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Congenital TEE > Congenital TEE > Flashcards

Congenital TEE Flashcards

Learn TEE for congenital heart disease

1
Q

What is a Gerbode defect?

A

When a perimembranous ventricular septal defect (VSD) forms a communication between the left ventricular outflow tract and the right atrium.

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2
Q

Define Type III Truncus Arteriosus.

A

In Type III truncus arteriosus, there is a single pulmonary artery arising from the lateral wall of the truncus, and the blood supply to the other lung is from either the base of the aortic arch or the systemic arteries.

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3
Q

What percentage of atrial septal defects (ASDs) are sinus venosous defects?

A

10%

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4
Q

What syndrome is found in 10% to 15% of patients with Ebsteins anomaly?

A

Wolff-Parkinson-White

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5
Q

What percentage of ventricular septal defects (VSDs) are perimembranous?

A

70%

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6
Q

What are the four categories of ventricular septal defects?

A

(1) Perimembranous,
(2) Muscular,
(3) Supracristal,
(4) Atrioventricular canal defects

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7
Q

What is thought to be the cause of Truncus Arteriosus?

A

Incomplete or failed septation of the distal conus, truncus arteriosus, and the aortic sac.

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8
Q

List right ventricular morphologic features.

A
  1. Heavily trabeculated
  2. Three papillary muscles
  3. Moderator band
  4. Tricuspid valve has chordal attachments to the ventricular septum
  5. Tricuspid valve has 3 leaflets
  6. Tricuspid valve has a more apical (distal) septal insertion
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9
Q

What percentage of patients with mild pulmonary stenosis will require valvulotomy?

A

5%

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10
Q

Which TEE view is most useful when differentiating a perimembranous VSD from a supracristal VSD

A

RV inflow-outflow view

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11
Q

Which TEE view demonstrates an over-riding aorta in Tetralogy of Fallot

A

Mid-esophageal long axis (ME Lax)

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12
Q

List left ventricular morphologic features.

A
  1. Smooth walls
  2. Two papillary muscles
  3. No moderator band
  4. The mitral valve does not have a chordal attachment to the ventricular septum.
  5. The mitral valve has two leaflets
  6. The mitral valve has a more basilar (higher) septal insertion.
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13
Q

Severe pulmonic stenosis is defined as a peak gradient greater then ______?

A

50 mm Hg

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14
Q

In the RV inflow-outflow view, a perimembranous VSD is close to which valve?

A

Tricuspid valve

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15
Q

In the RV inflow-outflow view, a supracristal VSD is close to which valve?

A

Pulmonary (pulmonic) valve and right ventricular outflow tract (RVOT)

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16
Q

What percentage of patients with moderate pulmonic stenosis will require intervention?

A

20%

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17
Q

What is the percentage of probe-patent foramen ovale in autopsy series?

A

26%

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18
Q

What is the embryologic cause of a patent foramen ovale (PFO)?

A

Failure of the septum primum and septum secundum to fuse after birth.

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19
Q

What percentage of sinus of Valsalva aneurysms occur in the right coronary cusp?

20
Q

What percentage of sinus of Valsalva aneurysms occur in the non-conorary cusp?

21
Q

Define Type I Truncus Arteriosus.

A

In Type I Truncus Arteriosus, an aortopulmonary septum is recognized (present) and a single main pulmonary artery is identified to originate from the posterior wall of the truncus arteriosus.

22
Q

Define Type II Truncus Arteriosus.

A

In Type II Truncus Arteriosus, there is no aortopulmonary septum and separate right and left pulmonary arteries are identified to originate from the posterior wall of the truncus arteriosus.

23
Q

What percentage of sinus of Valsalva aneurysms occur in the left coronary cusp?

24
Q

What is the most common congenital anomaly recognized at birth?

A

Ventricular septal defect (VSD)

25
Q

Describe Ebstein’s Anomaly

A

Two of the three leaflets of the tricuspid valve, septal and posterior leaflets, are displaced downward in the right ventricle. The anterior leaflet is large, redundant, and abnormally attached to the right ventricular free wall.

26
Q

What is the most commonly encountered congenital heart defect?

A

Bicuspid aortic valve (BAV)

27
Q

A bicuspid aortic valve is found in what percentage of general population?

28
Q

Define Type IV Truncus Arteriosus

A

In Type IV Truncus Arteriosus (very rare), the pulmonary arteries arise from the descending aorta (pseudotruncus). Probably a severe form of Tetralogy of Fallot with pulmonary atresia and large bronchial collaterals.

29
Q

What is the male:female ratio of sinus of Valsalva aneurysms?

30
Q

What is thought to be the cause of a congenital aneurysm of the sinuses of Valsalva?

A

A weakness in the aortic media at the junction of the annulus fibrosis.

31
Q

What consitutes the ‘Pentalogy of Fallot’?

A

The ‘Pentalogy of Fallot’ includes

  1. Ventricular septal defect
  2. Over-riding aorta
  3. Pulmonic valve stenosis
  4. Right ventricular hypertrophy
  5. Atrial septal defect (10% to 15%)
32
Q

Define D-Transposition of the Great Arteries?

A
  1. Atrioventricular concordance

2. Ventriculoarterial discordance

33
Q

What percentage of patients with Tetralogy of Fallot have a right aortic arch?

34
Q

Define L-Transposition of the Great Arteries?

A

Also known as congenitally corrected Transposition of the Great Arteries (ccTGA)

  1. Atrioventricular discordance
  2. Ventriculoarterial discordance
35
Q

What is the echocardiographic criteria for Ebstein’s Anomaly?

A

In the mid-esophageal four-chamber (ME 4C) view, the tricuspid valve is inserted greater than 20 mm (2.0 cm) to the mitral valve annulus.

36
Q

What percentage of ventricular septal defects (VSDs) are muscular?

37
Q

What percentage of ventricular septal defects (VSDs) are supracristal?

38
Q

The mitral valve is always associated with which morphologic ventricle?

A

The left ventricle

39
Q

What percentage of patients with Tetralogy of Fallot have an anomalous origin of the left anterior descending coronary artery?

40
Q

What percentage of ventricular septal defects (VSDs) are atrioventricular canal defects?

41
Q

What percentage of atrial septal defects are ostium secundum defects?

42
Q

What is the Gasul phenomenon?

A

When right ventricular outflow tract hypertrophy occurs in association with a ventricular septal defect. The RV outflow tract hypertrophy serves to limit the severity of pulmonary hypertension.

43
Q

What peak gradient defines mild pulmonic stenosis?

A

< 30 mm Hg

44
Q

What peak gradients define moderate pulmonic stenosis?

A

30 mm Hg to 50 mm Hg

45
Q

The tricuspid valve is always associated with which morphologic ventricle?

A

The right ventricle

46
Q

What percentage of atrial septal defects are ostium primum?

47
Q

Ostium primum atrial septal defects are associated with what other congenital abnormality?

A

Cleft mitral valve leaflet.

Congenital TEE (1 decks)

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