Emergent surgical intervention for a neonate with premature constriction of the ductus arteriosus with ductal-dependent tricuspid atresia: a case report.

Background: Premature constriction of the ductus arteriosus (PCDA) makes management difficult in neonates with congenital heart defects, particularly those with ductal-dependent pulmonary circulation. This report highlights the challenges and management of a neonate diagnosed with tricuspid atresia and severe right ventricular outflow tract obstruction (RVOTO), complicated by PCDA.

Case summary: A male neonate was diagnosed prenatally with tricuspid atresia and severe RVOTO. After birth, his oxygen saturation was around 60%, and no ductus arteriosus was detected. A systemic-to-pulmonary shunt was placed emergently. After surgery, antegrade blood flow from the right ventricular outflow tract was unstable depending on the right ventricular muscle contraction and relaxation, and the antegrade blood flow needed to be occluded. The postoperative course was uneventful after then.

Discussion: This case underscores the complexity of managing neonates with tricuspid atresia, severe RVOTO, and PCDA. Early surgical intervention is critical in stabilizing such patients.