Tricuspid Atresia Corrected with Valved Xenograft Conduits

Abstract

In eight patients from 1976 until 1980, tricuspid atresia (TA) was corrected with valved xenograft conduits between either the right atrium and the main pulmonary artery or between the right atrium and the rudimentary right ventricle. All patients suffered from transient right-heart failure postoperatively and eventually developed normalized cardiac function throughout the first two months after operation. At recatheterization one year postoperatively, the right atrial pressure had generally only increased slightly, the pulmonary artery pressure was normal in all patients and only minor pressure differences were present across the valved conduits. X-ray examination showed normalization of the heart size in the majority of the patients, and in those with conduits between the right atrium and the right ventricle a considerable enlargement of the right ventricular chamber together with normalization of right ventricular contractility had developed. Arterial oxygen saturation, haemoglobin and haematocrit values had normalized in all patients. One patient died postoperatively of intractable right ventricular failure, septicaemia and intravascular coagulation, and another was uneventfully re-operated on two years postoperatively because of conduit thrombosis Clinical results were gratifying. Two patients with valved conduits between the right atrium and the right ventricle showed a normal unrestricted level of activity without medication, while patients with valved conduits between the right atrium and the main pulmonary artery were digitalized with an almost normal level of activity. Early repair with valved conduits of patients with TA is advocated.