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DMST 367 Echo 3 > Post OP Congenitral Heart Disease > Flashcards

Post OP Congenitral Heart Disease Flashcards

1
Q

What does this image represent?

A

This shows how the closure device looks like fresh vs when it sits in a patient halter a long time

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2
Q

What does this image represent?

A

A septal patch

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3
Q

What does this image represent?

A

Jatene switch

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4
Q

What does this image represent?

A

D-TGA atrial switch AKA: Senning/ Mustard

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5
Q

What does this image represent?

A

Post senning/ Mustard

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6
Q

What are ASD and VSD closure devices used for?

A

Occluding larger ASD (~8mm - 40mm) or hemodynamically significant VSD

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7
Q

What are the 4 types of ASD?

A
  1. Primum
  2. Secundum
  3. Sinus venosus
  4. Coronary sinus
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8
Q

What is an amplatzer?

A

These guys have a disc on each side of the waist which is around 5-7 mm >hole

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9
Q

Can an ASDs/ VSD within 5-7 mm of be closed with a amplatzer device?

A

No, It is contraindicated

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10
Q

Which ASD/VSD would not work with amplatzer?

A
  1. Primum
  2. Membranous
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11
Q

What are indications for septal patches?

A

ASDs/ VSDs that are not suitable for amplatzer device, such as

  1. Too close to valve
  2. Too large >40mm
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12
Q

What are the materials that are in a septal patch?2

A
  1. Autologous pericardium
  2. Synthetic materials
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13
Q

What are some things we see with an evaluation of a septal patch?3

A
  1. Residual leaks
  2. Endocarditis
  3. Thrombus
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14
Q

How can we find residual leaks with septal patches?

A

Use low color doppler to asses for flow at the edges of the patch or around the sutures

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15
Q

Why is endocarditis a risk of septal patch?

A

Endocarditis loves foreign objects to attach to

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16
Q

Why may thrombus form with a septal patch?2

A
  1. May form on the surface of the patch in early stages, before the patch “endotheliazes”
  2. Once the endocardium grows over the patch, it is incorporated into the wall (6 weeks)
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17
Q

How easy is it to evaluate the patch from the heart?

A

Eventually it will be hard to discern

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18
Q

What is D-TGA- arterial switch?

A

Newer and preferred surgical repair for D-TGA

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19
Q

What is another name for Arterial switch?

A

Jatene procedure

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20
Q

What does Arterial switch involve?

A

Switching the aorta and PA to their normal positions

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21
Q

When performing arterial switch, and moving the coronary arteries to a new aorta, what must we do first?

A

Check for RWMA from coronary abnormalities

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22
Q

When is arterial switch performed?

A

Within the first weeks of life

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23
Q

What is something that is noticeable after arterial switch?

A

The PA is now anterior to the AO

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24
Q

What do we evaluate for if we have a patient that has undergone arterial switch?4

A
  1. Scarring at the suture lines on Aorta or PA
  2. Wall motion abnormalities
  3. Valvular regurgitation/ stenosis
  4. Residual shunts
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25
Q

What is atrial switch also known as?

A

Senning/ mustard method

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26
Q

What is the atrial switch?

A

Switches the atria using baffles (conduits) to line up the appropriate ventricle

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27
Q

What is the process of flow for the Atrial switch?

A
  1. SVC/IVC flow is redirected through the baffle to the MV/LV which now becomes the pulmonary ventricle
  2. PVs flow redirected behind the other baffle to bring LA flow to the RV which now becomes the systemic ventricle
28
Q

Which is the more common D-TGA switch method?

A

Arterial switch

29
Q

With Atrial switch O2 rich pulmonary venous return is directed where?

A

TV

30
Q

With atrial switch O2 Poor SVR blood is directed where?

A

MV

31
Q

What does the Morphologic LV do with atrial switch?

A

Lungs

32
Q

What does the morphologic RV do with Atrial switch?

A

Pumps aorta

33
Q

What is the post procedure flow similar to in terms of atrial switch?

A

ccTGA

34
Q

What are some complications of senning/mustard method?5

A
  1. Baffle leaks + obstructions
  2. RV systolic dysfunctions
  3. PS
  4. Valvular regurgitation
  5. Arrythmias
35
Q

Do baffles grow in with patients?

A

no

36
Q
A
37
Q

What does this image represent?

A

Fontan procedure - conduit

38
Q

What does this image represent?

A

Rastelli procedure

39
Q

What does this image represent?

A

Blalock taussig shunt

40
Q

What does this image represent? What does the numbers represent?

A

Surgical repair of Tetralogy of flow

  1. Open PV
  2. Close VSD
  3. Transannular RVOT
  4. +/- Rastelli procedure (pulmonary atresia)
41
Q

What does this image represent?

A

Coarctation repair

42
Q

What does this image represent?

A

Subclavian Flap aortoplasty

43
Q

What does this image represent?

A

Prosthetic patch aortoplasty

44
Q

What does this image represent?

A

Percutaneous balloon angioplasty

45
Q

What does this image represent?

A

Coarctation of the aorta (CoA)

46
Q

What does this image represent?

A

Mitral commissurotomy

47
Q

What does these images represent?

A

Left: old school method for Mitral commissurotmy

Right: New school balloon (Percutaneous method)

48
Q

What are these three repairs?

A
  1. Blalock- Taussig
  2. Rastelli
  3. Fontan
49
Q

What are these types of repairs?

A
  1. Jatene
  2. Senning- mustard
50
Q

Name the congenital abnormalities

A

1.Hypoplastic left heart
2. Total anomalous pulmonary venous return
3. D-TGA
4. Tetralogy of fallot

51
Q

Name the congenital abnormalities

A
  1. Double outlet RV
  2. Pulmonary atresia
  3. Coarctation of the aorta
  4. Tricuspid atresia
52
Q

What valves form from the Endocardial/ Lateral cushions?

A

AV valves (MV/TV)

53
Q

What valves form from the truncus arteriosus?

A

Semilunar valves (AV/PV)

54
Q

What is the best description of perimembranous VSD?

A

A defect which runs between the LVOT and the Right ventricle, seen only in the A5C or PSAX view

55
Q

What is the best description of Gerbode VSD?

A

A shunt directed from the left ventricle to the right atrium

56
Q

What is the best description of outlet VSD?

A

A defect between the LVOT and the RVOT

57
Q

What is the best description of trabecular VSD?

A

A defect surrounded by the myocardium various locations and multiple defects possible

58
Q

What is the best description of inlet VSD?

A

A ventricular defect adjacent to the mitral and tricuspid valves, seen well in the A4C view; caused by absent or deficient AV septum

59
Q

What type of valve is a Hall Medtronic?

A

Single tilting disc

60
Q

What type of valve is a St. Jude?

A

Bileaflet tilting disk

61
Q

What type of valve is a starr-edwards?

A

Ball cage

62
Q

What type of valve is a carbomedics?

A

Homograft

63
Q

What type of valve is a Bjhorks- shiley

A

Single tilting disk

64
Q

What type of graft is a hancock?

A

Xenograft

65
Q

What type of graft is a carpentier edwards?

A

Xenograft

DMST 367 Echo 3 (27 decks)

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