Complex Congenital Heart Dz

Question 1

Dx of top and bottom images

Answer 1

top= nl, bottom = coarctation

Question 2

usually, which ventricule is more trabeculated?

Answer 2

RV

Question 3

if you see complete heart block and severe AV valve regurge, what shoud you think of?

Answer 3

cogenitally corrected transposition

Question 4

if pt has a h/o lateral thoracotomy, what to think of?

Answer 4

has a shunt procedure

Question 5

Subclavian artery shunted to PA = ?

Answer 5

Blalock-Taussig Shunt

Question 6

SVC to R-PA = _____ Shunt, what about SVC to BOTH PA’s?

Answer 6

Classic Glenn, Bi-Directional Glenn

Question 7

name the shunts: Asc Ao–> RPA and Desc Ao to LPA

Answer 7

Waterston (RPA), Pott’s (LPA)

Question 8

if you have a shunt below TV, which side of the heart enlarges?

Answer 8

L

Question 9

what operation “excludes the Right AV valve?” and has high incidence of arrhythmias and RA thrombus?

Answer 9

Fontan

Question 10

Dx?

Answer 10

TOF Overriding Ao

Question 11

most common problem after TF repair?

Answer 11

PR

Question 12

this pt had surgery in childhood. what was his Dx?

Answer 12

d-TGA (mustard operation=atrial switch). (notice in right picture that the LV gives rise to an artery that dips posteriorly quickly = PA)

Question 13

does unoperated AV canal lead to PH?

Answer 13

yes

Question 14

what valve commonly regurgitates after Mustard (atrial switch) procedure?

Answer 14

TR

Question 15

in a 21 M w/ HTN w/ Ao root dilated at 5.4 cm and bicuspid AV. what is next step?

Answer 15

MORE imaging! look for coarctation and DO NOT jump to surgery.