Tetralogy of Fallot Flashcards
What are the characteristics of TET?
- ASD and large VSD
- RVOT obstuction or PS
- RVH
- PA atresia
- Large overriding AO
What does atresia mean?
Not there; remnant of.
What went wrong during fetal development in order to cause TET?
Truncus septation did not occur normally and there is an abnormality of the truncal and conal swellings.
What happens to the AO in TET?
It is abnormally large, with a big LVOT that is not positioned correctly. It overrides the IVS.
What happens to the PA in TET?
It is very small and atretic, which leads to PS.
What are the physical findings in a Pt with TET?
The Pt may have a bluish tinge because TET is a cyanotic lesion that causes poor gas exchange, poor profusion, and low O2.
What is clubbing?
Widening of the fingertips and abnormalities of the nail beds due to interference of flow and dilatation of the capillary beds. It will not go away.
What is squatting and what does it help relieve?
The baby squats down to relieve pressure in the RV. It stops venous flow by increasing pressure in the abdomen.
What is the most severe form of TET?
Pulmonary atresia with severe RVOT obstruction.
What are associated congenital lesions in TET?
- Coronary anomolies
- Bidirectional shunting
- ASD
- Right sided arch (in 25% of cases)
- Bicuspid Pulmonic valve
With new advancements in medicine how long after birth is a baby with TET taken into surgery?
Surgery is done within the first 6 months.
What are the surgical repairs done for TET?
- BT shunt (subclavian attached to RPA)
- ASD & VSD closed
- Closure of the PDA
- In PS the RVOT can be resected and reconstructed with a gortex graft in the PA.
- Pt may get a new pulmonic valve later in life
What does mortality mean?
Death
What does morbidity mean?
Incidence of disease.
What are some surgical complications with TET?
- Right heart failure
- Sudden death
- Ventricular arrhythmias
- Growth retardation
- Infection (due to abnormal myocardium)
- SBE: subacute bacterial endocarditis
- Pacemaker
