Echo 530

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Echo 530
2010-06-05 01:57:37

Post Operative CHD
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  1. List 2 ASD repairs:
    • 2 small umbrell shaped "clamshell" devices placed on both the Rt & Lt side of septum
    • 2 umbrellas attached together closing hole in heart

    Surgical sutures/patches = Dacron or synthetic material
  2. Describe pulmonary banding and what it's used for.
    Constriction of MPA to decrease PA flow

    • VSD
    • AV septal defects
    • Truncus arteriosus
    • TV atresia
    • single ventricle anatomy
  3. Describe the Ross procedure
    Replace malformed aortic valve using the patients pulmonic valve.
  4. Describe the Jatene procedure and what it is used for.
    Arterial switch......great vessels transected and reanastomosed
  5. Describe the Bi-directional Glenn procedure and what it is used for.
    Tricuspid Atresia

    • Connection of SVC --> undivided Pulmonary Artery
    • Temporary surgical procedure for hearts with only 1 usable ventricle
  6. Describe Coarctation repairs: (2)
    • 1. Older child - area of narrowing excised and 2 ends reattached
    • Younger child - can be quite narrow. Subclavian artery ligated and divided (subclavian flap procedure)
    • 2. Balloon dilation angiography
  7. Describe the Fontan procedure and what it's used for.
    Tricuspid Atresia

    • Separates RA from rest of heart via GoreTex baffle
    • SVC and IVC blood flows into RA
    • RAA is sewn to distal portion of PA providing desaturated venous blood to PA
  8. Describe the Mustard/Senning procedure and what it's used for.
    • Atrial switch: transposition of great arteries
    • atrial septum excised with atrial baffle, redirection systemic venous return to MV and LV while pulmonary venous return is baffled to TV and RV.
  9. List the 3 stages of Norwood procedure.
    Staged reconstruction of HLHS

    1. Norwood - small AO and dilated PA combined to form 1 large vessel. Branch PA disconnected and shunt created btw descending AO and Pulmonary arteries

    2. Hemi Fontan - SVC transected & each end sewn into RPA (Bidirectional Glen)

    3. Baffles - IVC & SVC are baffled away from RA; systemic venous return doesn't enter the RA but goes directly to pulmonary arteries
  10. Describe the Rastelli Procedure and what it's used for.
    Double Outlet Right Ventricle or Pulmonary Atresia

    External conduit from RV to PA and an intraventricular conduit from LV to AO
  11. List 3 common shunts that are performed and what they are used for.
    • Shunts
    • 1. Blalock-Taussig - connection btw subc a on opp side of ao arch and PA (permanent ductus arteriosus). Allows blood to flow to lungs to pick up O2

    2. Potts anastomosis - descending AO to LPA

    3. Waterston shunt - ascending AO to RPA
  12. Stage 1 and 2 of the Norwood procedure relieve ________________ ________________ problems to and from lungs.

    Stage 3 is used to further improve ____________________.
    • blood flow
    • circulation

    LA-->IAS-->RA-->RV-->new AO
  13. What do you look for post operatively with the Norwood procedure?
    residual flow (regurge) PDA ligated......