Congential cardiac abnormalities

Question 1

Fontan circulation

Answer 1

Question 2

Common ACYANOTIC heart lesions (6x)

Answer 2

VSD 32% PDA 12% Pulmonary stenosis 8% ASD 6% Coarctation 6% Aortic stenosis 5%

Question 3

Common CYANONTIC heart lesions

Answer 3

Tetralogy of fallot 6% Transposition of the great arteries 5%

Question 4

Six questions for planing congenital cardiac anaesthesia

Answer 4

1. What is the ANATOMY of the lesion 2. How’s does blood FLOW round this abnormal heart (from IVC/SVC/pulmonary vein) 3. Is there a SHUNT? If so which way? (Size of abnormality and pressure gradient) 4. If there is a Right to left shunt is it significant enough for the patient to be cyanotic? 5. Which chambers or vascular circuits are volume loaded and/or pressure loaded? 6. What effects (CO, oxygen delivery) are likely to occur with changes in PVR and SVR?

Question 5

Classification of cardiac lesions (5x)

Answer 5

1. Those increasing pulmonary blood flow (ASD/VSD/AVSD/PDA/Truncus) 2. Those decreasing pulmonary blood flow (ToF/PS) 3. Obstruction (AS/PS/Coarctation) 4. Incompatible with life without correction ie. Duct dependent tricuspid/pulmonary atresia, HLHS, D-TGA, TAPVD 5. Lesions hidden until adulthood (BAV, ccTGA, WPW)