Cyanotic Heart Disease Flashcards
Management of transposition of great vessels:
* procedure of choice in the 1st weeks of life
* reestablishes normal circulation with the L ventricle
acting out as the systemic pump
* transecting great arteries and anastomosing the main
pulmonary artery just above the aortic valve and
anastomosing the ascending aorta to the proximal
pulmonary artery
* coronary arteries switched from proximal aorta to the
proximal pulmonary artery
ARTERIAL SWITCH PROCEDURE
best recognized in the tongue and mucus membrane
Cyanosis
Management of Tricuspid
Atresia:
▪ Uses an intracardiac right atrial baffle, directing blood from
the inferior and superior vena cava to the pulmonary
arteries bypassing the right atrium and right ventricle.
▪ The TCP is used for patients with heart chambers which
allow recirculation and stagnation to occur
TOTAL CAVOPULMONARY REPAIR (TCR)
use of the patient’s atrial septum in intraatrial baffle repair
Senning-
Complications of Transposition
of Great
Vessels / Arteries
- Lack of oxygen to tissues.
- Heart failure.
- Reduced heart pumping function.
- Complete heart block.
- Heart valve disease.
Management of HLHS:
performed when an infant is 4 to 6 months of
age. This procedure creates a direct connection between the
pulmonary artery and the vessel (the superior vena cava)
returning oxygen-poor blood from the upper part of the
body to the heart. This reduces the work the right ventricle
has to do by allowing blood returning from the body to flow
directly to the lungs.
Bi-directional Glenn shunt Procedure
Management of total anomalous pulmonary venous connection
depends on how sick the child is
and the specific structure of the abnormal connections between the
pulmonary veins and the right atrium.
Surgery
right ventricle
of the heart becomes enlarged and thickened
due to the increased workload caused by the
other three defects.
Right ventricular hypertrophy:
Management of HLHS:
➢ performed soon after birth
➢ anastomosis of the main pulmonary artery to the aorta, to
create a new aorta,shunting to provide pulmonary blood flow
and the creation of a large ASD
➢ This surgery usually is done within the first 2 weeks of a baby’s life.
Norwood
a hole in the
wall that separates the two ventricles of the
heart.
Ventricular septal defect (VSD):
–if prosthetic material is used in intraatrial baffle repair
Mustard
medicine to improve cardiac function
digitalis
Management of transposition of great vessels: Performed during cardiac catheterization to
increase mixing and maintain cardiac output over
longer period of time
BALLOON ATRIAL SEPTOSTOMY
(RASHKINDPROCEDURE)
Discharge and home care
medications
activity restrictions
diet and nutrition
follow-up appointment
Management of transposition of great vessels:
* Created to divert venous blood to the mitral valve and
pulmonary blood to the tricuspid valve
- Continuing role of the right ventricle as the systemic
pump and the late development of right ventricular
failure
INTRAATRIAL BAFFLE REPAIR
Management of transposition of great vessels:
* Operative choice in infants with TGA, VSD and severe PS
* Involves: (1)closure of the VSD with a baffle directing L
ventricular blood through the VSD into the aorta and,
(2)closure of the pulmonic valve and placement of a
conduit from the R ventricle to the pulmonary artery
requires multiple conduit replacements as the child
grows
* An operation for repair of complete transposition of the great
arteries in association with a large VSD and pulmonic stenosis,
RASTELLI PROCEDURE
a good diagnostic cue for TOF
Squatting
Position for acyanotic
orthopneic position
Effect of Tricuspid
Atresia / Pulmonary
Atresia
- decreased blood flow to the lungs
- Complete mixing of oxygenated & unoxygenated
blood in the left side of the heart
Associated defects in HLHS
ASD, PDA
reduces the cardiac output by decreasing the venous return from the lower extremities and by
increasing the systemic vascular resistance.
knee-chest position
no communication between RA and RV
Tricuspid
Atresia / Pulmonary
Atresia
e changes in the structure
of the heart due can disrupt the electrical signals
that tell the heart to beat. It is when all signals are blocked
Complete heart block.
Nonsurgical Management in HLHS
Prostaglandin E1 infusion
Medicine
Nutrition
surgical Management of Transposition
of Great
Vessels / Arteries
ARTERIAL SWITCH PROCEDURE
INTRAATRIAL BAFFLE REPAIR
RASTELLI PROCEDURE
Tetralogy of fallot management: Complete repair in the first few years of life
BROCK PROCEDURE
Manifestations of Tricuspid
Atresia / Pulmonary
Atresia
- Cyanosis
- Shortness of breath
- Difficulty in feeding
- Clubbing of fingers
Manifestations in HLHS
- Problems breathing,
- Pounding heart,
- Weak pulse, or
- Cyanosis
- Heart murmur
management of tetralogy of fallot
BLALOCK TAUSSIG/MODIFIED BLALOCK TAUSSIG:
BROCK PROCEDURE
Tetralogy of fallot management: low and reduce right to left shunting in tetralogy
of Fallot. It involved resection of part of the RV
infundibulum using a punch or biopsy-like
instrument introduced through the right ventricle
so as to reduce RV outflow tract obstruction,
without VSD closure
BROCK PROCEDURE