AP III Exam 1 - CHD part 1

  1. What is the rate of congenital heart dz births?
    • 8 in 1000
    • 85% will survive into adulthood
  2. Define "repaired" congenital heart dz and which defects fall into this category.
    • No impact on pt's longevity, physical status or need for further medical care. 
    • PDA ligation
    • repair of secundum ASD in 1st decade
    • uncomplicated VSD in first yr (possibly)
  3. Ventricular septal defect (VSD) causes a __ --> ___ shunt.  This is the _____ _______ ______, found in 16.6% of CHD.. Repair invlolves _______ of defect, commonly with ______ _____.
    • L R
    • Most common defect
    • closure
    • synthetic cloth
  4. Describe why VSD can cause CHF:
    • After birth, PVR will fall, and therefor RV will fall.  This decrease (along with increasing systemic pressure) causes an increased gradient btw the L and R ventricles and blood will flow back into R from L side. 
    • CHF occurs when Qp is 2x Qs.
  5. What side effects are seen if VSD is repaired later in life?
    • elevated PVR
    • Excess RV workload
    • decreased exercise tolerance
  6. What is CAVC?
    • Atrioventricular Canal Defects
    • AKA- endocardial cushion, atrioventricular septal defect
  7. CAVC is common with ________ ___.  Describe this defect:
    • trisomy 21
    • open wall between chambers (like knocking out walls in apt to make it a studio.  Often only one av valve that must be made into 2 surgically.
  8. What is tx for CAVC?
    repair of VSD, ASD, valves  (making 1 into 2).
  9. What problems can occur with CAVC?
    • Incomplete closure of ASD or VSD
    • Stenosis or insufficient valves
    • elevated PVR (especially if repaired later)
    • *** DS pt's often have sleep apnea and develop high PVR more easily than non downs pt's.
  10. Tetralogy of Fallot has four associated lesions:
    • VSD
    • pulmoary stenosis
    • overriding aorta
    • RV hypertrophy
  11. TOF pt's after surgery are _____ but not ______
    • fixed
    • repaired
  12. What are the surgical goals of TOF repair?
    • Close VSD
    • relieve PS or RV outflow tract obstruction (RVOTO)
  13. with TOF RVOTO can be what three things?
    how can this be treated and what can be a problem?
    • 1- muscular stenosis
    • 2- valvular or annular stenosis
    • 3- supravalvular stenosis
    • transannular patch- increases volume work of RV, dilation may occur leading to possible regurge of tricuspid valve over time
  14. TOF is a ___ to ____ shunt, and division of PA and Aorta during embryonic development is ____.
    • R to L
    • unequal
Card Set
AP III Exam 1 - CHD part 1
congenital heart dz