[A seven-year course after Fontan operation in an older adult with tricuspid atresia].

Tricuspid atresia (TA) is a uncommon cardiac anomaly. Most patients with TA will develop severe hypoxia due to insufficient pulmonary flow at an early age and long-term survival without any surgical intervention may not be expected. A 38-year-old male with TA (type Ib) was referred with the complaints of increasing cyanosis and easy fatigability. After diagnosis was confirmed through the cardiac catheterization, modified Fontan operation was performed. In the procedure atrial septal defect was repaired by a patch, stenotic pulmonary valve was closed and prosthetic graft was inserted between the right atrium and the main pulmonary arterial trunk. In literatures about adult with TA, left ventricular dysfunction was generally reported. However, in our case postoperative course was uneventful and his symptoms improved dramatically. After the discharge from hospital, he has done well. But in the cardiac catheterization performed 7 years after operation, the cardiac index was slightly decreased and a significant stenosis along the left anterior descending coronary artery was incidentally discovered. In each laboratory examination after operation slight polycythemia was disclosed.