Lec 09 Surgery for Congenital Heart Diseases

Question 1

Drawback on using pericardium as a patch for ASD

Answer 1

One can use a pericardium patch over the ASD but it can become aneurysmal over time.

Question 2

Most common cause of death for patients with PDA

Answer 2

Congestive heart failure

Question 3

Indications for the surgical closure of a Patent Ductus Arteriosus

Answer 3

1. Premature

o Cardiorespiratory failure due to PDA (medical

failure)

2. 6 months

o On the confirmation of diagnosis

Question 4

Imaging modality used for patients with Coarctation of the Aorta

Answer 4

Aortogram

Question 5

State the most probable age for patients with Coarctation of the Aorta to experience the following events in the course of life with the defect:

Cause symptoms after:

Death occurs in mid:

Aortic dissection or rupture:

Left Ventricular failure occurs:

Answer 5

Cause symptoms after 20-30 years of age

• Death occurs in mid 30’s
• Aortic dissection or rupture: in 3rd or 4th decades
• Left Ventricular failure occurs after neonatal age or older than age 40 years

Question 6

The most common associated malformation for patients with Coarctation of the aorta

Answer 6

bicuspid aortic valve

Question 7

Difference between atresia and stenosis in terms of flow:

Answer 7

Atresia: no flow
Stenosis: limited flow

Question 8

The most popular systemic-to-pulmonary artery shunt procedure.

Answer 8

The Gore-Tex interposition shunt (or modified Blalock-Taussig shunt)

Question 9

Most commonly done arterial switch procedure. (Done for TGA)

Answer 9

Jatene procedure

Question 10

Steps for complete surgical repair of TOF:

Answer 10

A. Enlargement of the right ventricle to main pulmonary artery (PA) connection with a transannular incision if necessary.

B. Resection of muscle from the outflow tract and identification of edges of the ventricular septal defect (VSD) and MPA

C. Patch closure of the VSD.

D. Placement of a transannular patch if required.

Note: valve sparing is better than transannular repair.

Question 11

Surgical procedure involving the creation of holes between two heart chambers

Answer 11

Septostomy

Rashshkind balloon atrial septostomy -> Done in TGA. Involves inflation of a balloon to rupture the foramen ovale and create a hole between the left and right atriums.