Tricuspid atresia: Nursing

Definitions & Key takeaways

Tricuspid atresia is a congenital heart defect in which the tricuspid valve, located between the right atrium and right ventricle of the heart, is either missing or abnormally developed. This can impair the blood flow from the right atrium to the right ventricle. Luckily, additional defects that present with this disorder, such as an atrial septal defect (ASD) or patent foramen ovale, provide a substitute route for the blood that would otherwise be trapped on the right side. However, all of this leads to the mixing of poorly oxygenated and highly oxygenated blood.

Symptoms include cyanosis, shortness of breath, difficulty in breathing, poor feeding, and decreased energy. The condition is typically diagnosed through echocardiography, a non-invasive imaging test that uses sound waves to create images of the heart. Treatment for tricuspid atresia typically involves drugs like IV prostaglandin for newborns to keep the ductus arteriosus open until surgery can be performed.

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Tricuspid atresia0:00–3:12

Tricuspid atresia, also known as pulmonary atresia, is a term used to describe an under-developed or absent tricuspid valve.
Tricuspid atresia is a congenital condition who’s cause isn’t well understood, and is not as common as the other heart defects that obstruct or decrease pulmonary blood flow.
The tricuspid valve is located between the right atrium and right ventricle, allowing blood from the atrium to flow down into the ventricle.
Without it, blood can’t flow normally on this side. And, if there’s no alternate route to direct the blood flow, there would be virtually no blood in the right ventricle available to be pumped to the lungs for oxygenation.
This can also result in an underdeveloped, or hypoplastic, right ventricle. In order to maintain vital blood flow, an alternate route must be present.
Luckily, additional defects that present with this disorder; an ASD, patent foramen ovale, or PFO, and a VSD; provide a substitute route for the blood that would otherwise be trapped on the right side.So, blood from the right atrium flows through the ASD or PFO to the left atrium, eventually making its way down to the left ventricle then out through the aorta; and blood from the left ventricle flows through the VSD into the right ventricle, eventually making its way through the pulmonary artery then to the lungs.
However, it’s important to note that all of this leads to mixing of poorly oxygenated and highly oxygenated blood. Cyanosis, tachycardia, heart murmur and dyspnea are the most common early manifestations of tricuspid atresia, often noted at birth; while older children can exhibit signs of chronic hypoxemia, like clubbing of fingers and toes, as a result of long-term desaturated blood circulating in the body.
Though tricuspid atresia can be discovered during a prenatal ultrasound, diagnosis can be made through physical exam and diagnostic tests, like ECGs, echocardiogram, chest x-ray, cardiac catheterization, MRI of the heart and CT of the heart.
Once tricuspid atresia is confirmed, treatment is started. This generally consists of first initiating prostaglandin E1 to the newborn to keep the ductus arteriosus open until surgery can be performed.
This can be an added benefit, as it allows for blood to flow to the lungs, despite the obstructive nature of tricuspid atresia.
In other cases, medications like digoxin and diuretics will be prescribed. Most clients with tricuspid atresia will require surgical interventions done in stages, often starting within the first few days of life, continuing up until about the age of 3.
These procedures include placement of a temporary artificial shunt to maintain blood flow to the lungs and rerouting blood flow from the superior and inferior vena cava.
Once the final procedure is complete, the client will no longer exhibit cyanosis. In most cases, surgical repair improves the condition and the prognosis is very good.
However, complications that can develop include arrhythmias, heart failure, chronic diarrhea and even blockage of the temporary artificial shunt.
OK, so a quick recap, tricuspid atresia, also known as pulmonary atresia, is a term used to describe an under-developed or absent tricuspid valve and Without a tricuspid valve, the blood in the right atrium cannot make its way down to the right ventricle.

Summary3:12–4:31

Luckily, there are alternative routes that allow otherwise trapped blood on the right side to travel. However, all of this leads to mixing of poorly oxygenated and highly oxygenated blood.
Cyanosis, tachycardia, heart murmur and dyspnea are the most common early manifestations of tricuspid atresia, while older children can exhibit signs of chronic hypoxemia, like clubbing of fingers and toes.Tricuspid atresia can be discovered during a prenatal ultrasound, physical exam and diagnostic exams.
Once it is confirmed, treatment is started. This generally consists of first initiating IV prostaglandin to the newborn to keep the ductus arteriosus open until surgery can be performed.
In other cases, medications like digoxin and diuretics will be prescribed. Most clients with tricuspid atresia will require surgical interventions done in stages, often starting within the first few days of life.
In most cases, surgical repair improves the condition and