Cardiovascular ImagingTricuspid atresia
cyanotic
congenital cardiac anomaly consisting of absence of the tricuspid orifice, an interatrial communication, a
ventricular septal defect and small right
ventricle. 30 - 40% of patients have
transposition of the great arteries.
Pulmonary blood flow is usually dependent upon the size of the associated ventricular septal defect and severity of
pulmonary artery stenosis or atresia. Juxtaposition of the atrial appendages occurs in some patients with tricuspid atresia, usually in those with associated
D transposition. Chest
X-ray demonstrates a variable appearance. It may show decreased
pulmonary vascularity and normal heart size or
cardiomegaly. In tricuspid atresia associated with either a large ventricular septal defect or transposition,
pulmonary vascularity is increased. The right atrial border may be enlarged in patients with a restrictive
atrial septal defect.
Echocardiography and
MRI demonstrate a bar of tissue or membrane separating the right atrium and the hypoplastic right
ventricle (
Fig.1). These noninvasive techniques also depict the size of the atrial and ventricular septal defects and the ventriculoarterial relationships.
Cardiac angiography with right atrial injection of contrast media demonstrates immediate opacification of the left atrium and no flow of opacified blood across a tricuspid valve. A nonopacified triangle between the opacified right atrium and left
ventricle on the frontal view is a characteristic feature.
CBH
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ECG-gated spin-echo transaxial image demonstrates a bar of muscle and fat (arrowheads) (tricuspid atresia) separating the right atrium from the hypoplastic right ventricle (arrow).
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Tricuspid atresia, Fig.1 | |