Document Detail

Unguarded tricuspid orifice with pulmonary atresia: successful radiofrequency ablation of an accessory pathway in an infant.
MedLine Citation:
PMID:  9505931     Owner:  NLM     Status:  MEDLINE    
A male infant with the rare lesion of unguarded tricuspid orifice in the setting of pulmonary valve atresia, intact ventricular septum, and a hypoplastic right ventricle is described. The patient presented with cyanosis at 1 day old; transcutaneous oxygen saturations were between 20% and 30% in room air, and 60% in 100% inspired oxygen. Pre-excitation was found incidentally on the ECG and the potential for rapid antegrade conduction of atrial tachyarrhythmias, after eventual extended palliation with the Fontan procedure, was demonstrated at electrophysiological study. By 11 months old the patient was becoming increasingly cyanosed and interim palliation with a bidirectional cavopulmonary shunt was proposed. Successful radiofrequency ablation of the accessory pathway was performed before bidirectional cavopulmonary shunt, which would have prevented access to the heart via the superior vena cava. Difficulty with femoral venous access because of previous occlusion of a femoral vein was overcome by the use of 2 F pacing electrodes and a 5 F ablation catheter.
A G Magee; E Rosenthal; J Bostock; J Gill
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  79     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-23     Completed Date:  1998-03-23     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  101-3     Citation Subset:  AIM; IM    
Department of Paediatric Cardiology, Guy's Hospital, London, UK.
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MeSH Terms
Catheter Ablation*
Heart Bypass, Right*
Heart Conduction System / abnormalities*,  surgery*
Infant, Newborn
Pulmonary Atresia / therapy*
Tricuspid Valve / abnormalities*

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