Quiz 2-6 Questions Flashcards
4 components of TOF
Pulmonary stenosis, RV hypertrophy, Overriding aorta, VSD
boot shaped heart
TOF
TOF shunt direction
right to left
EKG with right axis deviation
RV enlargement
reduce symptoms of TET spell
vasoconstriction, squatting, oxygenation
TOF lungs are _____ on CXR than normal
darker
TOF patient with LAD arising from RCA surgical procedure
RV to PA valved conduit
causes of excessive shunting with TOF patient on bypass
- bronchial collaterals
- PDA
- B-T shunt
ebstein’s abnormality repair
- repair of tricuspid valve
- exclusion of atrialized ventricle
- closure of septal defect
single ventricle repair of ebsteins anomaly associated with ______
small RV
T/F tricuspid atresia may be associated with TGA
true
purpose of unofocalization operation
- fixes MAPCAs
- move pulmonary collaterals from aorta to PA
last operation for tricuspid atresia
fontan
MAPCAs
- develop from lack of pulmonary blood flow
- may be reimplanted to pulmonary artery
- are multiple aortopulmonary collateral arteries
most common type of tricuspid atresia has which of the following
- pulmonary valve stenosis
- small VSD
patients with tricuspid atresia are managed with _____ ventricle repair
single
this structure is funnel shaped and located below pulmonary valve
infindibulum
in pulmonary atresia, one or two ventricle repair depends on
size of the RV
purpose of fenestration in Fontan
-provide pop off in case of increase PVR/RV failure
_____ are associated with pulmonary atresia and develop from high RV pressures
sinusoids
conditions that affect myocardial protection in neonates
- bronchial collaterals
- variations in coronary anatomy
neonatal heart can tolerate ischemia better than adult heart because
it has more capacity to produce ATP from glycogen
how does calcium cause injury to neonatal heart
it passes through calcium channels based on concentration gradients
_________ causes rapid rewarming of the myocardium in neonates
increased bronchial flow
during the first year of life the weight of an infant increases to __ times birth weight
3x
neonatal myocardium has a higher proportion of _____ than adult myocardium
non-contractile elements
T/F an advantage of single dose cardioplegia in the immature heart is less edema
True
8 kg 8 month old with VSD - first dose of cardioplegia is
240 cc antegrade
delnido ratio
1:4
T/F HTK custodiol solution is crystalloid with high sodium
false
TGA occurs due to malposition of the aorta (direction)
anterior and to the right
common problems associated with senning or mustard procedures (atrial switch)
- atrial inflow obstruction
- arrhythmias
- RV failure
at the end of the arterial switch procedure, the aorta is ___ to the PA
posterior
most critical portion of arterial switch
reimplantation of coronary arteries
blood path of congenitally corrected TGA
RA-LV-PA-LA-RV-AO
blood path in TGA
RA-RV-AO-RA, LA-LV-PA-LA
which is a repair at the ventricular level
Rastelli procedure
surgeon with first atrial switch named after him
Jantene
Why does arterial switch need to be performed early in child with D-TGA and intact septum
prevent atrophy of LV - becomes systemic pump
which TGA patient more likely to have heart failure
d-TGA with VSD
compared with intact septum
T/F small aorta and moderate to sever tricuspid regurgitation increase risk of poor outcome in stage 1 norwood procedure
true
T/F bicuspid valve is commomn cause for valvular aortic stenosis in neonates
true
advantage of ross procedure
no anticoagulation needed postop
in HLHS the majority of cerebal and coronary blood flow is
retrograde through PDA
RV to PA conduit name in HLHS
sano shunt
hybrid procedure in HLHS
- bilateral PA bands (more blood to aorta)
- stented PDA
- balloon ASD
suendocardial fibrosis from aortic valve disease can lead to
cardiomyopathy
williams syndrome is associated with
supravalvular AS
ross procedure
- place pulmonary valve in aortic position
- place homograft in pulmonary position
- reimplant coronary arteries
Norwood procedure
- attach PA to aorta
- use homograft to augment the ascending aorta and arch
- place systemic to pulmonary shunt
most common type of coarctation of the aorta
postductal
rarely used repair for coarctation because impaired growth of left arm
subclavian flap
defect requiring treatment with PGE1 and surgery during neonatal period
incomplete aortic arch
T/F IAA repair will require dual aortic cannulation
true
diagnostic technique to diagnose patient with double aortic arch
- barium swallow
- echo
- CT scan
T/F most coarctation repairs require left heart bypass
false
present in patients with coarctation of the aorta
- LV hypertrophy
- congestive heart failure
- chest pulsations due to collaterals
if a patient has coarctation of the aorta and a VSD, which are true
- done in single operation with DHCA or regional cerebral perfusion
- a combined procedure requires bicaval cannulation
which are associated with DiGeorge syndrome
- hypocalcemia
- immune disorders due to missing thymus
- conotruncal malformations
- learning difficulties
most common complication with heart transplant
rejection
TAPVR
- totally anomalous venous return
- no pulmonary veins drain into LA
- all pulmonary veins drain into systemic circulation
T/F after repair of the cardiac type TAPVR, the coronary sinus drains into the RA
false
which is a palliation used on patients with TAPVR
BAS at time of catheterization
T/F supracardiac is the most common classification seen with
true
cannulation technique for heart transplant
aortic and bicaval venous cannulation
T/F cyanosis is always associated with TAPVR
True
T/F increased survival after pediatric heart transplant is associated with a younger age at the time of transplantation
True
T/F repair of supracardiac TAPVR requires that the confluence of the pulmonary veins be attached to the LA and the vertical vein ligated
True
which defect involves a single arterial trunk that araises from the heart, supplies systemic, pulmonary, and coronary artery systems
truncus arteriosus
A patient with DORV has a doubly committed VSD. this VSD is _____
in the middle just under both valves
if greater than 50% of the aorta arrises from the right ventricle the this would be considered what type of DORV
TGA
in a patient with DORV, which will best define the coronary anatomy and peripheral PA stenosis
cardiac catheterization
T/F a patient with TOF type DORV has most of their blood flowing out of the aorta with little pulmonary blood flow
True
3kg patient has truncus arteriosus. what precautions should be taken regarding the blood prime
irradiated packed RBC’s
the following has a membrane of fibromuscular tissue in the left atrium
cor triatrium sinister
surgical intervention for which requires a homograft between the RVOT and PA
truncus arteriosus
T/F ALCAPA is the most serious of coronary artery anomalies
true
the operation for removing the pressure on coronary arteries due to constriction between the aorta and PA is called
unroofing
