High Yield PTEexam review part 30-32 Flashcards
What type of ASD is seen with Ebstein Anomaly?
Ostium secundum ASD
Inlet VSD is associated with what syndrome?
Trisomy 21
INlet VSD is associated with what valvular disorder?
Cleft anterior mitral valve leaflets
Name all the synonyms for inlet VSD (4)
AV canal type VSD
Endocardial Cushion defect
AV septal defect VSD
Type 3 VSD
What type of AV canal is found with ostium primum ASD?
Partial AV Canal
What is a subpulmonic VSD associated with?
Prolapse of the right coronary cusp
AKA prolapse of the aortic valve
Subpulmonic VSD synonyms (7)
Outlet VSD
Supracristal
Conal
Intraconal
Subarterial
Doubly committed
Type 1
subpulmonic VSD associated with what race?
Asians
L-TGA is associated with what major complication
Complete heart block
PUT PADS ON!
Tetralolgy of Fallot patients have what abnormality of their aortic arch?
Right aortic arch 25% of the time
What are the clinical implications of a right aortic arch?
Right aortic arch when you put TEE probe in can dampen the left subclavian artery (If you have left radial arterial line)
If you have TOF with right aortic arch, then put in right radial arterial line
What is Williams syndrome associated with for general anesthetics?
Sudden death syndrome
Supravalvular aortic stenosis
What is LV non-compaction?
Disorganized, hypertrabeculated, stochastic non-functioning LV with deep recesses
Non-compaction cardiomyopathy (NCM) is a myocardial disorder, which is thought to occur due to the failure of left ventricle (LV) compaction during embryogenesis, leading to distinct morphological characteristics in the ventricular chamber.
What is the important ratio to remember with diagnosis of LV non-compaction?
Non-compaction to Compaction of > 2:1 at the end of systole
Where is the non-compaction to compaction >2:1 ratio seen most? (What area of the heart)
Mid and Apical inferior and lateral LV
What are the units of temporal resolution?
Frame rate
AKA
Frames / second
What is the frame rate for M-mode?
Up to 1000 frames / second
How do you calculate dp/dt for the RV?
Time required for the TR jet to increase in velocty from 1 to 2 m/s
Therefore
(16 - 4) = 12 mmHg divided by time in seconds, yeilding a value in mmHg / second
Rv dP/dt = 12 / dt mmHg/s
dp/dt for the RV
What is the normal value?
>400 mmHg/second = Normal
Calculate the dP/dt of the RV here in the picture
12 / 0.02 = 600 mmHg/sec
>400 = Normal
What is abnormal value of MPI for the RV for CWD?
>0.40 = Abnormal for CWD
You want an MPI that is low. Low = Good
What is abnormal value of MPI for the RV for TDI?
>0.55 = Abnormal for TDI
What is the formula for MPI for the RV?
[IVRT + IVCT] / ET
What is the resonant frequency formula?
Resonant Frequency = Velocity / [2 (Thickness of crystal)]
What is the formula for acoustic impedence?
Z = P * V
Z = Acoustic impedence
P = Density
V = Velocity
What is the formula for Q factor?
Q factor = [Resonant Frequency / Bandwidth]
What is the formula for near field length?
Ln = r2 / Wavelength
r = Radius of transducer length
What is seen here?
Membranous VSD
What is associated with membranous VSD?
LV septal aneurysm
What is associated with scimitar syndrome?
Inferior sinus venosus VSD
Septum primum defect results in what type of ASD?
Ostium secundum ASD
What is the nyquist limit?
Max doppler shift before aliasing
How does the nyquist limit relate to the pulse repetition frequency?
NL = 1/2 PRF
OR
PRF = 2 * NL
What is the difference in measurements of Cath vs. TEE?
Which is peak to peak?
Which is peak instantaneous?
Peak to peak = Cath (Pull back method)
Peak instantaneous = TEE
What is the formula for attenuation coefficient?
attenuation coefficient (AC) = Frequency / 2
If you have Freq = 4 Mhz, what is the attenuation coefficient?
AC = Frequency / 2
If frequency = 4 Mhz then AC = 4 Mhz /2 = 2 dB/cm
Which ASD subtype is associated with mitral valve prolapse?
Ostium Secundum ASD
What ASD is associated with cleft AV valves?
Ostium primum ASD
What VSD is more common in Asians?
Outlet VSD
What is associated with Williams syndrome in relation to the aortic valve?
Supraavalvular Aortic Stenosis
What two artifacts are seen here?
- LVOT has black acoustic shadowing (Caused by echogenic structure of mechanical MV)
- Reverberation Artifact = Comet tail
What is ventricular inversion also known as?
L - TGA (Transposition of the great vessels)
What percentage of L-TGA have VSD?
75%
What percentage of L-TGA have Pulmonary outflow obstruction?
30-60%
What percentage of L-TGA have TV abnormalities?
90%
What percentage of L-TGA have MV abnormalities?
55%
What is most common arrythmia of L-TGA patients?
Complete heart block
What is other names (2) for L-TGA other than ventricular inversion?
Double discordance
Congenitally corrected TGA
How do you repair a sinus venosus ASD?
Warden procedure
Anomalous pulmonary vein (RUPV high in the SVC) they will Transect the SVC
What type of VSD is seen in tetralogy of Fallot?
Membranous VSD
What coronary artery abnormalitiy is seen in Tetralogy of Fallot patients 10% of the time?
LAD comes off RCA in 10%
VERY SCARY!
When they make their ventriculotomy during repair, the LAD is just below their incision
What great vessel abnormalitiy is seen in Tetralogy of Fallot patients 25% of the time?
What are the clinical implications of this?
Right aortic arch 25% of the time
TEE probe may compress left radial arterial line
Be sure to put in right radial arterial line in these babies
What is a Jatene procedure?
Arterial switch in D-TGA kids
Arterial switch is a surgical procedure and the main treatment to correct transposition of the great arteries (TGA). Almost all children with TGA undergo the arterial switch repair (also called the Jatene repair).
What type of ASD is seen in Ebstein anomaly?
Secundum ASD
What type of VSD is associated with Trisomy 21?
Inlet VSD
aka
AV Canal VSD
aka
AV septal defet VSD
aka
Type 3 VSD
What is outlet VSD associated with?
Prolapse of RCC –> creates A.I.
What is #2?
RUPV in the modified bicaval view
What is the intertigonal distance used for?
Sizing on annuloplasty rings
