Congenital Heart Defects Flashcards
What are congenital heart defects?
The most common congenital malformation
What is the global incidence of congenital heart defects? (Per100 live births)
0.8 to 1.2 per 100 live births
What is the one-year survival rate for non-critical congenital heart defects?
97.1%
What is the one-year survival rate for critical congenital heart defects?
75.2%
What are the age classifications for patients with congenital heart defects?
- Neonate: 1 to 30 days
- Infant: 1 to 12 months
- Child: > 1 year
How many types of congenital heart defects exist?
Approximately 800 different types
What are the main categories of congenital heart defects? (7)
- Partial or total anomalous venous connections
- Septal defects
- Atrioventricular valve malformations
- Right ventricular outflow tract defects
- Left ventricular outflow tract defects
- Cardiac tumors
- Vascular rings and slings
What are the most frequent types of congenital heart defects? (6)
- Atrial septal defect
- Ventricular septal defect
- Patent ductus arteriosus
- Aortic coarctation
- Tetralogy of Fallot
- Transposition of the great arteries
What are the types of atrial septal defects? (4)
- Ostium secundum type
- Sinus venosus type
- Coronary sinus type
- Ostium primum type
What are the treatment options for atrial septal defect? (2)
- Catheter closure
- Surgical closure (direct or patch)
What are potential early complications after atrial septal defect closure? (4)
- Residual or recurrent defect
- Air embolism
- Supraventricular arrhythmias
- Pericardial effusion
What is the pathophysiology of ventricular septal defect characterized by? (4)
- Number (single, multiple)
- Size (small, moderate, unrestrictive)
- Shape
- Location (perimembranous, inlet, muscular, outlet)
What are the diagnostic methods for ventricular septal defect? (3)
- Trans-thoracic echo
- Trans-esophageal echo
- CT scan
What is the treatment for patent ductus arteriosus? (2)
- Ligature through postero-lateral left thoracotomy
- Clip closure
What complications can arise from patent ductus arteriosus treatment? (4)
- Residual or recurrent patency
- Hemorrhage
- Chylothorax
- Recurrent laryngeal nerve lesion
What is aortic coarctation?
Narrowing of the aorta, either isolated or with other defects
What are potential complications of aortic coarctation surgery? (4)
- Residual or recurrent coarctation
- Hemorrhage
- Paraplegia
- Renal failure
What is transposition of the great arteries?
A condition where the aorta and pulmonary artery are switched
What are the surgical options for transposition of the great arteries? And what age for infants? (2)
- Arterial switch (first 2-3 weeks of age)
- Atrial switch or 2-stage arterial switch (after 2-3 weeks)
What is the significance of the Patent Foramen Ovale during fetal circulation?
Allows blood to bypass the non-functioning fetal lungs
What mechanisms are associated with migraine and Patent Foramen Ovale?
Potential right-to-left shunt through the foramen ovale
What is the impact of pressure overload on the heart? (3)
- Ventricular hyperplasia
- Myocardium angiogenesis
- Hypertrophy
What is subaortic obstruction also known as?
Taussig-Bing
List three surgical options for complex transposition of the great arteries.
- Subaortic resection
- Arterial switch
- VSD closure
What does age-dependent ventricular response to pressure overload refer to? (2)
Ventricular hyperplasia + myocardium angiogenesis
What are the two types of atrial switch procedures?
- Senning
- Mustard
What is a palliative Mustard procedure?
Atrial re-routing, leaving the VSD open
What is the hemodynamics of TGA in terms of oxygen saturation?
O2 sat. in Aorta < O2 sat. in PA, ≤ 6%
Name two conditions that may necessitate a palliative Mustard procedure.
- Presence of Pulmonary Vascular Obstructive Disease
- Unfavorable intracardiac anatomy
What are potential complications of atrial switch procedures? (6)
- Supraventricular arrhythmias
- Disorders of the sino-atrial node
- Late sudden death
- Complete atrio-ventricular block
- Tricuspid valve regurgitation
- Right ventricular dysfunction
What is the arterial switch operation also known as?
Jatene procedure
What are potential complications of the arterial switch operation? (4)
- Residual or recurrent coronary artery stenosis
- Residual or recurrent obstruction of new right ventricular outflow tract
- Residual or recurrent obstruction of new left ventricular outflow tract
- Arrhythmias
What does the Lecompte manoeuvre do during the arterial switch operation?
Stretches the pulmonary arteries
What is a significant risk associated with coronary artery reimplantation? (3)
Kinking, twisting, stretching, etc.
What is the birth prevalence of congenital heart disease?
Worldwide prevalence varies, with systematic reviews indicating significant numbers
True or False: The arterial switch operation is indicated for all types of transposition of the great arteries.
False
Fill in the blank: The potential complication of atrial switch related to the sino-atrial node is _______.
disorders of the sino-atrial node
What does the term ‘isolated atrio-ventricular discordance’ refer to?
A condition where atrial and ventricular connections are mismatched without other associated anomalies
What is the focus of Corno AF’s 2003 publication?
Decision making for surgery in congenital heart defects, Volume 1: Common Defects
What does the term ‘tricuspid (systemic) valve regurgitation’ imply?
More frequent with VSD closure through the tricuspid valve
What can cause residual or recurrent obstruction of pulmonary and/or systemic venous return?
Stenosis of the new caval and/or pulmonary venous channels
What is the significance of the 1% per year statistic mentioned regarding late sudden death?
Indicates the risk of late sudden death in patients post-atrial switch procedures
