242. Acyanotic Defects Flashcards
What are the components of acyanotic cardiac defects?
Left-to-right shunting lesions, obstructive lesions, cardiomyopathy, atrioventricular valvular (AVV) disease
What is the primary cause of left-to-right shunts?
Septal defects
What factors determine the magnitude of a left-to-right shunt?
Size of the defect, blood viscosity (determined by hematocrit)
What is indicated for repair of an atrial septal defect (ASD)?
Right heart dilation
At what age is it common to repair a secundum ASD?
Preschool age
What are the indications for repair of ventricular septal defects (VSDs)?
Aortic valve insufficiency, left-sided heart dilation
What results from the absence of the atrioventricular septum?
Atrioventricular septal defect or atrioventricular canal defect
What is the Shone complex composed of?
Supravalvar mitral ring, parachute mitral valve, subaortic stenosis, coarctation of the aorta
What is a significant risk associated with left ventricular outflow tract obstruction?
Demand-related myocardial ischemia
What genetic deletion causes Williams syndrome (WS)?
Deletion of the elastin gene on chromosome 7
What are common noncardiac manifestations of Williams syndrome?
Generalized anxiety disorder, hypercalcemia, abdominal pain, subclinical hypothyroidism, glucose intolerance
What is the primary surgical treatment for supravalvar aortic stenosis in WS?
Surgical treatment occurs prior to the onset of severe left ventricular hypertrophy (LVH)
What are the anesthetic goals during intraoperative management for a WS patient?
Maintain preload, afterload, and coronary perfusion pressure (CPP)
What is the indication for preoperative evaluation in left-to-right shunts?
Volume loading and dilation of affected heart chamber(s)
What is the relationship between cardiac arrest in children with cardiomyopathy and anesthesia induction?
Arrest was often preceded by hypotension and bradycardia, more common with agents other than inhaled agents
