Palliation of tricuspid atresia. Potts-Smith, Glenn, and Blalock-Taussig shunts.
Aortopulmonary (Potts-Smith), subclavian-pulmonary (Blalock-Taussig), and cavopulmonary (Glenn) shunts are the commonly performed operations for palliation of tricuspid atresia. A total of 104 patients with tricuspid atresia have undergone these procedures, either alone or in combination over a 28-year-period at the Hospital for Sick Children, Toronto. Operative risk is high in the first six months of life (44%), reasonable after six months of age (7.4%), and low for reoperation (3.5%). Long-term palliation of the 75 survivors (mean follow-up, 8,5 years) is compared for the three operative groups and charted on an actuarial table. Potts shunt offers superior long-term palliation. Therefore, as an overall plan of management, a Potts shunt with restriction of its anastomotic growth is the initial procedure of choice. When the patient outgrows the Potts shunt, a Glenn anastomosis is constructed. Ideally, the combination of these two shunts will produce a balanced circulation offering excellent long-term palliation.
D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006349:Heart Valve Diseases / Q000151:congenital; D006801:Humans; D007223:Infant; D010166:Palliative Care; D011651:Pulmonary Artery / Q000601:surgery; D011667:Pulmonary Veins / Q000601:surgery; D013348:Subclavian Artery / Q000601:surgery; D014261:Tricuspid Valve / Q000002:abnormalities*; D014683:Vena Cava, Superior / Q000601:surgery