The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 452-458, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Right atrial-right ventricular anastomosis for correction of tricuspid atresia
VO Bjork, CL Olin, BB Bjarke and CA Thoren
Previously reported methods for the correction of tricuspid atresia involve
the use of conduits and/or valves. Since many of the younger patients will
outgrow their conduits and the long-term durability of the valve prostheses
is open to question, we have devised an operation in which the right atrial
(RA) appendage is anastomosed to the right ventricle (RV) with the aid of a
pericardial patch. The RV, if not too hypoplastic, is used as a pumping
chamber and the pulmonary valve is in its normal position. Three patients,
8, 9, and 12 years of age, were operated on with good clinical and
hemodynamic results. Postoperatively, all three were acyanotic and had
improved physical capacity compared with their preoperative status. The RA
pressure in the first two patients 1 year after operation was 12 mm. Hg and
at angiocardiography the RA-RV anastomosis was widely patent. In one of the
patients, the RV was too hypoplastic to function. It should be possible to
perform this operation even in younger patients and it may eliminate the
need for palliative procedures and reoperations.
