Exam (elaborations)
ALU 301, Ch. 13 CONGENITAL HEART DISEASE QUESTIONS AND ANSWERS
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ALU 301, Ch. 13 CONGENITAL HEART DISEASE QUESTIONS AND ANSWERS
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Peak gradient is 50-80 mmHg. From 1955 to 1980, the intervention was open heart
valvotomy. After 1985, the majority of cases undergo balloon valvuloplasty, which
seems to work equally well in both adults and children. Results of valvotomy and
balloon valvuloplasty are similar. Follow-up for balloon valvuloplasty is currently
limited to about 20 years.
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Moderate-Severe PS
,Peak gradient across the valve is 10-30 mmHg. These cases almost never need
intervention, in contrast to aortic valve stenosis. There is no progression of the valve
narrowing. The risk of endocarditis is low. There are several long-term studies
available with no deaths with up to 35 years follow-up
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Mild PS
The current doctor has no information regarding the type of lesion or where
operated. The underwriting approach with no information in a young adult with
congenital heart disease can vary depending on the size of the case. Scar location
obtained by interview or paramedical examination can direct the medical director to
the associated surgery performed. Minimal evidence would include a current EKG,
chest X-ray, and report of any murmurs by the family doctor or routine examiner. A
current echocardiogram by a reliable laboratory can provide valuable information
and should be considered for larger cases.
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A common underwriting scenario is a young adult with a history of
congenital heart surgery before the age of five years.
is a condition in which the ductus arteriosus (DA), the fetal connection between the
aorta and the main pulmonary artery, fails to close normally after birth.
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, Patent ductus arteriosus (PDA)
If the shunt flow is less than 20% of pulmonary blood flow, the mortality ratio in long-
term follow-up is close to 100%. If found in infancy, 50% of these defects will go on to
spontaneous closure. Chances of closure continue even after age 20.
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A small VSD is defined as a defect less than 5mm in diameter with normal
right ventricular and pulmonary artery pressures and a small left-to-right
shunt.
the second most common ASD. This defect is located in the lower part of the septum
and can be associated with a mitral valve defect
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Primum ASD is
can be dealt with the same as secundum ASD. The one additional concern is that
surgery can interrupt electrical transmission within the right atrium, sick sinus
syndrome can develop, and occasionally pacing may be needed
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Sinus Venosus Atrial Septal Defect Repaired
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