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ACHD > Nomenclature > Flashcards

Nomenclature Flashcards

1
Q

What is the nomenclature approach used for ACHD?

A

Sequential Segmental Approach

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2
Q

Who proposed the sequential segmental approach?

A

Praagh in 1960s and revised by Anderson and colleagues

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3
Q

What are the basic building blocks of the SSA?

A

Atria, Ventricles and the Great Arteries, AV and VA connections

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4
Q

Morphological characteristics of RAA

A

Blunt triangular appendage

Broad junction to RA

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5
Q

Morphological characteristics of LAA

A

Tubular

Narrow junction to LA

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6
Q

Morphological characteristics of RA

A

Pectinate muscles extend from RAA to postero-inferior wall of RA

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7
Q

Morphological characteristics of LA

A

Smooth posterior wall of LA

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8
Q

What atrial arrangements can you have?

A

Situs solitus
Situs inversus
Situs ambiguous (Right/Left isomerism = 2 x RA/2xLA)

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9
Q

How are the morphological characteristics in the SAA identified?

A

Echocardiogram

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10
Q

Morphological characteristics of RV

A

Coarse apical trabeculations
Muscular infundibulum between TV and PV
Septomarginal trabeculation and moderator band

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11
Q

Morphological characteristics of LV

A

Fine apical trabeculations
Fibrous continuity valves
Smooth septal surface

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12
Q

Ventricular Patterns

A

Balanced (Normal)
RV/LV Hypoplasia
Primitive morphological ventricle

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13
Q

How can you determine which is the primary ventricles in hypo-plastic RV/LV?

A

Based on morphological characteristics of large ventricle
Small ventricle in front and above –> large ventricle is LV
Small ventricle behind and below –> large ventricle is RV

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14
Q

What is a primitive morphological ventricle?

A

Very rare

Mixed morphological characteristics of LV and RV

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15
Q

Ventricular Arrangements

A 
Normal
Ventricular inversion (mirror image)
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16
Q

In what order do we undergo SSA?

A

Atria
Ventricles
AV
VA

17
Q

AV Connection Analysis

A

Mode

Type

18
Q

AV Connection Mode analysis

A

Details on AV valves, Chordae, papillary muscles and annuli

19
Q

AV Connection Type

A

Which atrium is connected or not to the ventricle:

Biventricular and Univentricular Types

20
Q

Biventricular AV Connection Types

A

Concordant (Atrial Situs solitus/inversus)
Discordant (RA to LV; LA to RV)
Ambiguous (In atrial isomerism = situs ambiguous)

21
Q

Univentricular AV Connection Types

A 
Double Inlet (Both atria >50% connected to LV)
Absent AV connection (Usually RA not connected to RV)
If remnants of TV tissue, it is biventricular or double inlet with imperforate valve
22
Q

Modes of AV Connection

A 
2 perforate valves
1 perforate and 1 imperforate valve
Common AV valve
Straddling 
Over-riding
23
Q

Types of common AV Valve

A 
Balanced AVSD (equally above both ventricles)
Unbalanced AVSD (Greater part above one ventricle)
24
Q

Straddling AV Connection

A

Of left, right or both AV valves
Concerns tension apparatus of the valves (one or more chordae/papillary muscles attached to the myocardium in the wrong ventricle)

25
Q

Over-riding AV Connection

A

AV valves is over-riding the other ventricle that has the other AV orifice
Biventricular type of AV connection if over-riding <50%
Univentricular (double inlet) type of AV connection if over-riding>50%

26
Q

VA Connection Mode analysis

A

Details on arterial valves and annuli

27
Q

VA type analysis

A

Which ventricle is connected or not to which great artery

28
Q

Types of VA Connection

A

Concordant (normal ventricular pattern or ventricular inversion)
Discordant (Normal ventricular pattern/ventricular inversion)
Double outlet (both great arteries connected to one ventricles - usually RV)
Single outlet VA connection

29
Q

What are the types of single outlet VA connection?

A

Common arterial trunk (truncus arteriosus)
Single outlet aorta (pulmonary atresia)
Single outlet aorta (Absent pulmonary trunk and arteries)

30
Q

Modes of VA Connection

A

2 perforate valves
1 perforate and 1 imperforate valve
Over-riding (Bother arteries > 50% above RV: Double outlet VA connection)

ACHD (8 decks)

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