Topic : cyanotic heart diseases cont

Transposition of the great arteries

The normal figure of 8 systemic / pulmonary blood flow is replace by 2 separate parallel circuits i.e systemic venous blood passing thro’ the rt side of the heart returns directly to the systemic circulation via connecting aorta. Pulm. Venous blood returning to  lt side is returned directly to pulm circ.  Via a connecting pulm. Artery

This condition is incompatible with life

Clinical features

—  Present in 1st few hrs of life

—  Worsening cyanosis

—  Severe hypoxia

—  Heart failure is NOT a feature

Treatment

 Maintain body temp ( hypothermia worsen metabolic acidosis)

Correct acidosis & hypoglycaemia

Prostaglandin E1 infusion b4 Cardiac sx in 1st 2wks

Tricuspid Atresia

There is no connection btn the Rt. Atrium & rt ventricle. Venous blood is diverted Lt side via a patent foramen ovale

Pulmonary blood flow is dependent on associated VSD or PDA

C/F: present early in 1st few days to early months with increasing cyanosis.  s+s vary

RX: Prostaglandin E1, then Surgery

 

Total anomolous pulmonary venous drainage

All blood returning to the heart returns to the Rt atrium, & an obligatory patent foramen ovale or ASD is necessary for survival

C/F: 1st few days of life; Cyanosis & CCF

Presentation will depend on the degree of obstruction to the pulm venous return

RX: Surgery