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Flashcards in Adult Congenital Surgery Deck (12):

What is primary cause of death for adult patients with cyanotic lesions

Arrhythmia followed by heart failure


What does Fontan conversion involve

Take down of the previously created venous connection and creation of an extra cardiac cavopulmonary connection with a conduit.


List surgeries that may require RVOT reconstruction

Tetralogy of Fallot
Double outlet right ventricle
Pulmonary atresia
Truncus arteriosus
Arterial switch prcoedure


What is Ebsteins Anomaly procedure

Tricuspid valve repair or replacement
Arrhythmia (Maze)


What are conduit options for RVOT

Percutaneous approach
Pulmonary homograft
aortic homograft
bovine jugular vein graft
bioprosthetic valve
mechanical prosthtetic valve


What are options for primary or secondary coartation of the aorta

coarctation resection and end to anastomosis
Onlay patch enlargement with tissue or posthetic patch
Synthetic tube interposition
Percutaneous approach can also be used.


What are the features of Scimitar syndrome

Right ventricle pulmonary vein draining the entire right lung into the IVC
Hypoplastic pulmonary parenchyma
Angiogram demonstrating "fir-tree" appearance
Anomalous pulmonary arterial supply
Dextroposition secondary to hypoplastic right lung


List treatment options for HOCM

Cardiac transplantation
Left ventricular myectomy
Septal reduction with ETOH ablation
Mitral valve replacement
Dual chamber pacing


What are indications for repairing coarctation in an adult

Non-invasive pressure difference of > 20 mmHg between upper and lower limbs regardless of symptoms but with upper limb hypertension (> 140/90mmHg in adults)
Patholoical blood pressure response during exercise
significant LVH


What are class IIa and IIb indications for adult coarction surgery

independent of pressure gradient, hypertensive pt with > 50% aortic narrowing relatiev to the aortic diameter at the level of diaphragm level


What are indications for interventions for right ventricular outflow tract obstruction

RVOT at any level regardless of symtpoms when doppler peak is > 64mmHg provided RV function is normal and no valve substitute is requires
PS vavlotomy should be the intervention of choice
if systolic RV is > 80mmhg


What are possible reasons for Fontan Revision

Pt present with extreme right atrial enlargment
right pulmonary vein compression
Protein-losing enteropathy
Systemic venous pathway obstruction
semilunar and atrioventricular valve dysfunction

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