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Peds Surgery
defects/procedures
| Defect | Procedure | Details | Key Feature |
|---|---|---|---|
| d-transposition (of the great vessels) and DORV with pulmonary stenosis | Damus-Kaye-Stansel Procedure | anastomosing the PA to the Ao • VSD is repaired • P. flow is reestablished by graft from subcl. artery or thoracic aorta | PA to the Ao |
| d-transposition | Great Artery Switch | • The aorta and pulmonary artery are transected above the valve and coronary arteries • The appropriate vessel is attached to the existing stump | transected above the coronary arteries |
| Tricuspid Atresia/Tetralogy | Glenn Anastomosis | • Procedure used to divert flow from SVC to Right PA • Classic Procedure attaches SVC to Right PA • Bidirectional Procedure connects SVC to the MAIN PA for bidirectional flow | 2 procedures: Classic and Bidirectional |
| Tetralogy of Fallot | Blalock-Taussig Anastomosis | Attaches Right Subclavian artery to Right Pulmonary Artery creating a permanent ductus arteriosus | Creates permanent DA |
| Coarctation | Two types of repair: 1)End to end: Used in older children 2)Subclavian Flap Procedure:Used in young children/infants | 1)End to end:Area of narrowing is resected and the two ends are sewn together 2)Subclavian Flap Procedure: Subclavian Artery is ligated and sewn over coarct creating a live tissue graft | 2 types: End to end & Subclavian Flap |
| ASD | Blalock-Hanlon Atrial Septostomy | Surgical creation of an ASD via a RIGHT THORACOTOMY | creation of an ASD |
| • Persistent truncus arteriosus • DORV • D-transposition with VSD | Rastelli Procedure | Consists of: • An external conduit from RV to pulmonary artery and • An internal conduit from LV to aorta | external & internal conduits |
| hypoplasia of aortic annulus or tunnel subaortic obstruction | Konno Procedure (Konno-Rastan) | • Widening of the LVOT with an incision that creates enlargement of the aortic root • Incision of aortic annulus with AVR (aortic valve replacement) | Widening the LVOT |
| d-transposition and DORV | Mustard/Senning Operation | Atrial septum is excised and atria are redirected: • Systemic venous return to MV and LV • Pulmonary venous return to TV and RV | IAS is excised |
| mitral stenosis | Balloon Valvulotomy | Catheter used across ASD then placed in MV orifice. Balloon is inflated, splitting the valve along the commissures without causing traumatic damage to valve leaflet | balloon placed in MV |
| hypoplastic left heart syndrome | Norwood Procedure | Done in 3 stages: • Stage I: new aorta made using PA with Blalock-Taussig shunt and creation of ASD • Stage II: Glenn anastomosis made. Blalock-Taussig shunt ligated and SVC is anastomosed to PA • Stage III: IVC is diverted to the PA w/ atrial tunnel | 3 stages |
| Tricuspid Atresia/Single Ventricle/Tetralogy of Fallot | Fontan Procedure | • Separates RV from rest of the heart with GoreTex baffle • SVC and IVC flow into the RA. The right atrial appendage is attached to the PA and pulmonary artery is oversewn (sewn shunt) • NOTE: Stage I uses Glenn Anastomosis first | GoreTex baffle |
| Small ASD | single suture | • Most repairs done in the first 5 years of life • Some require open heart; others are done via the cath lab • Post-op echo – look for any flow across repair | first 5 years |
| Larger ASD | Patch of pericardium or prosthetic material | • Most repairs done in the first 5 years of life • Some require open heart; others are done via the cath lab • Post-op echo – look for any flow across repair | first 5 years |
Created by:
lefut
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