Segmental analysis

Question 1

What is segmental analysis

Answer 1

Systematic classification of congenital heart diseases according to chamber, vessels position and morphology

Question 2

Cardiac looping: normal

Answer 2

D loop

Question 3

Risks of L looping

Answer 3

inverted ventricles
o Higher risk of AVB
o Ebstein like TV malformations
o Hypoplasia of RV sinus

Question 4

How to determine looping

Answer 4

• Thumb is always inflow
• Index is outflow
• Fingers are IVS
• Hand that fits the ventricle is the loop side

Question 5

Van Praagh classification

Answer 5

• Relationship of great vessels and semilunar valves to ventricles

o Visceroatrial situs:
 Solitus (S): normal
 Inversus (I): opposite
 Ambiguous (A): mix

o Ventricular situs: solitus (S) or D-loop (D), inversus (I) or L-loop (L), ambiguous (A)

o Arteries situs:
 Solitus (S): spiral clockwise
* Ao crosses in front of RPA
 Inversus (I): spiral counter clockwise
* Ao crosses in front of LPA
 Alignment
* D-transposition/inversion (D): AoV to R of PV
* L-transposition/inversion (L): AoV to L of PV
* Ambiguous (A)

Question 6

Anderson classification

Answer 6

o Visceroatrial situs: solitus, inversus (RA on L, LA on R), isomerism (bilateral LA = polysplenia or RA = asplenia)
o Atrioventricular connections: discordant, concordant, ambiguous
o Ventriculoarterial connections: discordant, condordant, double outlet, single outlet
o Ao arch: left (L), right (R)