When the doctor tells you that your newborn baby has a heart problem, it's normal for you, as a mother or father, to feel a great deal of fear and shock. Especially if it's a condition with an unfamiliar name like 'Tricuspid Atresia', there are a lot of questions that come to mind. "What is this? Will my baby be okay? Why did this happen?" Things like that are probably running through your mind. Don't worry. Today, we'll talk about this in a very simple way that you can understand.
Simply put, what is Tricuspid Atresia?
To understand this, let's first take a look at how a healthy heart works. Our heart has four main chambers. Two upper chambers and two lower chambers. The blood that has been used by the body and is low in oxygen first enters the upper chamber on the right side of the heart (Right Atrium). From there, a valve that acts like a door opens, and that blood goes to the lower chamber on the right side (Right Ventricle). This door is called
the Tricuspid Valve . Then, the lower chamber contracts and sends that blood to the lungs to get oxygen. However, in a baby with a birth defect called
Tricuspid Atresia , this so-called Tricuspid Valve is not
properly formed . That is, instead of that door, there is something like a thick membrane.
Imagine if there was a wall between two rooms instead of a door. Then you couldn't go from one room to the other, right? That's what's happening here.
As a result, the oxygen-poor blood that enters the upper right ventricle has no way to get to the lower chamber. Because this path is blocked, the lower right ventricle, which is no longer able to pump blood, does not develop properly, and is often very small. So, there is no way to send the blood that needs to be sent to the lungs to get oxygen. This results in
a fatal reduction in the amount of oxygen that the entire body receives.
Is this a serious situation?
Yes, this is definitely a very serious congenital heart defect that doctors consider a critical congenital heart defect. A baby with this condition requires treatment in an intensive care unit (ICU) that specializes in complex heart diseases right after birth. In many cases, emergency surgery is required to save the baby's life before they can go home. If this is not diagnosed and treated properly, it can have a very serious impact on the baby's life. Are there main types of this disease?
Doctors classify this condition in more detail. The reason for this is that there may be other changes in the baby's heart in addition to this main defect. The way the treatment plan is planned will vary depending on those changes. There are three main types (Type I, II, III).- Type I: This is the most common type. Here, the main blood vessels leaving the heart (the pulmonary artery and aorta) are in their proper places. However, there may be a hole between the lower chambers of the heart (a ventricular septal defect) or a problem with the valve that carries blood to the lungs .
- Type II: Here, the two main blood vessels are in an alternating position. There is also a hole between the lower chambers (Ventricular Septal Defect).
- Type III: This is a very rare type. Here, there are several complex changes in the major blood vessels and chambers.
You don't need to worry too much about these types. The doctors treating your baby will examine all of these and explain to you the treatment plan that is best for your baby. What symptoms does the baby have?
Most of the time, babies with this condition show symptoms within the first week of birth. You may notice these things. | Symptom | Simply explained |
|---|
| Blueness of the skin and lips (Cyanosis) | The main symptom is a blue or purple discoloration of the skin, lips, and nails, as the body does not receive enough oxygenated blood. |
| Difficulty breathing (Dyspnea) | The baby is breathing very fast and seems to be struggling to breathe. |
| Difficulty and fatigue in breastfeeding | The baby gets tired after drinking a little milk, stops drinking halfway through, or sweats while drinking. |
| Growth retardation | Even if the baby drinks a lot of milk, he or she will not gain weight properly. |
| Abnormal heart sounds (Heart Murmur) | While the doctor is examining the heart with a stethoscope, he hears an extra heart sound. |
Why did this happen to my baby?
You've probably asked yourself this question many times. The first thing to understand is that this is not your fault . Doctors have not yet found the exact cause of this type of congenital heart disease. It occurs during the first 6 weeks of a baby's development in the womb, when the heart is forming. However, some risk factors have been identified that increase the risk of this condition. The following factors can affect the mother during pregnancy:- Viral infections : contracting a viral disease like German measles during pregnancy .
- Diabetes : The mother has diabetes and it is not well controlled during pregnancy.
- Alcohol use : Drinking alcohol during pregnancy.
- Some medications:Use of certain medications for seizures or acne.
- Genetic conditions: This can also be associated with other genetic conditions, such as Down Syndrome .
How do doctors detect this?
In most cases, this condition can be diagnosed before the baby is born.- Before the baby is born: During your pregnancy scan (ultrasound), your doctor may see an abnormality in your baby's heart. If there is any doubt, you will be referred for a special scan that focuses only on the baby's heart, called a fetal echocardiogram .
- After the baby is born: If the baby is blue right after birth, doctors will immediately suspect a heart problem. If an abnormal heart sound (heart murmur) is heard when examining the heart with a stethoscope, that is also a major symptom. The main test to definitively diagnose the disease is an echocardiogram . This is also like a scan. This can clearly see if the heart valves are missing, the size of the chambers, the way blood flows, and if there are any other holes.
In addition, a chest X-ray, an ECG test, and a pulse oximetry test to check the oxygen level in the blood are also performed. What are the treatments? Can this be cured?
Although it cannot be completely “cured,” a series of surgeries can restore the baby’s blood circulation and allow them to live a normal life. Treatment can be divided into two parts. 1. Medication
As soon as the baby is born, they are given medication to keep the baby stable until the first surgery. The main medication given here is Alprostadil . This medication temporarily opens a special blood vessel (Ductus Arteriosus) that every baby has at birth and that closes a few days after birth. This creates an additional route for blood to reach the lungs. This is a life-saving measure.2. Surgery
Tricuspid atresia cannot be treated with a single surgery. As the baby grows, a series of surgeries are required in several stages. This is like building a large building piece by piece.- Stage 1 (within the first few weeks of life): This involves creating a stable blood flow to the lungs. This is done through a procedure called a BTT shunt . This involves inserting a small tube between a main blood vessel and the blood vessel that carries blood to the lungs.
- Stage 2 – Glenn Procedure: This procedure is performed when the baby is around 4-6 months old. Here, oxygen-poor blood from the upper body is diverted directly to the lungs, bypassing the heart.
- Stage 3 – Fontan Procedure: This final procedure is performed when the baby is around 2-4 years old. Here, the oxygen-poor blood from the lower body is diverted directly to the lungs. After this procedure, the mixing of oxygen-rich and deoxygenated blood in the heart almost completely stops.
If these surgeries are not successful or if the heart weakens over time, a heart transplant is considered as a last resort. What will my baby's future be like with this situation?
This is the biggest problem for every parent. Without treatment, most babies with this condition die before their first birthday. However, with timely surgery, the majority of these children survive into adulthood.
- Exercise: Most children can engage in normal activities. However, competitive, high-intensity sports may need to be limited. Talk to your doctor about this.
- Other health problems: Before some medical procedures, such as tooth extractions, you may need to take antibiotics to prevent heart infections.
- Learning: Some children may have learning disabilities or attention deficit hyperactivity disorder (ADHD). It is important to be aware of this as well.
Take-Home Message
- Tricuspid atresia is a serious but treatable congenital heart disease. It's not your fault.
- Early diagnosis of the disease and timely, staged surgery are essential for the baby's life.
- These children require lifelong follow-up with a cardiologist.
- Most children can live good, active lives after surgery. Don't give up hope.
- Talk openly with your baby's doctor about any questions or concerns you may have. They are always ready to help you.
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