CARDIO: Defects with decreased pulmonary BF (Tetralogy of Fallot)
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TETRALOGY OF FALLOT:
-includes four defects: VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy
if pulmonary vascular resistance is higher than systemic resistance, the shunt is from right to left; if systemic resistance is higher than pulmonary resistance, the shunt is from left to right.
- -cyanotic @ birth or may have mild cyanosis that progresses over the first year of life as the pulmonic stenosis worsens.
- -acute episodes of cyanosis and hypoxia (hypercyanotic spells), called BLUE SPELLS or TET SPELLS, occur when the infant's O2 requirements exceed the blood supply, such as periods of crying, feeding or defecating.
- -increasing cyanosis, squatting, clubbing of fingers, and poor growth.
- -squatting: compensatory mechanism to facilitate increase return of BF to the heart for oxygenation.
- -clubbing: abn enlargement in distal phalanges; seen in fingers.
- 1. PALLIATIVE SHUNT:
- -shunt increases pulmonary BF and increases O2 saturation in infants who cannot undergo primary repair.
- -the shunt provides pulmonary BF to the pulmonary arteries frm the left or right subclavian artery.
- 2. COMPLETE REPAIR:
- -performed in the first year of life
- -requires a median sternotomy and cardiopulmonary bypass
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