Congenital Heart Defects Flashcards by Brandon Edmondson

how is LA pressure affected by low pulm blood flow

low RA pressure

How well did you know this?

Not at all

Perfectly

ductus venosus

shunts blood from unbilical vein to IVC bypassing the liver

How well did you know this?

Not at all

Perfectly

foramen ovale

shunts blood from the RA to the LA bypassing the lungs

How well did you know this?

Not at all

Perfectly

ductus arteriosus

shunts blood from the pulm artery to aorta bypassing the lungs

How well did you know this?

Not at all

Perfectly

how many umbilical veins and arteries and what do they carry

1 umbilical vein carries oxygenated blood to fetus from mom

2 umbilical arteries carry deoxygenated blood from the fetus to mother

How well did you know this?

Not at all

Perfectly

how does atelectasis affect PVR?

^ PVR

PEEP can also ^ PVR though

How well did you know this?

Not at all

Perfectly

how would fluid bolus affect SVR?

^ SVR

How well did you know this?

Not at all

Perfectly

list the cyanotic R-L shunts

tetrallogy of fallot
transposition of the great arteries
truncus arteriosus
total anomalous pulm venous constriction

How well did you know this?

Not at all

Perfectly

how to r-l cyanotic shunts affect inductiontimes

faster IV induction
slower inhalation induction

How well did you know this?

Not at all

Perfectly

list the L-R a-cyanotic shunts

vent septal defect
atrial septal defect
patent ductus arteriosus
coarctation of the aorta

How well did you know this?

Not at all

Perfectly

most common L-R acyanotic shunt?

vent septal defect

How well did you know this?

Not at all

Perfectly

how to L-R a-cyanotic shunts affect induction times?

negligible effect on inhalation induction

possible prolongs IV induction

How well did you know this?

Not at all

Perfectly

what is eisenmenger syndrome

L-R shunts becomes R-L shunt 2ndary to PHTN

How well did you know this?

Not at all

Perfectly

whath is the most common congenital heart anomoly?

Tetralogy of fallot

How well did you know this?

Not at all

Perfectly

4 defects in tetralogy of fallot

RV outlfow tract obstruction
RV hypertrophy
VSD from septal malalignment
overriding aorta that receives blood from both ventricles

How well did you know this?

Not at all

Perfectly

name this condition

Tetrallogy of fallot

How well did you know this?

Not at all

Perfectly

What is a TET spell, S/S, cause, adn tx

from ^ SNS activity (crying or something)

hypoxemia and cyanosis

tx: increase preload and SVR

How well did you know this?

Not at all

Perfectly

anesthetic considerations and goals for tetraology of fallot

ensure adequete preload and SVR

prevent ^ in PVR

maintain contractility and HR

How well did you know this?

Not at all

Perfectly

bes induction agent in tetrallogy of fallot?

ketamine

How well did you know this?

Not at all

Perfectly

avoid what drugs in tetrallogy of fallot? why?

morphine
meperidine
atracurium

(histamine release)

inotropes can worsen RVOT obstruction

How well did you know this?

Not at all

Perfectly

severity of tetrallogy of fallot is highly correclated to what?

PVR/RV obstruction

How well did you know this?

Not at all

Perfectly

one way body tries to compensate in tetrallogy of fallot and the potential consequence?

erythopoeisis > polycythemia > ^risk of thromboembolism and stroke

How well did you know this?

Not at all

Perfectly

heart with tetrallogy of fallot might take on what apperance on x-ray

boot shaped apperance

How well did you know this?

Not at all

Perfectly

most common congenital cardiac defect in children?

VSD

How well did you know this?

Not at all

Perfectly

most common congenital cardiac defect in adults?

bicuspid aortic valve

most common type of VSD

perimembranous in middle of ventricular septum, just below septal leaflet of the tricuspid valve

most common site of ASD

fossa ovalis

how do ASD affect hemodynamic effects of anesthetic agents?

hemodynamic effects of anesthetic agents in ASD are usually well tolerated

three types of ASDs

secundum primum sinus venosus

where is secundum ASD?

middle of spetum

what kind of ASD is the most common?

secundum 80% of ASDs

where is primum ASD?

lower region of atrial septum

where is sinus venosus ASD?

just below of above the IVC

where does coarctation of teh aorta occur?

typically just before or after ductus arteriosus. rarely proximal to L subclavian artery

hemodynamic effects of coarctation of the aorta

^Afterload ^SBP in UE decreased SBP in lower extremities

lower body perfusion in the setting or aortic coarctation relies on what?

patent ductus arteriosus

what can you give to keep PDA open in coarctation of the aorta until surgery?

prostaglandin E1

when might you notice mild to moderate coarctation of the aorta?

it can go unnoticed for years

two types of coarctation, when they present, and which is more common?

pre-ductal less common, usually presents as neonate post ductal, more common, usually prsents in adults

what syndrome is strongly associated with coarctation of the aorta

turner syndrome

risk of aortic cross clamp in open procedure for coarctation of the aorta?

paraplegia is the risk

where should you monitor spo2 in coarctation of the aorta

RUE

what surgical approach to repairing coarcation of the aorta have gained popularity?

trancatheter approach

Ebsteins anomaly

displacement of tricuspid valve right atrial dilation atrialization of the RV usually ASD or PFO present

what can happen to IV drugs in ebsteins anomaly?

can pool in the RA

what arrhythmia is common in ebsteins anomaly?

SVT

what is common post op with ebsteins anomaly?

RV failure

name this condition

ebsteins anomaly

tranposition of the great arteries

parallel circulation medical emergency

survival in transposition of the great arteries depends on what?

mixing of blood through ASD, VSD or PFO

temp fix for transposition of the great arteries

protsaglandins to keep PDA open

what is rashkind procedure

creates intraarterial pathway to allow some oxygenated blood to reach the systemic circulation

definitive fix for transposition of the great arteries

intraarterial baffle and arterial switch

what happens in truncus arteriosis

1 artery for blood flow to pul ciruculation systemic circulation coronary circulation

what else is usually present in truncus arteriosis

large VSD

what happesn with ^pulm blood flow or decrased PVR in truncus arteriosus?

steals blood flow from systemic and coronary circulation

surgical correction for truncus arteriosus entails what?

close VSD discconect pulm arterty place graft between RV and pulm A to provide blood flow to the lungs

name this condition

truncus arteriosus

three main things for hypoplastic left heart syndrome

single ventricle pumping to entire body pulm blood flow is passive avoid anything that ^PVR

4 things that happen in hypoplastic L heart syndrome

hypoplastic LV hypplastic aortic arch mitral and aortic stenosis or atresia ductal dependent circulation

surgical goal in hypoplastic left heart

seperate pulm and systemic circulation

when does norwood stage 1 occur and what happens

neonatal period aortic reconstruction pulm arteries disconnected from pulm trunk, shunt from sublcavian arteries or RV

when does norwood stage 2 happen and does teh surgical procedure do?

3-6months new connection between SVC and pulm arteries

when does norwood 3 (fontan) procedure happne and what does it do?

2-4yrs conversion to fontan circulation IVC connected to pulm artery with a conduit

considerations after fontan procedure

single ventricle that pumps systemic circulation pulm blood flow is passive from SVC/IVC to Pulm A. minimze PPV as it will decrease pulm blood flow patients are pre-load dependent so dont let them get dry.

what is this condtion

hypoplastic left heart syndrome

Congenital Heart Defects Flashcards

(66 cards)