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Tricuspid
atresia (Diagnosis (History (PMH
Growth and development
…
Tricuspid
atresia
Diagnosis
Examination
Cardio
Cyanosis, tachypnoea, tachycardia
Diagnosis
Bloods
Cap blood gas
FBC, U+E, LFT
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Bedside
Obs (sats, RR, HR, BP, temp)
ECG (nil)
History
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POH
Antenatal: scans, bloods, growth
Perinatal: gestation, delivery, weight
Postnatal: complications, growth
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SH
Living arrangements, school/nursery
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Pathophysiology
Defect
Absent tricuspid valve, no connection between RA and RV RV is thus small and non-functional
Mechanism
Mixing of systemic and pulmonary return in LA
May have a duct-dependent circulation
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Management
Conservative
Info, advice, support
Surgical
Pulmonary artery banding
Indication: early palliation if breathless
MOA: reduces pulmonary blood flow,
reducing pulmonary oedema
Palliation surgery
Indication: step 1 >6m, step 2 at 3-5y
MOA: SVC connection to pulmonary artery (step 1), then
IVC connection to pulmonary artery (step 2); LV drives
blood around body and systemic venous pressure drives
blood around the lings
Shunt
Indication: early palliation if cyanotic neonate
MOA: subclavian-pulmonary artery shunt,
diverts some blood flow into pulmonary circulation
using pressure from LV
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