Tricuspid atresia with special emphasis on cases with increased pulmonary blood flow

Summary

Though an average case of tricuspid atresia offers no diagnostic challenge, the clinical picture of the relatively less common form of tricuspid atresia with increased pulmonary blood flow is not properly defined. The problem of suitable surgery for this type of lesion has not been given serious consideration. On the basis of clinical, radiological and electrocardiographic findings in twenty-six proven cases of tricuspid atresia (six of whom had increased pulmonary blood flow) we feel that a child with mild cyanosis, biatrial hypertrophy, left ventricular hypertrophy and/or absent normal right ventricular potentials in the precordial leads and the clinical picture of a large left to right shunt is likely to have tricuspid atresia with increased pulmonary blood flow. The presence of counter clock wise loop and electrical axis around +90° in the frontal plane is of further help. In the present state of our knowledge pulmonary artery banding seems to be a useful palliative procedure for these children.