Congenital Flashcards
0
Q
Bicuspid
A
Moderate to severe no sports
1
Q
Asymptomatic As 2d echo
A
> 50 mm hg echo every year
<50 every 2 years
2
Q
AS gradient more than 50
A
Valvuloplasty before pregnancy
Or sports
3
Q
Sub aortic stenosis repaired
A
Residual lesions Restenosis Endocarditis vSD Heart block
4
Q
Supra valvular
A
Coronary obstruction Williams tumor Peripheral pulmonary stenosis Surgery for mean gradient 50 and peak 70 HTN No pregnancy and screen all relatives
5
Q
Noonan syndrome
A
Pulmonary stenosis
Repair if the mean gradient is 40 and peak 60
6
Q
Ebstein
A
Accessary pathway in 25% Asd 50% Cyanosis due to ASD RV dysfunction Afib Peak T Pregnancy risk 6% Cardio thoracic ratio >65 need surgery
7
Q
Aortopathies
A
Lost-dietz 4.5 cm
Marfan syndrome pregnancy 4
Usually >5cm
8
Q
Coarctation
A
Bicuspid > 50% VSD Cerebral aneurysm 10% Aortic rupture Endocarditis ICH HTN MI High risk pregnancy
9
Q
D transposition
A
Aorta from RV Coronary ostial abnormalities vSD 45% Lot obstruction 25% Treatment rastelli if PS present Atrial switch mustard and senning Coronary switch
10
Q
D transposition complications After atrial switch Baffle obstruction SVC syndrome Baffle leak Sub pulm stenosis Residual VSD Arrhythmias RV failure
A
Arterial switch Coronary stenosis and LV dysfunction new aortic leak aortic dilatation RVOT stenosis After rastelli Rvot conduit obstruction RV failure Sudden death Branch pulm stenosis
11
Q
Congenitally corrected L transposition
Just the ventricles switch positions
Complications
Compete heart block
Vsd
RV failure
A
Mustard and senning switch VSD repair aV replacement Rastelli Complications arrhythmias, LV dysfunction RV dysfunction AI
12
Q
Single ventricle tricuspid atresia
Avoid air emboli
Hemodynamics are problematic
False BP readings
A
Bidirectional Glenn Modified fontan 1 1/2 ventricle repair Reconstruct 2 ventricle Fontan late complications arrhythmias RV thrombus protein losing enteropathy. Cirrhosis
13
Q
Asd adults 25-50% Secundum 75% Arrhythmias 20% Reversible pulm HTN Closure improves morbidity not mortality
A
Vsd most common defect at birth 80% peri membranous Loud p2 Diastolic mitral flow Close large shunts Endocarditis AI PAH
14
Q
Vsd closure
A
Do not for severe pulm HTN and eisenmenger
Post infarct vsd 50% mortality with surgery and 30% with device closure
