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32 Cards in this Set
- Front
- Back
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what are some common operations of CHD'S?
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-shunts
-closures -PA banding -atrial baffles -releif or stenosis -great vessel switch -conduits |
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why is PA banding done?
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-to reduce blood flow and stop irreversable damage to the lungs
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what are the similarities and differences btw conduits and baffles?
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-they both are used to redirect blood flow
-Baffles are inside the heart -conduits are outside the heart |
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Explain ASD repair
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-may be done in a cath lab where two small umbrella shaped clamshell devices are placed on both the right and left side of the septum
-umbrellas are attached together, closing the hole -can also have surgical sutures or patches(dacron, or synthetic material)(done more in the past) -don't need to do open heart surgery |
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Explain how VSD repair is done?
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-closure done using sutures or a patch
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explain palliative surgery
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-banding of the pulmonary artery
-small incision in the chest -synthetic band is placed around the pulmonary artery to decreased flow of blood and pressure in the pulmonary artery |
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what is pulmonary banding used for?
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-VSD's
-AV septal defects -Trunkus arteriosus -TV atresia -Single ventricle anatomy |
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Explain the ways in which PDA's can be repaired?
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-PDA is usually ligated w/ two or three separate sutures through the ductus
-Can also do and amplatz plug or coil(permanent) |
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Aorta/pulnonary valvulotomy
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-have sufficient releif of aortic or pulmonary valve obstruction
-commssures of the native valves are incised such that the function of the valve is normal -usually regurge is seen post op |
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Explain the Ross procedure?
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-done to replace a malformed aortic valve using a patients pulmonic valve
-a valve replacement is then done on the pulmonic valve from a deceased human donor -autograft |
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explain the jantene procedure
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-arterial switch(aorta switched with PA)
-coronary arteries are detached from the AO, and reconnected to the pulmonary artery -D-transposiiton -transpose the great vessels and reimplant the coronary arteries to new aorta |
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what are the different type of shunts that can be put in the heart?
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-blalock-Taussig
-potts -waterston |
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explain the blalock-taussig shunt?
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-most common shunt done
-temporary -connection btw subclavian artery on the side opposite the aortic arch and the lt pulmonary artery -allows blood to flow to the lungs to pick up O2 |
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when are blalock-taussig shunts done?
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-tricuspid atresia
-pulmonary stenosis -pulmonary atresia |
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Explain potts shunts?
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-anastamosis of the descending ao to left pulmonary artery
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explain waterston shunts?
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-ascending ao to rt pulmonary artery
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Bidirectional glenn procedure
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-tricuspid atresia
-connection of the SVC to an undivided pulmonary artery -temporary surgical procedure for hearts w/ only one usable ventricle |
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Explain the fontan procedure?
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-Done for tricuspid atresia
-separates the RA from the rest of the heart via a gore tex baffle -SVC and IVC blood flows into the RA -RA appendage is sewn to distal portion of the PA, providing desaturated venous blood flow to the pulmonary artery |
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Explain the types of repair done for co-artcation of the AO?
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1. older child-the area of narrowing is excised and two ends are reattached
2. younger child-can be quite narrow, so the subclavian artery is ligated and divided(subclavian flap procedure0 3. balloon dialation angiography |
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classic glen procedure
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-tricuspid atresia
-connectino of the SVC to a ligated right pulmonary artery and the SSVC is ligated as it enters the RA |
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how are endocardial cushion defects repaired?
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-patches for VSD and ASD
-common AV valve is divided and each side is reattached to teh patch @ the appropriate level |
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infundibular ressection
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-done w/ RVOT obstruction-TOF
-resection of muscle tissue in the subvalvular area of the RVOT-provides releif |
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explain the mustard/senning procedure?
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-arterial switch: transposition of the great arteries
-Atrial septum is excised w/ atrial baffle: -systemic venous return to MV and LV -pulmonary venous return is baffled to V and RV -used for d-transposition of the great arteries |
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pulmonary valvulectomy
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-very abnomral pulmonary valve removal of the valve provides releif of obstruction
-regurge is handled well(sometimes -later date may have a prosthetic valve |
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what are the indications for the rastelli procedure?
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-double outlet right ventricle
-pulmonic atresia and VSD -truncus |
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Explain the rastelli procedure?
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-external conduit from RV to PA and an intraventricular conduit from the LV to the AO
-VSD gaft -Done btw 1 and 2 years old -meanwhile, there is a blalock-tussig shunt |
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What is the norwood procedure?
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Staged reconstruction of hyperplastic LT heart syndrome: Done in 3 stages
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explain stage one of the norwod procedure>?
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-done on the first day of life
-small AO and dialated PA are combined to form one large vessel -coronary arteries commoff one great vessel -branch pulmonary arteries are disconnected from the main pulmonary artery -a shunt is created btw the desc. ao and the pulmonary arteries. (BT shunt) |
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explain stage 2 of fixing HLHS
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aka stage 2 norwood procedure:
-hemi-fontan procedure -SVC is transected and each end is sewn into the right pulmonary artery(bidirectional glenn) -ligation of BT shunt |
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explain stage 3 of the norwood procedure
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-IVC and SVC are baffled away from the RA
-systemic venous return doesn't enter the RA, but goes directly into the pulmonary arteries |
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what are the purposes of the stages of the norwood procedure?
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Stage 1&2-releives blood flow problems to and from the lungs
Stage 3-used to further improve circulation |
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when the norwood procedure is done, explain how the blood flow?
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-pulmonary venous return enters the LA and crosses the atrial septum
-passes from RA to RV through to TV and is pumped out the new AO |
