Tricuspid atresia, transposition of the great arteries, pulmonary atresia and Ebstein anomaly have distinct anatomical abnormalities, shunt pathways and treatment possibilities.
Tricuspid atresia
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The tricuspid orifice is absent and the right ventricle is hypoplastic.
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Associated features include a right atrium-to-left atrium shunt, a ventricular septal defect shunt and other anomalies.
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Surgical correction may be possible.
Transposition of the great arteries
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The aorta arises from the morphological right ventricle, while the pulmonary artery arises from the left ventricle.
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Shunting occurs through the atria, ductus and possibly a ventricular septal defect.
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Balloon atrial septostomy or enlargement provides palliation; surgical correction is possible.
Pulmonary atresia
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The pulmonary valve is atretic and the pulmonary artery is hypoplastic.
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There is a right atrium-to-left atrium shunt, with pulmonary blood flow through the ductus.
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Balloon atrial septostomy provides palliation, and surgical correction may be possible.
Ebstein anomaly
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The tricuspid valve is dysplastic and displaced into the right ventricle, which becomes ‘atrialised’.
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Associated findings include tricuspid regurgitation, a right atrium-to-left atrium shunt and arrhythmias.
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Severity varies widely. Surgical repair is possible but carries significant risk.