Tricuspid atresia

Tricuspid atresia is a cyanotic congenital cardiac anomaly which is characterised by agenesis of the tricuspid valve and right ventricular inlet. There is almost always an obligatory intra-atrial connection through either an ASD or patent foramen ovale (PFO) in order for circulation to be complete 5. A small VSD is also present. In a proportion of cases they may also be associated with transposition of great arteries (TGA) .

Pathology

Results from unequal atrio-ventricular canal division. The right ventricle is typically very hypoplastic.

Radiographic features

Plain film

Features may vary depending on the presence and extent of a VSD or TGA. May demonstrate decreased pulmonary vascularity (i.e. oligaemic appearance). Cardiac size may be normal of enlarged.

Echocardiography / Ultrasound

Usually the 1st line imaging modality in utero. Allows direct visualisation of anomaly.

CT and MRI

Allows direct visualisation of anomaly and may typically show a fatty and / or muscular separation of the right atrium from the right ventricle. Cine MRI can offer functional information in addition to anatomy.

Associations

Extra cardiac

* right sided aortic arch
* absent spleen : asplenia

Article Author : Dr Yuranga Weerakkody, Radiopaedia

References

* 1. Fletcher et.al, Right atrioventricular valve atresia: anatomic evaluation with MR imaging American Journal of Roentgenology, Vol 148, Issue 4, 671-674
* 2. Hyun Woo Goo et. al, CT of Congenital Heart Disease: Normal Anatomy and Typical Pathologic Conditions, RadioGraphics, 23, S147-S16, October 2003
* 3. Douglas L. Brown, Congenital Cardiac Anomalies: Prenatal Sonographic Diagnosis, AJR 153:109-114, July 1989
* 4. A Cook et.al, Right Heart Dilatation in Adults: Congenital Causes, AJR 2007; 189:592-601
* 5. M. Siegel et.al, MDCT of Postoperative Anatomy and Complications in Adults with Cyanotic Heart Disease, AJR 2005;184:241–247

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License