Surgery Flashcards
AV nodal conduction location in perimembranous VSD
Posterior/inferior rim of VSD
Which type of VSD has highest risk for AI
Doubly committed/sub pulmonary/supra cristal
AVSD Rastelli classifications
Based on superior bridging leaflet
- Type A is attachments to the crest of the septum
- Type B is straddling attachments
- Type C is no attachments
How is Trisomy 21 a protective factor in AVSD repair
Have more left AVV tissue in general so lower risk of AVV stenosis
What is Rastelli operation
Create a baffle from LV to aorta
What is a Nikaidoh operation
Posterior translocation of aorta to LV, VSD closure, connect PAs to RV (conduit or patch)
What is a REV operation
Excision of conus and then LV to aorta baffle and PAs to RV connection (direct with patch or conduit)
Simple definition of DORV
Conus under both semilunar valves
DORV with subaortic (or doubly committed) VSD and no PS physiology and repair
VSD physiology
- Baffle at 6-12 months, PA band if heart failure before
DORV with subaortic (or doubly committed) VSD and PS physiology and repair
ToF physiology
- Tet repair at 4-6 months (BTT shunt if needing Qp before)
DORV with subpulmonary VSD (Taussig Bing anomaly)
Transposition physiology
If PS: repair with REV, Rastelli or Nikaidoh
If arch problems: repair with baffle, arterial switch and arch repair
DORV with non-committed VSD
Remote VSD physiology
- PA band then complex repair at > 8 months or single ventricle
Tricuspid atresia types
Type 1: Normally related
Type 2: D-TGA
Type 3: L-TGA
A = atresia
B = balanced
C = overcirculated
Waterston vs Mee vs Potts shunts
- Waterston RPA to ascending aorta
- Potts LPA to descending aorta
- Mee MPA to ascending aorta
Normal proximal arch size (in setting of coarc repair lateral vs front)
-2 Z score
> 60% ascending aorta
Wt in kg + 1
