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8 Cards in this Set

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  • Back
What is the best way to approach CHD regardless of modality?
A sequential approach, whereby the heart and great vessels are analyzed segment by segment.
What is this approach?
1) Definition of ATRIAL situs

2) Type of ventricular loop

3) Type of cono-truncus

4) Position of great vessels

5) Intersegmental connections
How is atrial situs determined?
1) Define the morphology of the main bronchi and pulmonary arteries.

a) The right main bronchus is short and vertical, and has the right pulmonary artery coursing anterior to it.

b) The left main bronchus is longer arnd more horizontal. It has the left pulmonary artery coursing over (superior to) it.

2) The atrial situs follows the bronchial situs. So if the morphologically left bronchus/pulm artery is on the right side of the patient, there is atrial situs inversus.
What is both bronchi and pulmonary arteries appear the same bilaterally?
Situs ambibiguus
What can happen with situs ambiguus?
Patient will have either left or right morphology bilaterally
What if there are morphologically right bronchi with similar appearing pulmonary arteries bilaterally?
Patient will usually have right sided isomerism, thus asplenia.
What if morphologically left sided main bronchi and pulm arteries?
Paient will have left sided isomerism: Polysplenia, and azygos vein continuation of the IVC
Why azygos continuation?
Because the IVC is a right sided structure