ATI 20 - Congenital heart Disease - MIXED DEFECTS Flashcards
3 types of mixed defects
1 transposition of the great arteries
2 truncus arteriosus
3 total anomalous pulmonary venous return
**TRANSPOSITION OF THE GREAT ARTERIES
pathophysiology
PARALLEL CIRCULATION
LV pumps blood into pulmo artery
RV pumps blood into aorta
**TRANSPOSITION OF THE GREAT ARTERIES
prognosis
life-threatening at birth
-survival depends on OPEN DUCTUS ARTERIOSUS + FORAMEN OVALE to oxygenate blood
-survival w/o surgery is impossible
TRANSPOSITION OF THE GREAT
**clinical manifestations
- *cyanosis doesnt improve w O2
- *S2 loud + heard as single noise
-poor feed, need frequent rest bc tachypnea + fatigue
TRANSPOSITION OF THE GREAT
**clinical therapy
**PGE1 to maintain patent ductus arteriosus
until palliative balloon atrial septostomy is performed via cardiac catheriztn
TRUNCUS ARTERIOSUS
pathophysiology
- failure of septum formation
- VSD is usually present
TRUNCUS ARTERIOSUS
**clinical manifestations
- **cyanosis develops soon after birth
- poor feed, poor growth, CHF after 2wk
- systolic click
- VSD=harsh systlc mrmr
TRUNCUS ARTERIOSUS
**clinical therapy
- *RASTELLI procedure
- *repeated surgery may be necessary to enlarge pulmo artery conduit or repair truncal valve
- prophylaxis for life
***RASTELLI PROCEDURE
- **truncus arteriosus
- performed w/in 1wk of birht
- clos the VSD so that LV connects to large artery
- conduit created fr RV to pulmo arteries
**TRUNCUS ARTERIOSUS may require repeated surgery to ____ + to _____
- enlarge pulmo artey conduit
- repair truncal valve
bc they get bigger as they get older
TOTAL ANOMALOUS PULMONARY VENOUS RETURN
***pathophysiology
pulmo veins empty into RA
***mixed blood must pass thru foramen ovale or and ASD to provide systemic circulation
-any obstructn to pulmo veins incr severity
TOTAL ANOMALOUS PULMONARY VENOUS RETURN
**clinical therapy
- meds
- *surgery required for survival
- *surgery moves/creates a conduit to connect pulmo veins to LA
