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Adult Congenital Heart Disease - Introduction to General Medicine - Lecture Slides, Slides of Medicine

Adult Congenital Heart Disease, Development of Heart, Hypoplastic Left Heart Syndrome, Complex Chd, Spiral Truncoconal Septum, Subpulmonic Stenosis, Palliative Surgical Shunts are some points in Introduction to General Medicine lecture. This lecture is one of 61 lectures you can find here for this course.

Typology: Slides

2011/2012

Uploaded on 12/13/2012

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sethuraman_h34rt 🇮🇳

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Download Adult Congenital Heart Disease - Introduction to General Medicine - Lecture Slides and more Slides Medicine in PDF only on Docsity!

 Describe the changing profile of ACHD

 Describe the challenges in the transfer of care from pediatric to adult practitioners

 Review the development of the heart

 Describe the anatomy, natural history, surgical repair, and common adult presentations of tetralogy of Fallot, transposition of the great arteries, and hypoplastic left heart syndrome

 A gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance

 Overall incidence: 75 of every 1000 live births

 Incidence of moderate and severe CHD: 8 of every 1000 live births

 A gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance

 Overall incidence: 75 of every 1000 live births

 Incidence of moderate and severe CHD: 8 of every 1000 live births

 Over 90% of children survive to adulthood

 20,000 operations for CHD in the US each year

 Over 1 million adults in the US with CHD

 32 nd^ Bethesda Conference (2000)

 Regular evaluation at an ACHD center

 Health care passport

 Structured transfer/transition plan

 Co-management with cardiologists

having undergone advanced training

 Named by Etienne-Louis Arthur Fallot in 1888

 Approximately 10% of all complex CHD

 Single developmental error of the terminal portion of the spiral truncoconal septum

 Four distinct components: subpulmonic stenosis, VSD, overriding aorta, and RV hypertrophy

 Often accompanied by other anomalies

 Longest surgical history/most studied outcomes

 Palliative surgical shunts

 Classic/complete repair

 Infundibular muscle resection, VSD patch, & RVOT repair  Typically preformed between 4-6 months of age  Surgical risk: < 5%

 Survival rates: 85% at 30+ years

 Repaired

 RVOT obstruction  Pulmonary or tricuspid regurgitation

 Complete TGA or D-TGA

 Embryological inversion of the great arteries  Ventriculoarterial discordance

 Balloon atrial septostomy

 Developed by Rashkind (1965)  Enlarges the atrial communication

 Atrial switch

 Performed first by Senning (1958) and later modified by Mustard (1964)  Atrial baffle is created to direct venous return to the contralateral ventricle

 RV dysfunction

 Tricuspid insufficiency

 Bradyarrhythmias

 Atrial tachycardias

 Obstructed/leaky atrial baffle

 Coronary perfusion issues

 Supravalvar aortic and pulmonic stenosis

 Aortic root dilatation and valvular insufficiency

 Branch pulmonary stenosis

 Hypoplastic left-heart syndrome

 Hypoplastic right-heart syndrome (pulmonary atresia with intact ventricular septum)

 Tricuspid valve atresia

 Mitral valve atresia

 Double-inlet ventricle

 Atrioventricular canal defects

 Double outlet right ventricle