Lecture 3 Single Ventricle

Question 1

How would you in crease resistance to the pulmonary artery, and therefore limit the amount of blood sent to the lungs in the case of a single ventricle?

Answer 1

PA band

Question 2

If we do not limit the amount of blood sent to the lungs with the use of a PA band, what risk is the patient in?

Answer 2

Eisenmenger’s Physiology (Irreversible Supersystemic Pulmonary Resistance)

Question 3

As the child with a PA band grows, the PA becomes too restrictive which results in not enough blood going to the lungs, what should we do now?

Answer 3

PA Band > BT Shunt > Glenn > Bi-directional Glenn > TCPC > Fontan

Question 4

2 features of a single ventricle?

Answer 4

– Generally with TGA

– With or without small outlet chamber

Question 5

• SOC arises ANTERIORLY and to the RIGHT of the SV and gives rise to the Aorta.
• The Single ventricle connects to the PA.

1.) Palliative Care ?

Answer 5

Single Ventricle with NON-INVERTED SOC

1.) PA Band

Question 6

• SOC arises ANTERIORLY and to the LEFT of the SV and gives rise to the Aorta.
• The Single ventricle connects to the PA.

2.) Palliative Care ?

Answer 6

Single Ventricle with INVERTED SOC

2.) PA Band

Question 7

• SOC arises ANTERIORLY and to the LEFT of the SV and gives rise to the PA.
• The Single ventricle connects to the AORTA.

3.) Palliative Care ?

Answer 7

Single Ventricle (Holmes Heart)

Question 8

2 ventricles without an interventricuar septum with or without transposition of the great arteries (TGA).
3.) Palliative care?

Answer 8

Single Ventricle (Common Ventricle)

3.) Artificial Septation (rare)

Question 9

What are the 4 types of single ventricle CHD?

Answer 9

- Single Ventricle with NON-
  INVERTED SOC
- Single Ventricle with 
  INVERTED SOC
- Single Ventricle (Holmes 
  Heart)
- Single Ventricle (Common 
  Ventricle)

Question 10

What are the 4 types of TAPVR?

Answer 10

Type I Supracardiac
Type II Intracardiac
Type III Infracardiac
Type IV Multiple Sites

Question 11

Type I Supracardiac TAPVR Pathophysiology ?

Answer 11

APVR > Common Confluence > Vertical Vein or Cardinal Vein > Innominate Vein > SVC > RA > ASD > LA receives mixed blood.

Question 12

Type I Supracardiac TAPVR Surgical repair?

Answer 12

• Pulmonary veins anastamosed to the back of the LA.

- ASD patched to enlarge the LA chamber.

Question 13

Type II Intracardiac Pathophysiology ?

Answer 13

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