TheTs - THE TERRIBLE Ts Cyanotic Heart Disease GOALS To...

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THE “TERRIBLE T’s” Cyanotic Heart Disease
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GOALS To define the physiology of the five most common cyanotic defects To describe the long term sequelae of the corrective procedure. To describe the PE,ECG, and CXR results for the more common defects.
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INITIAL WORKUP: THE HYPEROXY TEST Give the patient as close to FiO2 of 1 for at least 5 minutes. Obtain pre and postductal ABG’S What should your PaO2 be on 100% O2? Is it reasonable to expect to get 100% using a mask or hood?
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CXR Mainly we are looking for situs, PBF, cardiac size and noncardiac abnormalities. Boot shaped, apple shaped, box shaped, valentine shaped, egg on it’s side shaped, ball on string shaped, boiled peanut shaped…el toro poo poo.
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ECG Get it! If you can’t read it fax it! Remember most term infants have relative RV dominance so a big LV would be unusual. Unless it’s a significant premie where there hasn’t been time to develop the pulmonary vascular bed. In a premie, RVE is not the norm
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WHAT ARE THEY? Tetralogy of Fallot d-Transposition of the great arteries Truncus arteriosus TAPVR A tre sia’s
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See handout for basics. The primary concerns after correction are: the degree of Pulmonary insufficiency, the presence of tachydysrhymias, and residual
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TheTs - THE TERRIBLE Ts Cyanotic Heart Disease GOALS To...

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