Pediatric heart Surgery

Question 0

Baby presents with stridor and episodes of respiratory distress – during incident, baby assumes hyperextended position. Suspected diagnosis?

Suspected diagnosis if baby also has difficulty swallowing? Prove latter diagnosis with? Surgical management?

Goal of surgery?

Answer 0

Tracheomalacia

Vascular ring

Bronchoscopy (shows segmental tracheal compression) and barium swallow (shows compression from abnormal vessel)

Surgery divides the smaller of the two aortic arches

Question 1

Patient in late infancy presents with systolic pulmonary flow murmur and fixed split second heart sound – suspected diagnosis? History may also show?

Diagnosed with? Treatment options?

Answer 1

ASD; history of frequent colds

Echo; Surgery or cardiac cath

Question 2

Work up of an infant’s heart murmur shows restrictive VSD low in septum – management? Why?

Answer 2

None – likely to close spontaneously within the first three years of life

Question 3

Work up of an infant’s heart murmur shows restrictive VSD high in septum management? Why?

Answer 3

ECHO and surgical closure;

Otherwise can lead to failure to thrive

Question 4

X-ray findings patient with large or high VSD?

Answer 4

Increased pulmonary vascular markings

Question 5

Patient with machinelike heart murmur – when surgery?

Answer 5

#Preterm pts with heart failure
#preterm pts who did not achieve closure with indomethacin
#Full term babies

Question 6

Characteristics of right-to-left shunts? Most common?

Answer 6

#Murmur
#Diminish vascular markings in lung
#Cyanosis

Tetralogy of Fallot > transposition of great vessels

Question 7

Typical patient who presents with tetralogy of Fallot?

Answer 7

Age 5 or six, who presents with episodes of cyanosis, and clubbing

Question 8

One or two day old child with cyanosis – suspected diagnosis?

Answer 8

Transposition of great vessels