Peds CV exam 2 Flashcards
(23 cards)
What influences shunting in ASDs/PFO
ventricular compliance
AV valve function
What influences shunts in VSDs/PDAs
Pulmonary vascular resistance
Systemic vascular resistance
What are the consequences of a low PVR with a left to right shunt
- volume overload of lungs
- increased workload for LV maintaining cardiac output
What are some defects that are associated with a right to left shunt (4)
Truncus
Transposition
TOF
HLHS
What are the hemodynamic goals of a patient with a right to left shunt
- Avoid decrease in SVR
- Decrease PVR
- increase FiO2
- hyperventilate
oxygen pulmonary vasodilator
CO2 causes pulmonary vasoconstriction
What effect does a right to left shunt have on an inhaled induction
prolonged
R -> L shunt will ____ the speed on an IV induction
increase
emboli are a serious concern with what shunt physiology
right to left
Hemodynamic goals of a left to right shunt
- Avoid increase in SVR
- avoid decrease in PVR
- use low FiO2 / subatmospheric
- avoid hyperventilation
Blood flow in mixing lesions is dependent on ________
vascular resistance
In obstructive lesions the ____ provides systemic flow
PDA
Primum ASD is in the ____ part of the atrial septum and is near the ____ valve
inferior; AV
Secundum ASD is near ______ _____ .
similar to PFO
fossa ovalis
Sinus venosus is ____ in the atrial septum and is close to ____
high; superior vena cava
ASDs are often closed via
percutaneous catheter device
Most common CHD
VSD
VSDs can be closed via
percutaneous device
Following VSD closure pHTN may occur if the VSD was ____ with a large ____ to ____ shunt
unrestricive ; left to right
Prostaglandins will prevent or assist closing a PDA
prevent
TGA needs a ____ to survive
2 options
VSD or PDA
Anesthesia for truncus
- intubated/ inotropes
- irradiated blood
- calcium levels
- iNO
