Tricuspid atresia

Description

Tricuspid atresia is a heart condition present at birth, known as a congenital heart defect. The valve does not form between the two chambers of the heart. In its place, a solid sheet of tissue that blocks the flow of blood between the right chambers of the heart. The condition restricts the flow of blood through the heart. Tricuspid atresia causes of the lower right part of the heart to be underdeveloped.

People with tricuspid atresia may not get enough oxygen through the body. So you tire easily, andcome back often for lack of air. Your skin and lips look blue or gray.

Tricuspid atresia is treated with multiple surgeries. The majority of infants with tricuspid atresia who have surgery live into adulthood, although the follow-up surgeries are often necessary.

Another names of tricuspid atresia are:

  • Atresia of the tricuspid valve
  • TV atresia

Symptoms

Tricuspid atresia symptoms are usually seen shortly after birth. Symptoms of tricuspid atresia may include:

  • The blue or the grey of the skin and lips from low oxygen levels in the blood
  • Difficulty breathing
  • Tire easily, especially during meals
  • The slow growth and poor weight gain

Some people with tricuspid atresia also develop symptoms of heart failure. The symptoms of heart failure include:

  • Fatigue and weakness
  • Shortness of breath
  • Swelling in the legs, ankles and feet
  • The swelling of the area of the abdomen, a condition called ascites
  • Sudden weight gain from fluid buildup

When to see a doctor

Serious congenital heart defects are diagnosed before or shortly after the birth of your child. If you notice that your baby has changes in the color of the skin, difficulty breathing, slow growth or poor weight gain, contact your health care provider.

Causes

The majority of congenital heart defects, such as tricuspid atresia, the result of the changes that occur early as the baby's heart is developing before birth. The exact cause is usually unknown.

How the heart works

To understand more about tricuspid atresia, may be useful to know how the heart works normally.

The heart is divided into four chambers, two on the right and two to the left.

  • The right upper chamber called the right atrium.
  • The right lower chamber is called the right ventricle.
  • The top left of the camera is called the left atrium.
  • The left lower chamber called the left ventricle. The left ventricle is the heart's main pumping chamber.

To pump blood throughout the body, the heart uses its left and right sides for different tasks.

  • The right side of the heart moves the blood to the lungs through the pulmonary arteries. These are the pulmonary arteries.
  • In the lungs, the blood picks up oxygen and then returns to the heart from the left side through the pulmonary veins.
  • The left side of the heart pumps blood through the body's main artery, called the aorta. Then, the blood flows to the rest of the body.

The valves control the blood flow into and out of the heart. Theart valves open to allow blood to move to the next chamber or to one of the arteries. The heart valves close to prevent blood from flowing backwards.

What happens in tricuspid atresia

In tricuspid atresia, tricuspid valve is missing. A sheet of tissue blockks the flow of blood between the right chambers of the heart. There is no way for the blood is moved from the top right of the camera to the bottom right side of the camera. The right side of the heart is not able to pump blood to the lungs.

Instead, the blood flows from the heart in the top right of the camera to the top left of the camera through a hole in the wall between them. The hole is a congenital heart defect called an atrial septal defect or a natural opening called the foramen ovale. When the foramen ovale doesn't close after birth, it is called a patent foramen ovale.

How blood flows after that depends on whether there is other, the structure of the heart of the problems. In some babies with tricuspid atresia, the blood moves from the lower left chamber of the heart to the body's main artery, the aorta. Then it goes to the lungs through a temporary connection called the ductus arteriosus. This connection normally closes after birth.

Many babies born with tricuspid atresia also have a hole between the lower chambers of the heart. This hole is called the ventricular septal defect (VSD). If this happens, blood can flow through the hole directly to the main pulmonary artery. The amount of blood going to the lungs depends on the size of the ventricular septal defect, and if the pulmonary valve is reduced. If the VSD is large, also the amount of blood may pass into the lungs. This can cause heart failure.

Risk factors

It is not entirely clear why congenital heart defects, such as tricuspid atresia occur. But some risk factors have been identified. Many babies are born with a genetic disorder called Down syndrome have tricuspid atresia.

Other things that can increase the baby's risk of tricuspid atresia include:

  • Having German measles (rubella), or another viral illness during early pregnancy
  • Family history of congenital heart disease
  • Drinking alcohol during pregnancy
  • Smoking before or during pregnancy
  • Poor control of diabetes during pregnancy
  • Use of certain medications during pregnancy, including some of those used to treat acne, bipolar disorder, and seizures

Complications

Tricuspid atresia restricts the blood flow from the heart to the lungs. The right lower chamber of the heart is small and poorly developed. A potentially fatal complication of tricuspid atresia is a lack of oxygen to the tissues of the body. This condition is called hypoxemia.

Timely treatment a lot of improvisationis the result of babies with tricuspid atresia. But complications may develop later in life. The complications of tricuspid atresia may include:

  • Easy to get tired during the activity
  • The irregular rhythms of the heart
  • Kidney or liver disease
  • Heart failure

Prevention

Because the exact cause of most congenital heart defects is unknown, it may not be possible to avoid the tricuspid atresia.

If you have a family history of congenital heart defects or who are at high risk of giving birth to a child with one, genetic analysis can be recommendednded before or during pregnancy. Consider talking with a genetic counselor and a cardiologist doctor about your specific risks.

Some ways you can help prevent your baby's overall risk of congenital heart defects are:

  • Obtaining proper prenatal care. Regular checkups with a health care provider during pregnancy can help to keep you and your baby healthy.
  • Take a multivitamin with folic acid. Take 400 micrograms of folic acid daily has been shown to reduce the problems with the brain and the spinal cord at birth. You can help reduce the risk of congenital heart defects as well.
  • Get a rubella (German measles) vaccine. An infection of rubella during pregnancy can affect the baby's heart development. Get vaccinated before you try to get pregnant.
  • Check with your provider before tak- ing any of the drugs. Some drugs taken during pregnancy can cause health problems in the baby. Tell your doctor about all the medicines you are taking, including those bought without a prescription.
  • Do not smoke tobacco or drink alcohol during pregnancy. Anyone can increase the risk of congenital heart defects.
  • Avoid exposure to chemicals, wherever possible. While you are pregnant, it is best to stay away from the chemicals, including cleaning products, and paint, as much as you can.
  • Manage other health conditions. If you have other health problems, talk with your health care provider about the best way to treat and manage them.

Tricuspid atresia

Diagnosis

Tricuspid atresia can be diagnosed during a routine pregnancy ultrasound before the baby is born. It is important to get proper prenatal care during the pregnancy.

After birth, a health-care provider immediately looks at the baby and hear the baby's heart and lungs. The doctor may suspect a heart problem, such as tricuspid atresia if a baby has a blue or gray skin, shortness of breath, or an irregular heartbeat sound called a heart murmur. The changes in the flow of blood to and from the heart may cause a heart murmur.

Tests

The tests for the diagnosis of tricuspid atresia may include:

  • The echocardiogram. Sound waves create movement im- ages of the flow of blood through the heart and heart valves. In infants with tricuspid atresia, the echocardiogram shows a lack of the tricuspid valve and irregular blood flow. The exam may reveal other problems of the heart also.
  • The electrocardiogram. Also called an ECG or EKG, this quick and painless test records the electrical activity of the heart. You can show the rapidity or slowness with which the heart is beating. An ECG can detect irregular heart rhythms.
  • Pulse oximetry. A small sensor is attached to a hand or a foot that measures the amount of oxygen in the blood. Pulse oximetry is a simple and painless.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. It can help determine the size of the heart and its chambers. A chest x-ray may show an accumulation of fluid in the lungs.
  • Cardiac catheterization. A thin, flexible tube called a catheter is inserted into a blood vessel, usually in the area of the groin, and is guided up to the heart. Contrast dye flows through the catheter into the chambers of the heart. The dye helps the cameras to be seen in x-ray images. The catheter can also be used to measure pressures in the heart chambers. Cardiac catheterization is rarely used for the diagnosis of tricuspid atresia, but can be performed to examine the heart, before the tricuspid atresia surgery.

Treatment

There is No way to replace a tricuspid of the valve in tricuspid atresia. If your child has tricuspid atresia, multiple surgeries are often done to improve the flow of blood through the heart and into the lungs. Medications are used to control the symptoms.

If your baby has tricuspid atresia, consider the possibility of getting care in a medical center with surgeons and other health care providers who have experience with complex congenital heart disease.

Drugs

Medications for tricuspid atresia may take into account:

  • Strengthen the heart muscle
  • Lower blood pressure
  • Remove the excess fluids from the body

Supplemental oxygen can be given to help the baby to breathe better.

Before heart surgery, an infant with tricuspid atresia can give the hormone prostaglandin to help you expand and maintain open the ductus arteriosus.

Surgeries or other procedures

Babies with tricuspid atresia often needs several heart surgeries or procedures. Some of them are temporary and fixed quickly to improve the flow of blood before a more permanent procedure can be done.

Surgeries or procedures for tricuspid atresia include open-heart surgery and minimally invasive heart surgery. The type of heart surgery depends on the congenital defect of the heart.

  • The derivation.This procedure creates a new path (shunt) to the flow of blood. In tricuspid atresia, the derivation of the redirects blood of a main blood vessel that leaves the heart to the lungs. Shunting increases the amount of blood flow to the lungs. Helps improve oxygen levels. Surgeons usually place a shunt during the first two weeks of life. However, babies usually outgrow the shunt. You may need another surgery to replace it.
  • Glenn procedure.In the Glenn procedure, the surgeon removes the first referral. Then, one of the large veins that normally returns the blood to the heart is directly connected to the pulmonary artery in place. The Glenn procedure, reduces the strain on the heart in the bottom left of the camera, reducing the risk of damage. The procedure may be done when the pressure in the baby's lung have gone down, what happens as the baby grows. The Glenn procedure, provides that the staffof ge for a more permanent corrective surgery called the Fontan procedure.
  • The Fontan procedure.This type of heart surgery is usually done when a child is 2 to 5 years of age. It creates a pathway for the majority, if not all, of the blood that would have gone to the right side of the heart can instead flow directly into the pulmonary artery. The short-and medium-term prospects for the babies who have a Fontan procedure is generally promising. But regular checkups are necessary to monitor for complications, including heart failure.
  • Of the pulmonary artery band placement. This procedure can be done if a child with tricuspid atresia has a ventricular septal defect. The surgeon places a band around the main pulmonary artery to reduce the amount of the movement of blood from the heart to the lungs.
  • Atrial septostomy. Rarely, a balloon is used to create or enlarge the opening between the upper chambers of the heart. This allows more blood to flow from the right upper chamber to the top left of the camera.

The derivation. This procedure creates a new path (shunt) for blood flow. In tricuspid atresia, the derivation of the redirection of blood from a main blood vessel that leaves the heart to the lungs. Shunting increases the amount of blood flow to the lungs. Helps improve oxygen levels.

Surgeons usually place a shunt during the first two weeks of life. However, babies usually outgrow the shunt. You may need another surgery to replace it.

Glenn procedure. In the Glenn procedure, the surgeon removes the first referral. Then, one of the large veins that normally returns the blood to the heart is connected directly to the pulmonary artery in place. The Glenn procedure, reduces the strain on the heart in the bottom left of the camera, reducing the risk of damage. The procedure may be done when the pressure in the baby's lung have come down, it happens as the baby grows.

The Glenn procedure sets the stage for a more permanent corrective surgery called the Fontan procedure.

The Fontan procedure. This type of heart surgery is usually done when a child is 2 to 5 years of age. It creates a pathway for the majority, if not all, of the blood that would have gone to the right side of the heart can instead flow directly into the pulmonary artery.

The short-and medium-term prospects for the babies who have a Fontan procedure is generally promising. But regular checkups are required for the follow-up of complications, such as heart failure.

After treatment, infants with tricuspid atresia need of regular health screenings, ideally with children of a medical doctor trained in congenital heart disease. This care provider is called pediatric congenital cardiologist. Many children with congenital heart defects, such as tricuspid atresia, grow, and lead a full life.

Adults treated for tricuspid atresia also the permanent necessity of checks, preferably with a doctor trained in adult congenital heart conditions. This care provider is called an adult congenital cardiologist.

Self-care

If your child has tricuspid atresia, lifestyle changes may be recommended to keep the heart healthy and prevent complications.

Try these tips to help a baby or a child with trichuspid atresia:

  • Adjustment of the power supply.Babies with tricuspid atresia may not be getting enough calories, because of fatigue during feeding, and other factors. Try giving the baby small, frequent feeding. Breast milk is an excellent source of nutrition. But a specithe high-calorie formula may be needed if your baby is not getting enough nutrition because of fatigue during feeding. Some babies may need to be fed through a feeding tube.
  • Ask about the preventive antibiotics.Sometimes, a congenital defect of the heart can increase the risk of infection in the lining of the heart or of the heart valves. This condition is called infective endocarditis. Antibiotics may be recommended before dental and other procedures to prevent this infection. Ask your child's heart doctor if preventive anti -biotic are necessary for your child. The practice of good oral hygiene — brushing and flossing, getting regular dental check-ups — it is also important for general good health.
  • Stay active. Physical activity is important for the health of the heart. To promote the play people and activity that you or your child can tolerate, or as recommended by your doctor. Allow plenty of time for rest.
  • Talk about sports restrictions. Some children and adults with congenital heart defects may need to limit certain types of exercise or sports activities. A care provider can tell you if there are sports or activities that you or your child should limit or avoid.
  • Get the recommended vaccines. Standard vaccines are recommended for children with congenital heart defects. So are vaccines for the flu, COVID-19, pneumonia, and respiratory syncytial virus infections.
  • Keep follow-up appointments with the provider of care. Your child will need at least yearly appointments with a pediatric congenital cardiologist.

Adjustment of the power supply. Babies with tricuspid atresia may not be getting enough calories, because of fatigue during feeding, and other factors. Try giving the baby small, frequent feeding.

Breast milk is an excellent source of nutrition. But a high-calorie formula may be necessary if your baby is not getting enough nutrition because of fatigue during feeding. Some babies may need to be fed through a feeding tube.

Ask about the preventive antibiotics. Sometimes, a congenital defect of the heart can increase the risk of infection in the lining of the heart or of the heart valves. This condition is called infective endocarditis. Antibiotics may be recommended before dental and other procedures to prevent this infection. Ask your child's heart doctor if the use of preventive antibiotics are necessary for your child.

The practice of good oral hygiene — brushing and flossing, getting regular dental check-ups — it is also important for general good health.

Pregnancy and tricuspid atresia

If you have tricuspid atresia and are pregnant or are hoping for, consider the possibility of talking to an adult congenital heart disease specialist and maternal-fetal medicine specialist. During pregnancy, it is important to receive care from a provider who specializes in the number of pregnancies in those with congenital heart disease.

Pregnancy is considered high risk for those who have had a Fontan procedure. If you have a history of heart failure, may be discouraged from becoming pregnant.

Coping and support

Try these tips to help you support your child with tricuspid atresia:

  • Stick to a regular routine. Maintaining a regular daily routine can help you and your child. Even if your baby is in the hospital, try to spend as much time together as you can. Include other children you have, if it is possible. Family bonding is important for a baby's social and emotional development.
  • Registration of your child's health history. Write your baby's diagnosis, medications, surgery, and other procedures and their dates, the name and phone number of your child's health care providers, and other important information about your baby's attention. Keep copies of the reports of surgery.
  • Communicate with care providers. You may have many questions as your child grows and develops. Discuss your concerns with your child's health care providers.
  • Join a support group. You may find that speak wit ... h people who have experienced the same situation brings comfort and encouragement. Ask your health care provider if there are support groups in your area.
  • Manage stress and anxiety. Living with a congenital heart defect can cause some children feel stressed or anxious. Talking with a therapist or a counselor can help you and your child to learn new ways to manage stress and anxiety. Your health care provider may suggest therapists that may be useful to you or your child.

Preparing for your appointment

If your child has a life-threatening congenital heart defect, is likely to be diagnosed soon after birth. Sometimes it is diagnosed before birth during an ultrasound of the pregnancy.

If you believe that your child has a congenital heart defect that was not recognized at birth, talk to your child's health care provider. Be prepared to describe the symptoms of your child and provide a medical history of the family. Some congenital heart defects may be passed down through the families. These are known as hereditary diseases.

If you or your child hass tricuspid atresia, you will likely be referred to a medical center that specializes in pediatrics congenital heart defect or congenital heart disease adult.

What you can do

Before the appointment, make a list of important information and bring it with you to the appointment. Include information about:

  • The symptoms that you have noticed in yourself or your child, including any that may seem unrelated to a congenital defect of the heart
  • Important personal information, including family history of congenital heart disease, life-style choices during pregnancy, such as smoking or drinking alcohol, or disease during pregnancy
  • Questions for the health care provider
  • All medicines, including those bought without a prescription. To include in the dose.

A family member or friend to the appointment, if possible. Someone who goes with you can help you remember the information from your medical professional.

Prepare a list of questions can help you and your health care provider that the majority of their time together. Tricuspid atresia, mflight they want to ask questions such as:

  • What tests are needed?
  • What treatments are available, and which do you recommend?
  • Will this require more than one surgery?
  • How can I do it myself, or my child is more comfortable?
  • Are there any restrictions to follow?
  • If I get pregnant again, there is a way to prevent tricuspid atresia happen?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask many questions. Be prepared to answer them you can save your time to go through any thing that you want to spend more time. Your provider may ask:

  • Can you describe the symptoms?
  • When do these symptoms occur?
  • The symptoms come and go, orr are always present?
  • The symptoms seem to get worse?
  • Is there something that the symptoms better?
  • Do you have a family history of congenital heart defects?
  • Your child has been growing and the developmental milestones as expected? Ask your child's provider if Ior you are not sure.
Symptoms and treatment of Tricuspid atresia