de Rubens J, Castellano C, Attié F, Guzzo D, Vargas Barrón J, Calderón J, Buendía A
Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1989 Mar-Apr;59(2):139-43.
The clinical presentation and long-term follow-up of 14 cases of tricuspid atresia associated with pulmonary atresia were reviewed. The electrocardiograms, hemodynamic findings and a definition of anatomic types were outlined in order to facilitate therapeutic decisions. In these types of tricuspid atresia the clinical presentation depends on the patent ductus. Despite the caliber of the ductus arteriosus, the poor tolerance to the malformation is frequent and the clinical presentation is similar to those malformations with decreased pulmonary blood flow (cyanosis since birth and hypoxic spells). In considering the age of these patients, the modified Blalock-Taussig anastomosis is the initial procedure. The Fontan procedure should be considered carefully as an alternative in older children.
回顾了14例合并肺动脉闭锁的三尖瓣闭锁病例的临床表现及长期随访情况。概述了心电图、血流动力学检查结果及解剖类型的定义,以辅助治疗决策。在这类三尖瓣闭锁中,临床表现取决于动脉导管是否通畅。尽管动脉导管口径各异,但对该畸形的耐受性差很常见,其临床表现与肺血流量减少的畸形相似(出生即有青紫和缺氧发作)。考虑到这些患者的年龄,改良布莱洛克-陶西格分流术是初始手术方式。对于大龄儿童,应谨慎考虑将Fontan手术作为替代方案。