Download Congenital Heart Defects: Decision Making for Cardiac by Antonio F. Corno MD, FRCS, FETCS (auth.) PDF

By Antonio F. Corno MD, FRCS, FETCS (auth.)

Expressly created to aid with selection making for surgical operation of congenital center defects, this new reference covers all proper aspects.

The Congenital center Defects are awarded with each one bankruptcy dedicated to a unmarried malformation, with prevalence, morphology, linked anomalies, pathophysiology, analysis (including scientific trend, electrocardiogram, chest X-ray, echocardiogram, cardiac catheterization with angiography), symptoms for surgery, info of surgical procedure, strength problems and literature references.

Morphology, pathophysiology and surgical operation of the defects are defined with schematic drawings, whereas photographs taken from morphologic specimens, echocardiographic and angiographic investigations in addition to from intra-operative pictures illustrate higher than any phrases the foremost issues of the decision-making approach for the surgical procedure of congenital center defects.

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Extra info for Congenital Heart Defects: Decision Making for Cardiac Surgery Volume 2 Less Common Defects

Example text

As a final comment on the indication for surgical treatment, it is highly unlikely that a single management strategy will be optimal for this very heterogeneous group of patients. I Surgical treatment • Pulmonary artery banding In these patients the achievement of an adequate pulmonary artery banding is particularly difficult, in consideration of the several in- I terrelated variables in continued evolution, particularly the need to obtain and maintain a low pulmonary artery pressure, an adequate balance between the systemic and pulmonary circulation, at the same time avoiding an excessive ventricular pressure overload.

The size of the patch is crucial, since too large of a patch will bulge into the right ventricle in systole, impairing the right ventricular function; too small of a patch will result in an elevated incidence of dehiscence. The suturing lines of the patch will be dictated by the position of the tension apparatus of the two I atrioventricular valves, the location of the two semilunar valves and the position of the ventricular septal defect. Staged ventricular septation consists of placing an apical patch and a second patch at the superior portion between the atrioventricular valves, using widely spaced interrupted sutures, with the addition of a pulmonary artery banding; the ventricular septation (with debanding) is completed 6-18 months later with a third patch.

In order to evaluate the size of the ventricular septal defect, and to define whether its size is restrictive or unrestrictive, generally its dimensions are related to the size of the corresponding aortic root. The second chamber is of right ventricle morphology, is always anterior, and is located either to the left or the right. The size of the outlet chamber is related to the degree of development and straddling of the tricuspid valve, in addition to the size of the ventricular septal defect.

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