Surgical Treatment Of Congenital Heart Disease

Front 1

What is a Blalock-Taussig Shunt?

Back 1

An end to side anastomosis of a subclavian artery to the ipsilateral pulmonary artery

Front 2

What are some typical results of a Blalock-Taussig Shung procedure?

Back 2

1. asymmetry of the pulmonary arteries (the side of the shunt is enlarged)
2. Extra volume load on the left ventricle
3. Pulmonary vascular changes due to transmission of arterial pressures through the systemic shunt

Front 3

One modification of the Blalock-Taussig shunt procedure?

Back 3

using a graft to anastomose a systemic vessel (usually the subclavian artery) to the pulmonary artery

Front 4

What is a classic Glenn shunt?

Back 4

In a unidirectional Glenn shunt the SVC is anastomosed to the right pulmonary artery (which has been separated from the main and left pulmonary artery)

Front 5

What is a bidirectional Glenn shunt?

Back 5

End to side anastomosis of the SVC to the ipsilateral pulmonary artery (which remains in continuity with the main and left pulmonary arteries) so blood flows in two directions (to the right and left pulmonary arteries)

Front 6

What are two benefits of the bidirectional Glenn shunt to the classic Glenn?

Back 6

1. Increases flow of desaturated blood to the pulmonary arteries without volume overload of the left ventricle
2. Protects against the development of the pulmonary vascular disease that follows many systemic pulmonary shunts.

Front 7

What surgery is usually performed after a Glenn shunt?

Back 7

Fontan repair

Front 8

What is a Jatene procedure?

Back 8

Arterial switch procedure. Great vessels are transected above their respective valves and switched. Then the coronary arteries are replaced onto the systemic outflow vessel.

Front 9

When is a Fontan procedure utilized?

Back 9

Single ventricle
Tricuspid atresia
Hypoplastic right ventricle
other complex anomalies

Front 10

What is a Fontan procedure?

Back 10

Direct anastomosis or placement of a conduit (with or without a valve) from the right atrium to the main pulmonary artery.

Front 11

What does a Fontan procedure accomplish?

Back 11

Diverts systemic venous return to the lungs and bypasses the right ventricle

Front 12

Name some complications of the Fontan procedure

Back 12

1. Elevated systemic venous pressures
2. elevated right atrial pressure
3. thrombosis in the right heart chambers
4. pulmonary ateriovenous malformations

Front 13

What is a fenestrated Fontan procedure

Back 13

a small ASD is created to decompress the right atrium which can be closed at a later date

Front 14

What is a Mustard (or Senning) repair?

Back 14

Atrial repairs that were used to repair patients with d-TGA. The arterial switch procedure is the preferred method now.

Front 15

what is a Norwood procedure?

Back 15

two or three stage procedure.
1. Neo-aorta constructed using the proximal main pulmonary artery which is anastomosed to the descending aorta. The distal pulmonary artery is oversewn and a blalock-Taussig shunt carries systemic blood to the pulmonary arteries.
2. Bidirectional Glenn shunt is placed and BT shunt is ligated.
3. Conversion of Glenn to a Fontan

Front 16

In what patients is the Norwood procedure utilized?

Back 16

Hypoplastic left heart syndrome

Front 17

What is a Rashkind Balloon Septostomy?

Back 17

atrial septostomy performed via a percutaneous technique. A balloon is inflated in the left atrium and rapidly pulled back across the septum

Front 18

In what patient is a Rashkind Balloon Septostomy performed?

Back 18

d-TGV
tricuspid atresia

Front 19

What does a Rashkind balloon septostomy accomplish physiologically?

Back 19

allows better mixing of blood between the atrial chambers

Front 20

What is a Rastelli procedure?

Back 20

An external conduit is formed connecting the right ventricle to the pulmonary artery. Blood flows from the left ventricle to the ascending aorta through the VSD.

Front 21

In general when is a Blalock-Taussig (BT) shunt used?

Back 21

initial palliation of cyanotic lesions with decreased pulmonary flow

Front 22

In general when is a Glenn shunt used?

Back 22

complex cyanotic heart disease as initial stage of Fontan operation

Front 23

In general when is a Fontan used?

Back 23

complex heart disease not suitable for bi-ventricular repair (single ventricle physiology)

Front 24

In general when is a Mustard/Senning procedure used?

Back 24

D-TGA

Front 25

In general when is a Jatene procedure used?

Back 25

D-TGA

Front 26

In general when is a Norwood procedure used?

Back 26

Hypoplastic Left Heart Syndrome (HLHS)

Front 27

In what patients is a Rastelli procedure performed?

Back 27

(RV to PA conduit)
Pulmonary Atresia
VSD
Aortopulmonary collaterals
Tetralogy of Fallot
TGA with VSD and pulmonary stenosis

Front 28

Who gets heart transplants?

Back 28

Hypoplastic left heart syndrome
End stage CHD