Tricuspid atresia medical therapy: Difference between revisions

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{{CMG}}; '''Associate Editor-In-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu] [[Priyamvada Singh|Priyamvada Singh, MBBS]] [[mailto:psingh13579@gmail.com]]; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [[mailto:kfeeney@elon.edu]]
{{CMG}}; '''Associate Editor-In-Chief:''' {{Sara.Zand}}[[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu] [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu]


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==Medical Therapy==
==Overview==
===ACC/AHA 2008 Guidelines - Recommendations for Medical Therapy - Tricuspid atresia (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677  }} </ref> ===
The mainstay of therapy for the cyanotic neonate with severe  [[ pulmonary stenosis]] and small-sized  [[VSD]] is using [[ prostaglandin E1]] (PGE1) for keeping patency of [[ductus arteriosis]]. The mainstay of therapy for [[heart failure]] symptoms is using [[diuretic]] for reduction of [[congestion]] and then starting [[ ACEI]].


{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''[[Warfarin]] should be given for patients who have a documented atrial shunt, atrial thrombus, atrial arrhythmias, or a thromboembolic event.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}


{|class="wikitable"
== Medical Therapy ==
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''It is reasonable to treat systemic ventricle (SV) dysfunction with [[angiotensin-converting enzyme]] ([[ACE]]) inhibitors and diuretics.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}


===ACC/AHA 2008 Guidelines - Recommendations for Management Strategies for the Patient with Prior Fontan Repair - Tricuspid atresia (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677  }} </ref> ===


{|class="wikitable"
*The mainstay of therapy for the cyanotic neonate with severe  [[ pulmonary stenosis]] and small-sized  [[VSD]] is using [[ prostaglandin E1]] (PGE1) for keeping patency of [[ductus arteriosis]].<ref name="AkkinapallyHundalani2018">{{cite journal|last1=Akkinapally|first1=Smita|last2=Hundalani|first2=Shilpa G|last3=Kulkarni|first3=Madhulika|last4=Fernandes|first4=Caraciolo J|last5=Cabrera|first5=Antonio G|last6=Shivanna|first6=Binoy|last7=Pammi|first7=Mohan|title=Prostaglandin E1 for maintaining ductal patency in neonates with ductal-dependent cardiac lesions|journal=Cochrane Database of Systematic Reviews|year=2018|issn=14651858|doi=10.1002/14651858.CD011417.pub2}}</ref>
|-
 
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
*The mainstay of therapy for [[heart failure]] symptoms is using [[diuretic]] for reduction of [[congestion]] and then starting [[ ACEI]].
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Management of patients with prior Fontan repair should be coordinated with a regional ACHD center. Local cardiologists, internists, and family care physicians should develop ongoing relationships with such a center with continuous availability of specialists.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''a.'''At least yearly follow-up is recommended for patients after Fontan repair.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''b.'''[[Arrhythmia]] management is frequently an issue, and consultation with an electrophysiologist is recommended as a vital part of care.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''c.'''New-onset atrial tachyarrhythmia should prompt a comprehensive noninvasive imaging evaluation to identify associated atrial/baffle thrombus, anatomic abnormalities of the Fontan pathway, or ventricular dysfunction.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Disease]]
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[[Category:Cardiovascular diseases]]
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Latest revision as of 19:30, 8 November 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sara Zand, M.D.[2]Keri Shafer, M.D. [3] Priyamvada Singh, MBBS [4]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

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Overview

The mainstay of therapy for the cyanotic neonate with severe pulmonary stenosis and small-sized VSD is using prostaglandin E1 (PGE1) for keeping patency of ductus arteriosis. The mainstay of therapy for heart failure symptoms is using diuretic for reduction of congestion and then starting ACEI.


Medical Therapy

References

  1. ↑ Akkinapally, Smita; Hundalani, Shilpa G; Kulkarni, Madhulika; Fernandes, Caraciolo J; Cabrera, Antonio G; Shivanna, Binoy; Pammi, Mohan (2018). "Prostaglandin E1 for maintaining ductal patency in neonates with ductal-dependent cardiac lesions". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD011417.pub2. ISSN 1465-1858.

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