Intro to Congenital Heart Disease Flashcards
What are the 4 types of ASD’s?
- Ostium Secundum
- Ostium Primum
- Sinus Venosus
- Coronary Sinus
What is the most common type of ASD?
Secundum
What is ASD Secundum associatad with?
Mitral Valve Prolapse (MVP)
ASD Secundum is amenable to what therapy?
Closure in the cath lab
Where is primum ASD found near?
Close to AV Valves
ASD Primum has what leaflet disorders?
- Cleft AV Valve Leaflets
- Cleft Septal Tricuspid Valve Leaflets
- Cleft Anterior Mitral Valve Leaflets
ASD Primum associated with what systemic pathology?
Trisomy 21
Endocardial Cushion Defect
What are the two types of Sinus Venosus defect?
which is more common?
Superior Vena Cavae Sinus Venosus ASD >. Inferior Vena Cavae Sinus Venosus ASD
Superior Sinus Venosus ASD is associated with what syndrome?
Anomalous Pulmonary Venous Drainage of the right upper pulmonray vein
Inferior Sinus Venosus VSD is associated with what syndrome?
Scimitar syndrome
What is a coronaray sinus ASD associated with?
Persistent left superior vena cavae
Primum ASD classified as what type of AV Canal?
Partial AV Canal
Primum ASD with restrictive inlet VSD classified as what type of AV Canal?
Transitional AV Canal
Primum ASD with non-restrictive inlet VSD classified as what type of AV Canal?
Complete AV Canala
What is simetar syndrome?
- Hypoplastic RLL of the lung
- Aorto to Pulmonray Collateral blood flow of RLL
- Anomalous pulmonary venous drainage to “Simetar sword” from RLL to IVC
What is a coronary sinus ASD
Persistent Left Superior Vena Cava that drains into the Coronary Sinus
Defect is an unroofing of Coronary Sinus allowing higher pressure LA blood to drain into the CS and then drain into the low pressure RA
Where is aa secundum ASD located?
Fossa Ovalis
In both of these images, what is the bottom right arrow pointing to?
What is the relevance to this positioning?
Crista Terminalis
The crista terminalis is generally a smooth-surfaced, thick portion of heart muscle in a crescent shape at the opening into the right atrial appendage.
Secumdum ASD = Middle
Sinus Venosus ASD = Closer to Crista Terminalis
What type of ASD is present here?
Secundum ASD = Located in the Fossa Ovalis
What is seen here?
PFO
*NOTE: PFO does not equal ASD*
What is the difference between a PFO and an ASD?
Patent foramen ovale (PFO) and is flap-like valve in between left and right atria found in ~ 25 percent of adults that remains open as an intraatrial shunt
ASD = Open communication between the atria after septation (4 types as discussed)
What is the flap seen here?
Flap = Septum Primum and is what is a PFO with blood coming under the flap
Due to the location of primum ASD, what is a common sequalae that needs to be addressed emergently?
Complete heart block after repair (Due to close proximity to AV Valve (AV nodes)
What exactly is an endocardial cushion defect?
Primum ASD + Inlet VSD = Complete AV Canal
Involve AV septum and AV valves
What is seen at the green arrow?
Ostium Primum
What is seen in the middle arrow?
Complete AV canal
What is seen here?
Sinus Venosus ASD
Sinus Venosus VSD associated with?
Anomalous Pulmonary Venous Return
Sinus Venosus = Anomalous Pulmonary Venous return
How do you see a sinus venosus defect?
Pull back from ME 4 chamber as this is a higher defect
What is the size of a normal coronary sinus?
<10 mm
What is seen in a coronary sinus ASD?
Dilated coronary sinus >10 mm
How will you investiagate a Coronary Sinus ASD?
Left sided IV –> Inject contrast
Coronary sinus bubbles/contrast will light up first before filling RA due to persistent Left SVC
What are the 4 major ways of classifying VSD in terms of location?
- Relative to Crista Supraventricularis
- Relative to RV inflow/outflow
- Relationship to the Semilunar Valves
- Relationship to the septum