Fetal Tricuspid Atresia

Case of a fetal tricuspid atresia with severe right ventricular hypoplasia. There is a large ventricular septal defect shunting from the left ventricule to the right ventricle. There is concordant ventriculo-arterial connections (MPA coming off the RV, Aorta coming off the LV). There is moderate pulmonary stenosis with confluent pulmonary arteries and normal branching of the pulmonary arteries. The ductus is shunting from the PA to the Aorta (but does have some occasional left to right shunting in diastole - which may be a worrisome sign regarding the need for post-natal early procedure to sustain pulmonary blood flow).

More on postnatal Tricuspid Atresia here. 

The anterior sweep outlines the connection from the LV to the Aorta, and the residual RV to the MPA (with branching of the pulmonary arteries). 

4 chamber view outlining the hypoplastic right ventricle. The atrial septum is redundant and hypermobile from the right to left atrial shunting.

Flow by colour doppler going from the LV to the LV outflow tract. 

Long axis view outlining the redundant septum that is hypermobile. One can also appreciate the VSD and the mitral valve. 

Colour view with blood from the LV to the RV via the VSD. There is no significant mitral valve regurgitation. 

LV to LVOT to Aorta in long axis.

Short axis views. 

Sweep outlining the LV to Aorta and RV to MPA connections. 

Sweep outlining the LV to Aorta and RV to MPA connections. 

Colour flow showing the branching pulmonary arteries coming off the hypoplastic RV.

Short axis

Arch views in the sagittal plane.

Case by Dr Wadi Mawad, pediatric cardiologist at the Montreal Children's Hospital

Case of fetal tricuspid atresia. One may appreciate the hypoplastic right ventricle. The atrial septum is streched and bulging towards the left atrium, secondary to the increased RA to LA flow. 

Created by Gabriel Altit - Neonatologist / Créé par Gabriel Altit (néonatalogiste) - © NeoCardioLab - 2020-2023 - Contact us / Contactez-nous