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NIGERIAN CARDIAC SOCIETY, 2005 UPDATE COURSE.

NIGERIAN CARDIAC SOCIETY, 2005 UPDATE COURSE. VENUE: UNTH, ENUGU. TOPIC: UPDATE IN MANAGEMENT OF NEONATES WITH CRITICAL PULMONARY AND AORTIC STENOSIS LECTURER: DR. J.C EZE FWACS DATE: MARCH 21, 2005. SEVERE PULMONARY STENOSIS WITHOUT VSD. Symptoms and Signs:. 1. Cyanosis

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NIGERIAN CARDIAC SOCIETY, 2005 UPDATE COURSE.

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  1. NIGERIAN CARDIAC SOCIETY,2005 UPDATE COURSE. VENUE: UNTH, ENUGU. TOPIC: UPDATE IN MANAGEMENT OF NEONATES WITH CRITICAL PULMONARY AND AORTIC STENOSIS LECTURER: DR. J.C EZE FWACS DATE: MARCH 21, 2005

  2. SEVERE PULMONARY STENOSIS WITHOUT VSD Symptoms and Signs: 1. Cyanosis 2. R sided C.H.F 3. R.V. lift 4. Systolic ejection click 5. Widely split S2 6. Grade I-VI/VI Systolic murmur

  3. PROBLEMS OF NEONATES • Supportive Care • Medical Therapy at ICU

  4. PATHOLOGY (i) Cusp Fusion (ii) 20 infundibular Stenosis

  5. INVESTIGATIONS I C X R ii ECG iii 2D Echo/3D Echo iv Cardiac Catherterization v Angiography

  6. DEFINITIVE TREATMENT • Immediate Surgery when indicated • Transventricular Valvotomy {closed heart surgery} • Resection and insertion of an outflow prosthetic patch {Extracorporeal circulation}

  7. AORTIC STENOSIS I. Anatomic a. Valvular b. Discrete membranous subvalvular c. Supravalvular d. Hypertrophic muscular subaortic ii. Physiologic

  8. PATHOLOGY • Effects of obstruction • 02 demand • L.V.H.F • Coronary insufficiency etc.

  9. SYMPTOMS AND SIGNS • L.V thrust at apex • Systolic thrill at the base etc. • Aortic type ejection click • Split 2nd Hs • Grade iii - v/vi, ejection systolic murmur

  10. INVESTIGATIONS i CXR ii ECG iii ECHO iv Cardiac Catheterization v Angio cardiography

  11. TREATMENT i Patient stabilization preoperatively ii Indication for surgery iii Operative technique

  12. COMPLICATIONS OF SURGERY - Regurgitation - Death

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