Quiz #39: Where is the catheter?

Two sets of images are given (PA and Lateral views in each set, from the same angiogram before and during contrast injection) obtained during pre-Glenn catheterization in this patient with Tricuspid Atresia.

Questions & Answers:

1) Trace the catheter course.

Answer: IVC-RA-ASD-LA-MV-LV-VSD-RV

2) Where do you think is the tip of the catheter?

Answer: RV

3) Using the second set of images, comment on great arteries relationship? (Normal relationship or not?).

Answer: Normally-related great arteries.

4) Bonus question: Based on the above observations, what classification type of tricuspid atresia is this?

Answer: Type 1b (Tricuspid Atresia with normally-related great arteries, Small VSD and PS). See the last image for classification of Tricuspid atresia.

(Click on the image to enlarge)

(Click on the image to enlarge)

(From Moss & Adams 5^th ed. 1995. Chapter 61: Tricuspid Atresia by Dr. Rosenthal A, Dick, McD II. p 903.)