Congenital Flashcards
What is an LV -> RA shunt called?
Gerbode defect
What are the four types of VSD?
Perimembranous (most common)
Supracristal
AV canal
Muscular
Alternative:
Outlet
Membranous
Inlet
Muscular
Four VSD closure indications
- Any symptoms
- Left heart enlargement (1.5:1 shunt + enlarged LV + LA)
- PHTN (as long as PASP <50% systemic + PVR <1/3 SVR)
4) Endocarditis
Indications for repairing (stent or surgery) aortic coarctation
CoA peak-to-peak gradient >20mmHg
Significant collateral flow on CTA/MRA
HF or systemic HTN
Stenosis >50%
If undergoing bicuspid AVR, at what aortic diameter is aortic replacement also indicated?
4.5cm (2a, lower threshold than non-bicuspid)
Lutembacher’s syndrome definition
ASD (secundum > primum) plus MS (congenital or acquired)
Taussig-Bing syndrome
DORV + subpulmonic VSD
What is Ebstein anomaly?
Congenital malformation characterized by apical displacement of the septal TV leaflet
Sinus of Valsalva aneurysms usually arise from _________ and rupture into _______ causing a continuous murmur
right coronary sinus
right ventricle
What is scimitar syndrome
RUL + some RLL pulmonary veins anomalous connection to IVC
(a/w R lung hypoplasia)
How is “step up” defined on shunt run
SVC -> PA >8%
4 types of ASD (in order of most common)
Secundum (80%)
Primum, includes canal (15%)
Sinus venosus (<5%)
Unroofed CS (<1%)
ASD ECG findings
Incomplete RBBB
Crochetage (inferior QRS notching)
Where do left upper PAPVR drain?
LUPV -> innominate
Secundum ASD has normal life expectancy if repaired before age ____
25yo
What is a gooseneck deformity?
LVOT elongation due to apical displacement of MV in AV canal defect
ECG findings in Down Syndrome w/ AV canal defect
RBBB + LAFB
AV canal defects are always associated with what other MV defect?
cleft anterior MV leaflet -> MR
Ebstein associations
PFO/ASD (50%)
WPW (20%)
Himalayan P waves
What is the “Witches nose” on CXR?
Post-stenotic PA dilation then taper in PS
pV and MG criteria for severe PS
pV >4
MG >35
Eisenmenger treatment
class I: Bosentan (?class effect for endothelin receptor antagonists)
class IIa: Dual therapy w/ bosentan + PDE5
4 components of Tetralogy of Fallot
VSD
RVH
RVOT obstruction
Overriding aorta
A/w anomalous coronaries
What are D-TGA and L-TGA
D-TGA is complete transposition:
RA -> RV -> Aorta
LA -> LV -> PA
L-TGA is CC-TGA
RA -> LV -> PA
LA -> RV -> Aorta
(D you die without a surgeon, L you can live without a surgeon)
