Cyanosis surgery: Difference between revisions

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❑ Asymptomatic moderate to severe [[ pulmonary regurgitation]] after repaired [[TOF]]<br>
❑ Asymptomatic moderate to severe [[ pulmonary regurgitation]] after repaired [[TOF]]<br>
<span style="font-size:85%;color:red"> Pulmonary stenosis valvotomy<span style="color:red"> Pulmonary stenosis valvotomy:</span>]] Surgical or balloon valvotomy in case of severe PS during infancy or childhood is recommended. Both of interventions can result pulmonary regurgitation and right ventricle dilation  in the future and the need for pulmonary valve replacement.</span><br>
<span style="font-size:85%;color:red"> Pulmonary stenosis valvotomy<span style="color:red"> Surgical or balloon valvotomy in case of severe PS during infancy or childhood is recommended. Both of interventions can result pulmonary regurgitation and right ventricle dilation  in the future and the need for pulmonary valve replacement.</span><br>
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Revision as of 13:41, 27 October 2020

Cyanosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Recommendation for surgery in cyanotic heart disease

Recommendation for surgery in cyanotic congenital heart disease
Indications for repair of a scimitar vein in Anomalous pulmonary venous connection (TAPVC) (Class I, Level of Evidence B ):

❑ Decreased functional capacity
Right ventricle enlagment
❑ Net left to right shunt or QP/QS > 1.5/1
Pulmonary artery systolic pressure less than 50% systemic pressure
Pulmonary vascular resistance less than 1/3 of systemic resistance
❑ Repair at the time of closure of a sinus venous defect or ASD
Definition: Abnormal connection between pulmonary veins and systemic veins leading to right heart volume overload such as ASD

Indications for surgery in Anomalous Pulmonary Venous Connections (TAPVC)(Class 2a, Level of Evidence B) :

❑ Asymptomatic adults with right ventricle volume overload
❑ Large left to right shunt( QP/QS > 1.5/1
Pulmonary artery pressure <50% systemic pressure and pulmonary artery resistance <1/3 systemic resistance
❑ Evidence of Right ventricle volume overload and QP/QS>1.5/1

Indications for surgery repair or reoperation in Ebstein anomaly : (Class I, Level of Evidence B)

❑ Significant tricuspid regurgitation in the presence of the following:
Heart failure symptoms
❑ Decreased functional capacity
❑ Progressive right ventricular dysfunction by echocardiography or cardiac MRI
Definition: Malformation of tricuspid valve and right ventricle , atrialization of right ventricle, huge right atrium, accompanied by ASD, VSD, PS

Indications for surgery repair or reoperation in Ebstein anomaly:(Class 2a, Level of Evidence B)

❑ Significant tricuspid regurgitation in the presence of the following:
❑ Progressive right ventricle enlargement
❑ Systemic desaturation due to right to left shunt via ASD, VSD
Paradoxical emboli through ASD, VSD
Atrial tachycardia

Indication for Glenn anastomousis at the time of repair in Ebstein anomaly : (Class 2b, Level of Evidence B)

❑ Severe right ventricle dilation
❑ Severe right ventricular systolic dysfunctionbr ❑ Normal left ventricle function
❑ Normal left atrium or left ventricle end diastolic pressure
Glenn anastomosis: Bidirectional superior cavopulmonary anastomosis which is the connection between superior vena cava and pulmonary artery with bypassing right artium and right ventricle

Indication for pulmonary valve replacement ( surgical or percutaneous in Tetralogy of fallot (Class I, Level of Evidence B):

❑ Symptomatic Moderate to severe pulmonary regueritation after repaired TOF in which symptoms can not be explained otherwise.
Definition: The combination of Right ventricle hypertrophy, VSD, PS, Overridding aorta

Indication for pulmonary valve replacement ( surgical or percutaneous in Tetralogy of fallot : (Class 2a, Harm, Level of Evidence B)

❑ Asymptomatic moderate to severe pulmonary regurgitation after repaired TOF
Pulmonary stenosis valvotomy Surgical or balloon valvotomy in case of severe PS during infancy or childhood is recommended. Both of interventions can result pulmonary regurgitation and right ventricle dilation in the future and the need for pulmonary valve replacement.

References

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