Palliative reconstruction of the right ventricular outflow tract in tricuspid atresia: a report of 5 patients.

Five patients with tricuspid atresia, normally related great arteries, and decreased pulmonary flow underwent reconstruction of the right ventricular outflow tract on enlargement of the ventricular septal defect (VSD) (outlet foramen) or both in order to increase pulmonary blood flow. The age of the patients ranged from 9 months to 4 years. All patients previously had had a systemic-pulmonary artery anastomosis. Preoperative mean arterial oxygen saturation was 67.2%. A restrictive outlet foramen was enlarged in 3 patients. Infundibulectomy and enlargement of the outlet chamber with a Dacron patch were performed in 4 patients. A pulmonary valve commissurotomy alone was done in 1 patient. There were no hospital or late deaths (mean follow-up, 16 months). Four patients out of 5 have obtained symptomatic and documented (increase in partial pressure of oxygen) benefit. In 1 patient, arterial oxygen saturation failed to rise to a satisfactory level.