Congenital Heart Defects Flashcards
Four types of ASD?
Ostium secundum (most common)
Ostium primum
Sinus venosus
Coronary sinus
Associations for each ASD
Ostium secundum → most common, center of fossa ovalis, mitral valve prolapse, cath lab closure
Ostium primum → near AV valves, cleft AV leaflets (septal TV, anterior MVL), trisomy 21
Sinus venosus → anomalous pulm v return/drainage, near SVC (more common) or IVC, near SVC (RU pulm v), near IVC (assoc Scimitar syndrome)
Coronary sinus → least common, unroofing or hole where higher pressure LA blood → enters sinus → RA, persistent L SVC
Where is the defect in ostium secundum ASD?
defect in septum primum
Criteria for partial, transitional, and complete AV canal defect?
Primum ASD → partial
Primum ASD + restricted inlet VSD → transitional AV canal
Primum ASD + unrestricted inlet VSD → complete AV canal
What is Scimitar syndrome?
Hypoplastic RLL lung
Aorto to pulmonary collateral blood flow
Anomalous pulmonary venous drainage from lung → Scimitar vein → IVC (lower sinus venosus defect)
How do you distinguish ostium secundum ASD from sinus venosus ASD based on ME bicaval view?
Secundum → caudad to crista terminalis
Sinus venosus → cephalad to crista terminalis
What is the defect in ostium primum?
Endocardial cushion defect
What is a PFO?
Separation of septum primum and secundum → flap
NOT the same as ASD
Anatomically, is septum primum ASD more anterior or posterior?
What is it near and what is the risk after repair?
More posterior.
Won’t see LVOT.
Near AV node, Inc risk for arrhythmia.
Is coronary sinus anterior or posterior structure?
What does coronary sinus defect look like on echo?
Posterior structure.
Will be dilated, associated persistent L SVC
Four anatomic types of VSDs?
Subpulmonic
Subaortic
Inlet
Muscular/trabeculated
Synonyms for VASD types?
Subpulmonic = type I = supracristal = RV outlet
Subaortic = type II = membranous = infracristal = cono-ventricular
Inlet = type III = AV canal type
Muscular/trabeculated = type IV
Which VSDs are posterior? posterior inferior? anterior?
Subpulmonic and subaortic → anterior
Inlet → posterior
Muscular/trabeculated → inferior and posterior
Most common type VSD? Anatomy? Associations?
Membranous. Aka type II, subaortic, cono-ventricular, infracristal.
Near LVOT/AV/Tricupsid valve. Posteriorly positioned.
Associated septal LV aneurysm and RCC prolapse → AI
Most common cause of RCC prolapse + AI in setting of VSD?
Subpulmonic VSD.
Near pulmonic valve.
