operation are discussed as are the possible long term hazards of homograft failure, atrial dysrhythmias and hepatic dysfunction. The successful outcome of these two patients suggest that palliative surgery in infancy should allow for this form of correction in later life.