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Echo 3 > Module 3 : Acyanotic CHD's > Flashcards

Module 3 : Acyanotic CHD's Flashcards

1
Q

what are the 5 types of acyanotic CHDs that involve shunting

A
  • ASD
  • VSD
  • PDA
  • atrioventricular septal defects
  • CC-TGA
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2
Q

what rest the 3 types of acyanotic CHDs that do not involve shunting (obstructive)

A
  • congenital aortic stenosis
  • pulmonary stenosis
  • coarctation of the aorta
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3
Q

what two things can ASD lead to

A
  • tricuspid annular dilation > TR

- RA dilation > afib

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4
Q

what are the echo signs of an ASD

A
  • RV volume overload
  • paradoxical septal motion
  • image from multiple planes
  • asses location and size Qp/Qs
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5
Q

what measurement corresponds to a small ASD

A

<3mm

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6
Q

what measurement corresponds to a moderate ASD

A

3-6mm

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7
Q

what measurement corresponds to a moderately large ASD

A

6-8mm

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8
Q

what measurement corresponds to a large ASD

A

> 8-10mm

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9
Q

what is the most common ASD

A

secundum

- associated with MVP or pulmonary stenosis

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10
Q

what is the treatment of secundum ASd

A
  • most often closed percutaneously

- amplatazer

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11
Q

where is a secundum ASD located

A
  • most central portion of atrial septum
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12
Q

what is the location of an ostium Primum ASd

A
  • adjacent to AV valves

- associated with inlet VSD, cleft MV, T21

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13
Q

what is the treatment for ostium primum ASD

A
  • percutaneous device closure of the primum ASD not an option
  • woven Dacron patch
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14
Q

what is the location fo the coronary sinus ASD

A
  • rare located in the inferior region fo the right atrium adjacent to the coronary sinus
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15
Q

what is the treatment for coronary sinus ASD

A
  • patch closure
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16
Q

what are the associations with coronary sinus ASD

A
  • coronary sinus ASD is almost always associated with connection o the left SVC to the LA
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17
Q

what is the location of sinus venosus ASD

A
  • superior/posterior region of the atrial septum and most often seen adjacent to eh SVC
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18
Q

what are the associations with sinus venosus ASD

A
  • partial anomalous pulmonary venous return

- anomalous drainage of the right upper pulmonary vein to eh SVC/RA junction

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19
Q

with is the treatment of sinus venosus ASD with PAPVR

A
  • surgical correction to restore connection of the RUPV to the LA, then use patch to cover shunt
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20
Q

what is the rate of echo detection with ASDs

A
  • with TEE primum = 100%
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21
Q

how is contrast used to detect ASD/PFO

A
  • shows passage of microbublles into the LA from RA where shunt would be
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22
Q

what is the definition of AVSD

A
  • spectrum of lesions characterized by deficient AV station and a variety of AV vale abnormalities
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23
Q

what are the two main subtypes of AVSD

A
  • complete

- incomplete

24
Q

what other anomaly is AVSD associated with

A

T21

25
Q

what usually occurs after repair of AVSD

A
  • MV and TV regurge
26
Q

what is complete AVSD characterized

A
  • malformation of endocardial cushion at crux of heart
  • primum ASD that is contihous with an inlet VSD
  • presence of common AV valve
27
Q

what is the goal of surgery with complete AVSD

A
  • close any intracardiac shunts

- divide common AV valve into competent MV and TV orfices

28
Q

what is an incomplete AVSD distinguished by

A
  • absence of an inlet VSD

- comprised of a primum ASD and a cleft in the anterior MV leaflet

29
Q

what is the goal of surgery in incomplete AVSD

A
  • close interatrial communication

- repair the MV

30
Q

what is the post op echo procedure for AVSD

A
  • evaluate MV/TV for leaks

- evaluate surgical patches for adhesions and lake

31
Q

what are the other names for CCTGA

A
  • corrected transposition
  • L transposition
  • L loop
  • L TGA
32
Q

what is CCTGA characterized by

A
  • L lopping of the ventricles and transposition of the great arteries
  • BOTH VENTRICLES AND GREAT ARTERIES SWITHCED
33
Q

what is the orientation of the great vessel with CCTGA

A

aorta anterior anterior and the the left of PA

34
Q

what is the blood flow with CCTGA

A
  • physiologic blood flow is maintain due to double discordance
  • ## morphologic RV pumps to aorta morphologic LV pumps to lungs
35
Q

what are the severity of symptoms dependant on in CCTGA

A
  • degree of TR, VSD and severity of outflow tract obstruction
36
Q

what are 4 associated lesion with CCTGA

A
  • VSD
  • TV anomalies
  • pulmonary outflow tract obstruction
  • conduction defects
37
Q

what cor triatriatum

A
  • perforated membrane that partitions the left or right atria into two chambers
38
Q

what determines the severity with cor triatriatum

A
  • size of hole in the tissue that divides the atrium
  • small hole = more symptoms
  • large hole = les symptoms
39
Q

what is cor triatriatum sinister

A
  • divided ledt atrium is characterized by a perforate membrane in the left atrium
  • pulmonary veins come together postieorir
40
Q

what is cor triatriatum dexter

A
  • rare

- perforate membrane in the right atrium

41
Q

what is partial anomalous pulmonary venous return PAPVR

A
  • one or more but not all of the pulmonary veins are connected to a systemic vein, right atrium, coronary sinus, left innominate vein
42
Q

what is left sided PAPVR

A
  • pulmonary veins may connect to the coronary sinus and or left innominate vein
43
Q

what is right sided PAPVr

A
  • pulmonary veins may connect to the right atrium, SVC,IVC
44
Q

what can a PAPVR be found with

A
  • sinus venosus ASD
45
Q

what is the echo assessment of PAPVR

A
  • hypertrophy and dilation of the RA nd RV
  • dilation of the PA
    _ volume overlaid in the right heart
46
Q

what is a patent ductus arteriosus PDA and what is it caused by

A
  • connection between the descending aorta and origin of he left pulmonary artery
  • failure of the ductus arteriosus to close at birth
47
Q

what is the shunt direction with PDA

A
  • AO blood pressure higher than pulmonary blood pressure so blood flows through a PDA continuously left to right shun t
48
Q

what is the echo role with PDA

A
  • PSAX level of AO or ascending aorta
  • color doppler continous red high jet in main PA
  • spectral doppler = low pulmonary artery pressure there iscontinos now form aorta to PA
  • LVOT, AV and VTI increased
49
Q

what is the repair for a PDA

A
  • accomplished with drugs

- surgery or percutaneously

50
Q

what is a persistent left SVC

A
  • formed by the confluence of the left jugular and subclavian vein and descend inferiorly parallel to the right SVC in most cases
51
Q

where does the L-SVC common enter

A
  • coronary sinus
52
Q

what otters anomalies are associated with L-SVC

A
  • any type of ASD

- coronary sinus ASD most common

53
Q

what is the physiology and symptoms of L-SVC

A
  • LSVC drains into the right atrium through the coronary sinus , physiology normal
  • no clinical maifesteion
54
Q

what is the role of echo with L-SVC

A
  • coronary sinus may be dilates

- IV test = saline into left arm vein will result in pacification of coronary sinus before RA

55
Q

characteristics of Gerbode VSD

A
  • rare tru left ventricular to right atria shunt
  • usually congenital but may be acquired as a complication of endocarditis or surgery
  • causes RA enlargement, pulmonary hypertension

Echo 3 (4 decks)

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