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MCN > Acyanotic heart diseases > Flashcards

Acyanotic heart diseases Flashcards

1
Q
  • Narrowing at the entrance of PA
  • IF RV failure develop – RA pressure will increase resulting to re-opening of foramen ovale
  • Shunting of unoxygenated blood into
A

Pulmonary Stenosis

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2
Q

Open surgical Management of PDA

A

ligation of PDA thru left
thoracotomy

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3
Q

Medical management of VSD with cardiac failure:

A

digoxin and diuretics

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4
Q

type of ASD that comprises
about 5% cases of ASD. The
defect lies low in the interatrial
septum adjacent to
atrioventricular valves. There
may be cleft in the aortic leaflet
of the mitral valve producing
mitral insufficiency.

A

ostium primum

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5
Q

nonsurgical Management of PDA

A

coil occlusion

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6
Q

Management of PDA

A
  • Indomethacin IV (prostaglandin
    inhibitor)
  • Digoxin
  • Diuretics
  • adequate nutrition

Surgical management:
* Open: ligation of PDA thru left
thoracotomy
* Closed: VATS (visual assisted
thoracoscopic surgery)

  • Nonsx: COIL OCCLUSION
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7
Q

Closed surgical Management of PDA

A

VATS (visual assisted
thoracoscopic surgery)

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8
Q

Medical management of AS: used to treat CHF

A

rapidly acting inotropic
agents and diuretics

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9
Q

Management of ASD: prophylactic
antibiotics to prevent bacterial
endocarditis before dental
procedures and other invasive
procedures

A

infection control

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10
Q

Type of AS: stricture caused by a fibrous
ring below the normal valve

A

Sub valvular stenosis

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11
Q

Management of ASD: helps strengthen the
heart muscle, enabling

A

digoxin

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12
Q

Management of AS:
o Replacing the child’s diseased aortic valve with his/her own pulmonary valve (pulmonary autograft) and the pulmonary valve replaced with homograft

A

Ross procedure

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13
Q

Management of AS:
Additional sx for recurrent stenosis: valve replacement (artificial) may be required at the second procedure

A

Aortic homograft with a valve

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14
Q

Other term for AVC

A

endocardial
cushion defects

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15
Q

Management of PDA:
-the standard procedure
-The technique of video-assisted thoracoscopic clip ligation has become the standard of care for surgical management of a ductus with adequate length

A

ligation of PDA thru left
thoracotomy

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16
Q

Management of PS:
Surgical for Infants

A

TRANSVENTRICULAR
VALVOTOMY/BLOCK

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17
Q

Management of PS: closed surgical

A

TRANSVENTRICULAR
VALVOTOMY/BLOCK

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18
Q

Partial atrioventricular canal defects is also called as

A

atrioventricular
septal defect, or AVSD.

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19
Q

Type of AS: occurs
infrequently

A

Supra valvular stenosis

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20
Q

Medical management of VSD: for complete repair of small defects

A

purse-string approach

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21
Q

type of ASD that accounts
for about 5% cases of ASD. The
defect is located high in the
interatrial septum near the
entry of the superior vena cava.

A

Sinus venosus

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22
Q

Type of AVC: severe defect in which there is a large hole in the septum that separates the left and right sides of the heart. The hole is in the center of the heart, where the upper chambers and the lower chambers meet.

A

Complete atrioventricular canal (CAVC)

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23
Q

Management of PS:
o during cardiac catheterization to dilate the narrowed valve
/STENT PLACEMENT
o A doctor inserts a long, thin tube (catheter) with a balloon on the tip into an artery in the arm or groin. X-rays are used
to help guide the catheter to the narrowed valve in the heart. The doctor the inflates the balloon, which widens the opening of the valve and
separates the valve flaps. The balloon is when deflated, and the catheter and balloon are removed.

A

Balloon Valvuloplasty

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24
Q

Management of COA

A
  • Surgical correction is advisable in all but the mildest cases
  • Nonsx:
    o BALLOON ANGIOPLASTY
  • Sx:
    o Resection/removal of
    narrowed ends and
    anastomosis of both ends
    o Enlargement of the
    constricted section using a
    graft of prosthetic
    material/portion of left
    subclavian artery
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25
Q

Management of PDA: help close a PDA
works by stimulating the muscles
inside the PDA to constrict,
thereby closing the connection

A

Indomethacin IV (prostaglandin
inhibitor)

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26
Q

Management of PDA:
use of thoracoscope and instruments, 3 small insicion on the L side of chest to place a clip on the ductus)

A

VATS (visual assisted
thoracoscopic surgery)

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27
Q

Palliative Medical management of VSD

A

pulmonary artery
banding

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28
Q
  • Surgical closure is contraindicated
    in fully developed Eisenmenger’s
    syndrome when heart-lung
    transplantation may be the only
    effective treatment
A
29
Q

Types of AVC

A
  • Complete atrioventricular canal (CAVC)
  • Partial atrioventricular canal defects
30
Q
  • Abnormal opening between R&L ventricles creating pulmonary vascular resistance
  • Because of increase pressure at LV, blood flows through the
    defect into the pulmonary artery and pumps into the left
  • Increase pulmonary Vascular resistance, increase pressure to
    RV
A

VSD
(Ventricular
Septal Defect)

31
Q

Type of AVC: The hole does not extend between the lower chambers of the heart and the
valves are better formed.

A

Partial atrioventricular canal defects

32
Q

Management of ASD:
o This technique involves
implantation of one of several devices (basically single or double wire frames covered by fabric) using cardiac catheterization

A

Transcatheter Device Closure
(NonSx)

33
Q

Management of ASD: relieve pulmonary
congestion

A

diuretics

34
Q

most common type of ASD form comprising
about 90% cases of ASD. The
defect is situated in the region
of the fossa ovalis that, in
utero, was the foramen ovale

A

ostium secundum

35
Q

Medical management of AS: to reopen the ductus

A

intravenous infusion of PGE

36
Q

Management of PS: open surgical

A

PULMONARY
VALVOTOMY

37
Q

Management of ASD:
o For larger ASDs, a patch is usually used to close the hole. This patch can be taken from the pericardium (the sac that
surrounds the heart) or from synthetic materials such as Dacron or Teflon.
o Done at preschool age

A

Dacron Patch Closure (Sx:open)

38
Q

Types of ASD

A

Ostium secundum
Ostium primum
Sinus venosus

39
Q

Management of AS

A

Medical:
o balloon valvuloplasty
o use of rapidly acting inotropic agents and diuretics to treat CHF
o intravenous infusion of PGE
o Percutaneous balloon
valvuloplasty

Sx:
➢ Aortic valvotomy
1. Ross procedure
2. Aortic homograft with a valve

40
Q

Narrowing of the aortic lumen specifically in the region where the ductus arteriosus joins the aorta, i.e. at the isthmus just below the origin of the left subclavian artery.

A

Coarctation of Aorta

41
Q

seen more
often in the following:
o premature infants
o infants born to a mother
who had rubella during
the first trimester of
pregnancy
* Communication between PA +
aorta due to failure of ductus
arteriosus to close after birth (1
week of life)

A

PDA
(Patent Ductus
Arteriosus)

42
Q
  • Narrowing of the stricture of the aortic valve causes ↑pressure in the heart -> L ventricular hypertrophy
  • Causes the resistance to
    ejection of blood from LV > which cause the hypertrophy
  • LA pressure increases which causes increase pressure in pulmonary veins results to pulmonary congestion
A

AS
(Aortic Stenosis)

43
Q
  • They account for about 5 percent of all congenital heart disease, and are most common in infants with down syndrome.
  • (About 15 percent to 20
    percent of newborns with
    down syndrome have
    atrioventricular septal defects).
  • Incomplete Fusion of
    endocardial Cushions -ASD continues with VSD and Cleft of mitral and tricuspid valveCreating a large central AV valve allowing blood to flow in
    4 chambers=@risk of pulmonary vascular obstructive disease
A

AVC
(Atrioventricular
Canal)

44
Q

Management for AVC:
Reduce pulmonary blood flow in patients with significant pulmonary over circulation secondary to significant left to- right shunting in as palliation prior to later
definitive surgical repair

A

Pulmonary artery banding

45
Q

Type of AS: most
common type and is usually caused by malformed cusps

A

Valvular stenosis

46
Q

Medical management of VSD: for complete repair of large defects

A

Knitted Dacron patch

47
Q

o The ventricle has to work harder to try to move blood through the
narrowing in the aorta left sided heart failure
o BP is higher above the narrowing, and lower below the narrowing.
o Older children may have headaches from too much pressure in the vessels in the head, or cramps in the legs or abdomen from too little blood flow in that region.

A

Coarctation of Aorta

48
Q

palliative Management of AS

A

aortic valvotomy

49
Q

Management for AVC

A
  • Pulmonary artery banding
  • Complete repair: patch closure of the septal defect and reconstruction of the AV valve;
    mitral valve replacement if severe
50
Q

Management of ASD

A
  • digoxin
  • diuretics
  • infection control
  • surgical repair
  • Closure can be accomplished by
    using cardiac catheterization of
    implantable closure device.
  • Dacron Patch Closure (Sx:open)
  • Transcatheter Device Closure
    (NonSx)
51
Q
  • Abnormal opening between R &
    L auricles (Atrial allowing blood
    from higher pressure LA to
    flow into the lower pressure RA
    crossing the pulmonic valve)
  • LA pressure exceeds the RA
    pressure causes increase flow
    of oxygenated blood into the R
    side of the heart Management
  • Overloading of the RVentricle
    → R. Ventricular Hypertrophy
  • Increase pulmonary blood flow
    & increase pressure → murmur
    (harsh systolic), and extra
    amount of blood
A

Atrial septal defect

52
Q

Management of COA for older children

A

BALLOON ANGIOPLASTY

53
Q

Types of AS

A
  • Valvular stenosis
  • Sub valvular stenosis
  • Supra valvular stenosis
54
Q

Management of PS

A
  • Balloon Valvuloplasty
  • Sx:
    ➢ TRANSVENTRICULAR
    VALVOTOMY/BLOCK (closed)
    ➢ PULMONARY
    VALVOTOMY (open)
55
Q

Management of VSD:
for small VSD

A

no specific treatment

56
Q

treatment for Eisenmenger syndrome

A

heart-lung transplant

57
Q

Management of AS regarded as the first step in the management of symptomatic neonates

A

Percutaneous balloon
valvuloplasty

58
Q

Medical management of VSD:
o Placing a band around the pulmonary artery to decrease the pulmonary blood flow
o It increases the resistance to blood flow through the pulmonary artery. Pressure increases in the right ventricle
and prevents excess shunting from left to right

A

pulmonary artery
banding

59
Q

Management of ASD: involves slowly moving a
catheter (a long, thin, flexible,
hollow tube) into the heart.
The catheter is initially
inserted into a large vein
through a small incision made
usually in the inner thigh
(groin area) and then is
advanced into the heart

A

cardiac catheterization

60
Q

when will ductus arteriosus close

A

72 hrs after birth

61
Q

Management of AS:
(valve taken from a cadaver) is then used to replace the patient’s own pulmonary valve.

A

pulmonary allograf

62
Q

Management of PS:
Surgical for children

A

PULMONARY
VALVOTOMY

63
Q

Medical management of VSD

A
  • digoxin and
    diuretics.
  • Pulmonary artery
    banding
  • purse-string approach.
  • Knitted Dacron patch
64
Q

how to provide adequate nutrition in PDA

A

o high-calorie formula or breast milk
o supplemental tube feedings

65
Q

Management of ASD: machine in surgical repair

A

heart-lung machine

66
Q

Management of PDA:
o Ligation and division through
left posterolateral
thoracotomy without
cardiopulmonary bypass

A

ligation of PDA thru left
thoracotomy

67
Q

extreme
form of PS; total fusion of
commisures; no blood flow to
the left

A

Pulmonic Atresia

68
Q

Management of AS:
cardiac surgery operation
where a diseased aortic valve is replaced with the person’s own pulmonary valve.

A

The Ross-Yacoub procedure
(or pulmonary autograft)

MCN (6 decks)

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