CTICasesFontan Palliation Progression for Tricuspid Atresia
Imaging findings
Serial imaging in a patient with tricuspid atresia and single-ventricle physiology demonstrates the progression of surgical palliation. Initial CT shows a systemic-to-pulmonary Blalock-Taussig (BT) shunt, a subsequent CT shows a bidirectional Glenn shunt with BT shunt ligation, and the final CT shows a completed Fontan circuit with an extracardiac conduit directing inferior vena cava flow to the pulmonary arteries.
Key takeaways
The classic surgical pathway for single-ventricle congenital heart disease involves three stages: an initial BT shunt to secure pulmonary flow, a bidirectional Glenn shunt to connect the superior vena cava directly to the pulmonary artery, and a completed Fontan procedure. Radiologists must be familiar with each surgical configuration to evaluate conduit patency and detect complications like stenosis or collaterals.
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