tetralogy of fallot ideal case 2
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The echocardiogram showed septal hypertrophy, a large non-restrictive ventricular septal defect, severe infundibular pulmonic stenosis, aortic override, and right ventricular hypertrophy. No other structural defects were seen. Cardiac catheterization measurements confirmed these findings and additionally showed normal coronary arteries. Surgical repair would need to consider approaches, pulmonary arteriotomy, transannular patching, preserving coronary arteries, and managing other septal defects while dividing obstructive muscles in the right ventricular outflow tract.
tetralogy of fallot ideal case 2
- 1. Echocardiography • SS, LC, NRGA, Atrio ventricular and ventriculo-atrial concordance,3 PV to LA, SVC and IVC to RA, • Septal hypertrophy, Large non-restrictive VSD (15 mm) with RL shunt, subaortic in location, Severe Infundibular with valvar PS (gradient 50 mmHg), Aortic over-ride present (<50%), RVH, Decreased Qp, Confluent good sized pulmonary arteries, • No ASD/PDA/COA, Normal mitral/tricuspid/aortic valves, No TR, Normal Biventricular function. • Dimensions – MPA – 15.7 • RPA- 11.2 • LPA- 10.3 • DTA (at the level of diaphragm) – 11.4 • Mc Goon Ratio – 1.88
- 3. Basic Echo Views -PLAX
- 4. Basic Echo Views- PLAX
- 5. Basic Echo Views- PSAX
- 6. Basic Echo Views- PSAX
- 7. Basic Echo Views- A4C
- 8. Basic Echo Views- A4C
- 9. Basic Echo Views- A4C
- 10. Basic Echo Views – SUBCOSTAL VIEW
- 11. Basic Echo Views – SUBCOSTAL VIEW
- 12. Basic Echo Views – SUBCOSTAL VIEW (IVC)
- 13. Basic Echo Views – SUPRASTERNAL NOTCH VIEW
- 14. Echocardiography in Tetralogy Of Fallot
- 26. Treatment • Medical • Surgical – considerations – • Review the investigations thoroughly • Dealing with collaterals preoperatively/consideration of coiling collaterals or artificially created shunts. • Approaching repair via trans atrial or trans-ventricular incisions • Need of Pulmonary Arteriotomy • Performing trans annular patch (TAP) – Yes/No • Preserving or sacrificing RCA branches/ Anomalous LAD from RCA • Dealing with pulmonary valve/Monocusp repair • Managing Atrial Septal Defects /PFO/PDA/Ligamentum/Shunts • Managing tricuspid valve • Dividing/Resecting obstructive septal and parietal muscle bands in RVOT.