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Principal Groups of CHD

Principal Groups of CHD. Acyanotic CHD L't-to-R't shunt group Obstruction group Cyanotic CHD Obstruction group Venous mixture group. Three Basic Lesions of CHD. Defect e.g. : ASD , VSD Obstruction e.g. : AS , PS

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Principal Groups of CHD

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  1. Principal Groups of CHD • Acyanotic CHD L't-to-R't shunt group Obstruction group • Cyanotic CHD Obstruction group Venous mixture group

  2. Three Basic Lesions of CHD • Defect e.g. : ASD , VSD • Obstruction e.g. : AS , PS • Congenital malformation (Transposition ,Hypoplasia) e.g. : TGA , HLHS

  3. Acyanotic CHD c L't-to-R't Shunt • ASD (atrial septal defect) • VSD (ventricular septal defect) • CAVC (Complete Atrioventricular Canal ) • PDA (patent ductus arteriosus)

  4. Acyanotic CHD c Obstruction • CoA (Coarctation of Aorta) • Congenital AS (Aortic Stenosis) • Congenital PS (Pulmonary Stenosis)

  5. Cyanotic CHD c Obstruction • ToF (Tetralogy of Fallot) • Tricuspid Atresia • Ebstein's anomaly

  6. Cyanotic CHD c Venous Mixture • TAPVR (Tatal anomalous pulmonary venous Return) • Truncus Arteriosus • TGA(Transposition of Great Artery) • HLHS(Hypoplastic Left Heart Syndrome) • Single Ventricle Variants • Common Atrium

  7. Acyanotic CHD c L-to-R Shunt • e.g. : ASD ,VSD ,CACV ,PDA • Main lesion : Defect • Pulmonary blood flow • Ventricular volume load

  8. Acyanotic CHD c Obstruction • e.g. : CoA , AS , PS • Main lesion : Obstruction • Ventricular Pressure Load

  9. Cyanotic CHD c Obstruction • e.g.: ToF , Tricuspid atresia , Ebstein's anomaly • Main lesion : Obstruction • Associated lesion : Defect • Pulmonary Blood Flow

  10. Cyanotic CHD c Venous Mixture • e.g.: TGA , TAPVR , Truncus Arteriosus, Common Atrium , Single V. ,HLHS • Main lesion: Congenital Malformation (Transposition , Hypoplasia) • Associated lesion:Defect and/or obstruction • Pulmonary Blood Flow • Ventricular volume load

  11. Palliative Surgery ( I ) Pulmonary Blood Flow • PA Banding Pulmonary Blood Flow • Blalock-Taussig shunt (Modified or Classical) • Waterston shunt • Pott's shunt • Central shunt

  12. Palliative Surgery ( II ) Venous Mixing • Blalock-Hanlon shunt • Balloon Atrial Septostomy • Blade Atrial Septectomy

  13. Closed Heart Surgery • PDA ( ligation or division ) • CoA repair • Interrupted Aorta repair • Pulmonary Valvotomy (Brock Procedure)

  14. Open Heart Surgery • 1953, Dr. Gibbon in USA • Cardiopulmonary bypass support • Intracardiac repair of ASD under direct vision

  15. Acyanotic CHD c Shunt • Indications of Surgery Failure to thrive Congestive heart failure Qp/Qs >1.5 Progressive Pulmonary vascular change • Timing of Surgery At any age Prevent Eisenmenger's complex Perimembranous VSD varied (30% spontaneous closure)

  16. Acyanotic CHD c Obstruction • Indications of Surgery Pressure gradient > 50mmHg Progressive heart failure • Timing of Surgery At any age Mostly during infancy

  17. Cyanotic CHD c Obstruction • Indications of Surgery Symptoms and signs Depends on size of PA • Timing of Surgery Primary repair during infancy Staged repair before school age

  18. Cyanotic CHD c Venous Mixture • Indications of Surgery Failure to thrive Varied in single ventricle variants • Timing of Surgery Primary repair during infancy Staged repair before school age

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