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Pediatric Echocardiography
Pediatric Echo
167
Health Care
Post-Graduate
07/14/2014

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Term
Atrial Situs Solitus
Definition
RA Located on the right, LA on left
Term
Atrial Situs Inversus
Definition
RA on left, LA on right
Term
Bulboventricular loop
Definition
Location of the morphological ventricles
Term
D-loop
Definition
Inutero vintricles twisted rightward, morphological RV on right
Term
L-loop
Definition
Inutero verntricles twisted leftward, morphalogical RV on left
Term
Concordance
Definition
Proper connection
Term
Discordance
Definition
Abnormal connection
Term
Atrial Septal Defects (ASD)
Definition
Communication between left and right atrium.
6% of CHD
Spontaneous closure within 2 years but unlikely
Term
4 types of ASD
Definition
Sinus venosus (6-8%)
Septum secundum (70%)
Septum primum (20%)
Coronary sinus (least common)
Term
Sinus Venosus ASD
Definition
Most superior region near entrance of SVC/IVC
Term
Associated Defect Sinus Venosus ASD
Definition
Anomalous pulmonary veins
Term
Septum Secundum ASD
Definition
Central portion of septum
Term
Associated Defect Septum Secundum ASD
Definition
MVP
Term
Septum Primum ASD
Definition
Inferior portion of septum near AV valves
Term
Associated Defect Septum Primum ASD
Definition
Cleft MV, Endocardial cushion defect
Term
ASD Treatment
Definition
Transcatheter closure, surgical repair with Dacon patch
Term
Patent Foramen Ovale (PFO)
Definition
Flap is stil open, blood crosses IAS
Term
Ventricula Septal Defects (VSD)
Definition
A hole in IVS
20-25% of CHD
60-70% spontaneously close
Term
4 Types of VSD
Definition
Membranous
Muscular
Outlet
Inlet
Term
Membranous VSD
Definition
80% of VSD's
Hole in small thin tussue below AO and above TV
Term
Muscular VSD
Definition
5-20% of VSD's
Hole in muscular tissue from membranous septum to apex
Term
Outlet VSD
Definition
5-7%
In the RVOT proximal to the PA
Superior to muscular septum inferior to great vessels
Term
Inlet VSD
Definition
5-8% of VSD's
Posterior and inferiorly beneath the TV superior region of septum
Term
Surgical repair of VSD
Definition
Dacron patch, transcatheter closur
Term
VSD associated Defects
Definition
Coarctation of AO, ASD, PFO, PDA, Eisenmenger's complex and Endocardial cushion defect
Term
Small VSD Classification
Definition
Restrictive, <0.5cm^2
Term
Moderate VSD Classification
Definition
0.5-1cm^2
Term
Large VSD Classification
Definition
Unrestrictive, >1cm^2
Term
Patent Ductus Arteriosus (PDA)
Definition
Connection between the Aorta and Pulmonary artery
5-10% of CHD
After closure it becomes the Ligamentum Arteriosus
Term
PDA Surgical treatment
Definition
Transcatheter coil
Ligation
Term
Aortopulmonary Window
Definition
Defect causing communication between AO and PA
Rare 0.2% of CHD
Hole like defect in lateral wall of ascending AO and MPA
Term
AO-PA Window Surgical treatment
Definition
Dacron patch early in life
Term
AO-PA Window associated defects
Definition
Anomalous origin of RCA off of RPA, Right aortic arch, coarctation of AO
Term
Atrioventricular Septal Defect (AV Canal)
Definition
Consists of a Membranous VSD and Septum Primum ASD
Term
3 Types of AV Septal Defects
Definition
Complete
Partial
Unbalanced
Term
Complete AV Canal
Definition
Most common, Primum ASD, Inlet VSD, Common AV valve at equal distance from apex
Term
Partial AV Canal
Definition
Primum ASD, Cleft MV
Term
Unbalanced AV Canal
Definition
AV valve overides the IVS causing one ventricle to be well developed and other is hypoplastic
Term
AV Canal Treatment
Definition
Surgical repair necessary, between 3-12 months. Patch ASD and VSD, common AV valve is repaired to make to valves, Pulm Artery banding.
Term
AV Canal Associated Defects
Definition
Down's syndrome (40%), cleft MV, PDA, TOF, PS
Term
Left Vertricular Outflow Abnormalities
Definition
Obstruction of blood flow from LV to aortic arch. 5% of CHD.
Term
3 types of LVOT Abnormalities
Definition
Valvular (75%)
Subvalvular
Supravalvular
Term
Valvular Aortic Stenosis (AS)
Definition
Obstruction due to abnormal valve leaflets and or annulus
Term
4 types of AV Stenosis
Definition
Unicuspid
Bicuspid (Most common)
Tricuspid
Quadricuspid (Rare)
Term
Unicuspid
Definition
Single leaflet with pinhole of commissural attachment
Term
Bicuspid
Definition
2 functional leaflets
Term
Tricuspid
Definition
3 small restrictive leaflets or hypoplastic
Term
Quadricuspid
Definition
4 functional leaflets
Term
Valvular AS Treatment
Definition
Balloon valvuloplasty (if more than 50mmHg PPG w/out AI), AV replacement, Ross procedure
Term
Valvular AS Associated Defects
Definition
AI, coarctation, PDA, subaortic stenosis
Term
Subvalvular AS
Definition
Obstruction occurs between the RV and the PV
Term
3 types of Subvalvular AS
Definition
Discrete fibromuscular ridge encircling the LVOT (most common).
Long fibromuscular narrowing beneath base of AV.
Tunnel-like narrowing of entire LVOT and small AO Root.
Term
Subvalvular AS Treatment
Definition
Surgical resection, AV replacement, Kono procedure. High recurrence risk
Term
Supravalvular AS
Definition
Obstruction occurs distal to AO Valve
Term
3 types of Supravalvular AS
Definition
Membranous: fibrous diaphragm above sinuses of valsalva.
Hourglass deformity: internal stricture of ascending AO.
Hypoplastic segment: severe narrowing from area above sinuses to innominate artery.
Term
Supravavular AS Treatment
Definition
Surgical excision of fibrous tissue, patch widening
Term
Supravalvular AS Associated Defects
Definition
Frequent with mental retardation, PPS, coarctation of the aorta, PDA
Term
Coarctation of the Aorta
Definition
A narrowing of the aortic lumen
Term
3 types Coarctation of the Aorta
Definition
Type A: between subclavian and ductal region (isthmus)
Type B: between the left common carotid Artery and the left subclavian artery (most common 55-69%)
Type C: between the innominate artery and left common carotid (Rare <4%)
Term
Coarctation Treatment
Definition
Resection with end-to-end anastomoses, subclavian flap aortoplasty, dacron patch, balloon angioplasty
Term
Coarctation Associated Defects
Definition
Bicuspid AV (46%), VSD, PDA, hypoplastic left sided structures
Term
Interrupted Aortic Arch (IAA)
Definition
Lack of continuity between the ascending and descending aorta
<1% of CHD
Term
3 types of IAA
Definition
A: distal to left subclavian (30-40%)
B: between left subclavian and left common carotid (55-60%)
C: proximal to left common carotid (5%)
Term
IAA Treatment
Definition
Keep PDA open, anastomosis of 2 segments, closure of VSD and PDA
Term
IAA Associated Defects
Definition
PDA, VSD, subaortic obstruction, bicuspid AV
Term
Pulmonary Stenosis (PS)
Definition
Obstruction of blood flow from the RV to the lungs
Term
Valvular PS
Definition
90% of PS
Term
Valvular PS Treatment
Definition
Balloon valvuloplasty, valvotomy, valve replacement
Term
Subvalvular PS
Definition
Obstruction occurs between the RV and PV
Term
Stenosis of Infundibulum
Definition
Occurs at level of infundibular ostium below PV
Term
Double-Chambered RV
Definition
Hypertrophied muscle bundle crosses RV from septum to free wall creating 2 different pressure systems.
90% have VSD
Term
Supravalvular PS
Definition
Obstruction occurs distal to PV
Term
Supravalvular PS: Thick Fibrous Ring
Definition
Occurs in MPA, Thick ring or tubular hypoplasia of MPA
Term
Supravalvular PS: Tubular hypoplasia of MPA
Definition
Norrowing past PV due to narrow walls
Term
Peripheral Pulmonic Stenosis (PPS)
Definition
Narrowing of branch PA's
Term
Pulmonary Atresia
Definition
Complete obstruction of flow from RV to lungs.
<1% of CHD
Term
3 types of Pulmonary Atresia
Definition
Type 1: Normal RV size
Type 2: Small RV
Type 3: Diminutive RV
Term
Tricuspid Atresia
Definition
Absence of the tricuspid valve. No communication between the RA and the RV
3% of CHD
Term
Tricuspid Atresia Treatment
Definition
Fontan procedure
Term
Tricuspid Atresia Associated Defects
Definition
PFO/ASD (80%)
TGA (30%)
VSD
Coarctation of the AO
Term
Ebstein Malformation
Definition
Apical displacement of the TV. >20mm from MV annulus.
0.3-0.8% of CHD
Term
Ebstein Malformation Treatment
Definition
TV replacent
ASD closure
If RV is unuseable, Fontan
Term
Ebstein Malformation Associated Defects
Definition
ASD (50%)
PDA
MVP
Term
Cleft Mitral Valve
Definition
A cleft in the anterior leaflet of the MV. Usually part of AV canal
Term
Double-Orifice Mitral Valve
Definition
Abnormal tissue connects the two MV leaflets, usually in center resulting in two separate MV orifices.
Term
Double-Orifice MV Treatment
Definition
MV repair, or replacent
Term
Double-Orifice MV Associated Defects
Definition
AV Canal
VSAD
Coarctation of the AO
Term
Congenital Mitral Stenosis
Definition
Obstruction of flow from the LA to the LV due to MV
Term
Valvular MS
Definition
Thick, non pliable leaflets, small annulus
Term
Parachute MV
Definition
All chordae tendineae insert into a single papillary muscle
Term
Supravalvular Mitral Ring
Definition
Membrane just superior to MV annulus
Term
Congenital MS Treatment
Definition
Balloon Valvotomy, Valve replacement, resection of ring
Term
Congenital MS Associated Defects
Definition
Hypoplastic LV, Coarctation, AS, PFO, PDA, VSD, component of Shone's complex
Term
Cor Triatriatum
Definition
LA is divided into 2 by a perforated membrane
<1% of CHD
Term
Cor Triatriatum Treatment
Definition
Excision of obstructive membrane
Term
Cor Triatriatum Associated Defects
Definition
Anomalous pulmonary return
LSVC draining into coronary sinus
PFO, ASD, VSD
Term
Pulmonary Vein Stenosis
Definition
Narrowing of one or more of the pulmonary veins where they enter LA
Term
Pulmonary Vein Stenosis
Definition
Balloon angioplasty
Stent
Pericardial patch
Term
Pulmonary Vein Stenosis Associated Defects
Definition
MS, Anomalous pulmonary venous return, cor triatriatum, ASD
Term
Total Anomalous Pulmonary Venous Return (TAPVR)
Definition
Pulmonary veins converge and drain into right sided structures
20% of CHD
Term
Infracardiac TAPVR
Definition
Pulmonary veins-portal system-IVC
20%
Term
Supracardiac TAPVR
Definition
Pulmonary veins-SVC
50%
Term
TAPVR Treatment
Definition
Balloon atrial septostomy to temporarilly allow mixing.
Anastomosis of common pulmonary vein to LA.
Term
TAPVR Associated Defect
Definition
Trunctus
Hypoplasatic LH
Term
Partial Anomalous Venous Return (PAPVR)
Definition
One, two or three pulmonary veins drain into the RA.
Term
In PAPVR Right PV usually drains into?
Definition
SVC, RA, IVC, or Coronary Sinus
Term
In PAPVR Left PV usually drain into?
Definition
Left Innominate Vein
Term
PAPVR Treatment
Definition
Surgical connection of anomalous vein to LA
Term
PAPVR Associated Defects
Definition
ASD, Scimitar Syndrom
Term
Tetralogy of Fallot (TOF)
Definition
Overriding Aorta
Malalignment VSD (Inlet)
RVH
RVOT obstruction
10% of CHD
Term
TOF Treatment
Definition
B-T shunt, Rastelli, Catheter balloon dialation of PA's, Closure of VSD
Term
TOF Associated Defect
Definition
Right Aortic Arch, PFO/ASD, VSD, AV Canal
Term
Transposition of the Great Arteries (d-TGA)
Definition
Aorta arises from the RV
Pulmonary artery arises from LV
Aorta is anterior to pulmonary artery
Usually ASD, VSD, PDA
5% oc CHD
Term
d-TGA Treatment
Definition
Arterial Switch
Term
d-TGA Associated Defect
Definition
VSD (50%)
LVOT obstruction (20%)
Term
Transposition of the Great Arteries (l-TGA)
Definition
Morphological RV on patients left
Morphological LV on patients right
Atrial situs
AO arises from RV
PA arises from LV
0.6% of CHD
Term
l-TGA Associated Defect
Definition
VSD (80%)
PS (50%)
Pulmonary Atresia (10%)
TR (30%)
Term
Truncus Arteriosus
Definition
One arterial trunk gives rise to pulmonary systemic and coronary circulation. All have VSD
Term
4 types of Truncus Arteriosus
Definition
Type 1: MPA present, arises from truncal root (60%)
Type 2: RPA and LPA arise separately from posterior portion of truncal root (20%)
Type 3: RPA and LPA arise separately from lateral portion of truncal root (20%)
Type 4: No PA's, bronchial arteries arise from descending AO (10%)
Term
Truncus Arteriosus Treatment
Definition
Rastelli
Term
Truncus Arteriosus Associated Defect
Definition
Coronary artery abnormalities
RAA (30-50%)
ASD
Term
Double-Outlet Right Ventricle (DORV)
Definition
Both great vessels arise from RV. Large VSD
<1% of CHD
Term
4 types of DORV VSD's
Definition
Subaortic (70%)
Subpulmonic
Dubly commited
Noncommitted
Term
DORV Treatment
Definition
Intraventricular tunnel between VSD and AO
Term
DORV Associated Defects
Definition
Coarctation of the Aorta
PS
Anomalies of AV canal
Hypoplastic LV
Term
Hypoplastic Left Heart
Definition
Severely underdeveloped LV
1-2% of CHD
67% Male predominance
Term
Hypoplastic Left Heart Treatment
Definition
Complete Norwood Procedure
Term
Kawasaki Disease
Definition
Mucocutaneous Lymph Node Syndrom, Vasculitis of the coronary arteries leading to aneurisms, thrombosis etc.
Term
Kawasaki Treatment
Definition
90% of untreated results in Coronary aneurysms
Term
Trisomy 21 (Down Syndrome)
Definition
AV Canal (50%)
Term
Trisomy 18 (Edwards Syndrome)
Definition
VSD, AV Canal, DORV
Term
Turner Syndrome
Definition
Coarctation of AO, Bicuspid AoV, AS
Term
Williams Syndrome
Definition
Supravalvular AS, PPS
Term
DiGeorge Syndrome
Definition
Trunctus Arteriosus, IAA, TOF
Term
Noonan Syndrome
Definition
Pulmonary valve stenosis (50%), HCM
Term
[image]
Definition
Sinus Venosus ASD
Term
[image]
Definition
IAS Aneurysim and PFO
Term
[image]
Definition
Septum Primum ASD
Term
[image]
Definition
Muscular VSD
Term
[image]
Definition
Perimembranous VSD
Term
[image]
Definition
PDA
Term
[image]
Definition
Aortopulmonary Window
Term
[image]
Definition
AV Canal
Term
[image]
Definition
Unicuspid AoV
Term
[image]
Definition
Bicuspid AoV
Term
[image]
Definition
Quadcuspid AoV
Term
[image]
Definition
AS
Term
[image]
Definition
Coarctation of the Aorta
Term
[image]
Definition
IAA
Term
[image]
Definition
PS
Term
[image]
Definition
PPS
Term
[image]
Definition
Tricuspid Atresia
Term
[image]
Definition
Ebstein Malformation
Term
[image]
Definition
Cleft MV
Term
[image]
Definition
Double-Orifice MV
Term
[image]
Definition
MS
Term
[image]
Definition
MVP
Term
[image]
Definition
Cor Triatriatum
Term
[image]
Definition
PAPVR
Term
[image]
Definition
TOF
Term
[image]
Definition
TOF
Term
[image]
Definition
Truncus Arteriosus
Term
[image]
Definition
Truncus Arteriosus
Term
[image]
Definition
Double Outlet RV
Term
[image]
Definition
Hypoplastic Left Heart
Term
[image]
Definition
Hypoplastic Left Heart
Term
[image]
Definition
Kawasaki Disease
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