ECG in DORV
(double outlet right ventricle) varies with the clinical type. In tetralogy like DORV which has a subaortic ventricular septal defect with pulmonary stenosis, the ECG shows right axis deviation. TGA like (transposition like) DORV has a subpulmonic VSD without pulmonary stenosis. In this type, ECG shows left ventricular volume overload and right axis deviation. VSD like DORV has subaortic ventricular septal defect with no pulmonary stenosis. This condition has left ventricular volume overload on the ECG with left axis deviation.
The post ECG in DORV appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - October 24, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs
Cardiology MCQ 321: Ellis-van Creveld syndrome
Most common cardiac anomaly in Ellis-van Creveld syndrome:
a) Ventricular septal defect
b) Patent ductus arteriosus
c) Single atrium
d) Single ventricle
["Click here for the answer with explanation", "Correct Answer:"]
c) Single atrium
Single atrium is seen in 40% cases of Ellis-van Creveld syndrome. Mutations in two genes – EVC and EVC2 situated on the same chromosome have been documented in Ellis-van Creveld syndrome. It is an autosomal recessive disorder. Other features are short stature and polydactyly.
The post Cardiology MCQ 321: Ellis-van Creveld syndrome appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - September 22, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ 285: ECG Quiz
This ECG is suggestive of:
a) Wenckebach phenomenon
b) Ashman phenomenon
c) Katz-Wachtel phenomenon
d) None of the above
["Click here for the answer with explanation", "Correct Answer:"]
c) Katz-Wachtel phenomenon
The Katz-Wachtel sign is tall diphasic RS complexes at least 50 mm in height in lead V2, V3 or V4 – mid precordial leads [Circulation 1963;27;1118-1127 (Free full text at: http://circ.ahajournals.org/cgi/reprint/27/6/1118.pdf); original description by Katz and Wachtel was published in 1937: Katz LN and Wachtel H. The diphasic QRS type of electrocardiogram in congenital heart disease. Am Heart J; 1937, 1...
Source: Cardiophile MD - August 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs
TGA like physiology
– cyanotic heart disease with high pulmonary blood flow
Following congenital heart diseases have cyanosis with high pulmonary blood flood flow (TGA like physiology or transposition like physiology):
Dextro transposition of great arteries (D- TGA) with ventricular septal defect (VSD) and no pulmonary stenosis (PS)
Double outlet right ventricle (DORV) with VSD and no PS
Tricuspid atresia with VSD and no PS
TGA like physiologies can present with cyanosis and heart failure in very early life due to increased pulmonary blood flow as there is no pulmonary stenosis to restrict the pulmonary blood flow. D-TGA with VSD and no P...
Source: Cardiophile MD - August 4, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Arterial switch operation cyanotic heart disease cyanotic heart disease with high pulmonary blood flow d-TGA dextro transposition of great arteries DORV Jatene's operation PS Pulmonary stenosis TGA like physiology Source Type: blogs
Fallot like physiology
– cyanotic heart disease with low pulmonary blood flow:
Basic components of this physiology are a large ventricular septal defect (or single ventricle) and severe pulmonary stenosis so that there is right to left shunt across the VSD and low pulmonary blood flow due to the pulmonary stenosis. They can develop hypercyanotic spells and cerebrovascular accidents while they seldom go in for heart failure, unlike the congenital cyanotic heart diseases with increased pulmonary blood flow. Chest X-ray shows pulmonary oligemia and cardiac size is seldom enlarged. The conditions included in this physiology are:
Tetralogy of Fall...
Source: Cardiophile MD - August 4, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology CCHD with low pulmonary blood flow cyanotic congenital heart disease with low pulmonary blood flow cyanotic heart disease with low pulmonary blood flow Fallot like physiology Gasul phenomenon Gasul variant Tetralogy of Fal Source Type: blogs
Pulmonary artery banding
Pulmonary artery banding is used to reduce the pulmonary blood flow in situations of high pulmonary blood flow as a result of left to right shunts. Classical example is a large ventricular septal defect (VSD) where immediate surgical repair is not feasible. “Swiss cheese VSD” in which there are multiple muscular VSDs, adequate surgical repair may not be easy. Some of these defects may even have multiple right ventricular openings for a single left ventricular opening. When the surgical VSD closure is done from the right ventricle, when one VSD is closed, another one may be seen puffing from nearby. Pulmonary ...
Source: Cardiophile MD - August 2, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Arterial switch Balloon expandable pulmonary artery bands corrected transposition of great arteries cTGA d-TGA d-transposition of great arteries double switch operation l-TGA l-transposition of great arteries large vent Source Type: blogs
Great artery relationship in DORV
What is the commonest great artery relationship in DORV?
Double outlet right ventricle (DORV) is a cyanotic congenital heart disease in which both the aorta and pulmonary artery arises from the right ventricle. There will be an obligatory ventricular septal defect as well for the left ventricular blood to flow out. Commonest great artery relationship in DORV is side by side aorta and pulmonary artery. This pattern is seen in about two thirds of the cases, with aorta to the right of the pulmonary artery. Both semilunar valves will be in the same transverse and coronal planes.
Other types of great artery relationship in DO...
Source: Cardiophile MD - August 2, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Bilateral conus commonest great artery relationship in DORV D-TGA like double outlet right ventricle L-TGA like NRGA side by side great artery relationship Sub-pulmonic ventricular septal defect Taussig Bing anomaly Source Type: blogs
Cardiology MCQ 283: Asymmetric ventricular septal defect (VSD) closure device
Asymmetric ventricular septal defect (VSD) closure device has been designed for the closure of:
a) Sub-pulmonic ventricular septal defect
b) Peri-membraneous ventricular septal defect
c) Muscular ventricular septal defect
d) Inlet ventricular septal defect
["Click here for the answer with explanation", "Correct Answer:"]
Peri-membraneous ventricular septal defect
Asymmetric VSD closure device has a shorter flange on the aortic side than the apical side to prevent impingement on the aortic valve and the conduction system. Read more… The asymmetric device needs only two millimeters of tissue on the aortic rim to ho...
Source: Cardiophile MD - August 1, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology MCQ DM / DNB Cardiology Entrance Asymmetric ventricular septal defect closure device Asymmetric VSD closure device Inlet ventricular septal defect Muscular ventricular septal defect Peri-membraneous v Source Type: blogs
Asymmetric VSD closure device
Complete heart block is an important risk of device closure of perimembranous veentricular septal defect (VSD). This is because of pressure from the device damaging the atrioventricular (AV) conduction system. An asymmetric VSD closure device is found to decrease the chance of complete heart block. Amplatzer asymmetric ventricular septal defect occluder is the one which is used often (AAVSDO) [Pinto RJ et al. Transcatheter closure of perimembranous ventricular septal defects using amplatzer asymmetric ventricular septal defect occluder: preliminary experience with 18-month follow up. Catheter Cardiovasc Interv. 2006;6...
Source: Cardiophile MD - August 1, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology AAVSDO Amplatzer asymmetric ventricular septal defect occluder Asymmetric ventricular septal defect closure device Asymmetric VSD closure device atrioventricular conduction system AV conduction system perimembranous ventri Source Type: blogs
Asymmetric ventricular septal defect (VSD) closure device
Asymmetric ventricular septal defect (VSD) closure device
Complete heart block is an important risk of device closure of perimembranous VSD. This is because of pressure from the device damaging the atrioventricular (AV) conduction system. An asymmetric device is found to decrease the chance of complete heart block. Amplatzer asymmetric ventricular septal defect occluder is the one which is used often (AAVSDO) [Pinto RJ et al. Transcatheter closure of perimembranous ventricular septal defects using amplatzer asymmetric ventricular septal defect occluder: preliminary experience with 18-month follow up. Catheter Cardiovasc ...
Source: Cardiophile MD - August 1, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology AAVSDO Amplatzer asymmetric ventricular septal defect occluder Asymmetric ventricular septal defect closure device Asymmetric VSD closure device atrioventricular conduction system AV conduction system perimembranous ventri Source Type: blogs
Perventricular VSD closure
Perventricular VSD closure
Perventricular VSD closure is a hybrid procedure in which the cardiac surgeon opens the chest and the cardiologist passes a sheath through the right ventricle to achieve a device closure of the ventricular septal defect (VSD). Hybrid procedures are done in hybrid suites with facility for both open heart surgery and radiographic equipment for cardiac catheterization and angiography (hybrid of open heart surgery theatre and cardiac catheterization laboratory or cathlab). Heart is exposed through a lower partial sternotomy. The advantage is that cardiopulmonary bypass is not needed. Intra oper...
Source: Cardiophile MD - July 31, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiac Surgery device occluder guide wire Perventricular closure of ventricular septal defect Perventricular closure of VSD TEE guidance trans esophageal echocardiographic guidance Source Type: blogs
Perventricular closure of ventricular septal defect (VSD)
Perventricular closure of VSD
Perventricular closure of VSD is a hybrid procedure. Cardiac surgeon opens the chest and the cardiologist passes a sheath through the right ventricle to achieve a device closure. Heart is exposed through a lower partial sternotomy. The advantage is that cardiopulmonary bypass is not needed. Intra operative trans esophageal echocardiography is used to confirm the size of the defect, its rim from the aortic valve and the function of the aortic valve. The location of the ventricular septal defect is determined intraoperatively by palpating the region over the right ventricle with maximum intensit...
Source: Cardiophile MD - July 31, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology device occluder guide wire Perventricular closure of ventricular septal defect Perventricular closure of VSD TEE guidance trans esophageal echocardiographic guidance Source Type: blogs
Can a coronary artery fill from the right ventricular injection?
It can occur if the aorta is arising from the right ventricle or when there is a large ventricular septal defect. Another possibility is retrograde filling through the sinusoids in coronary cameral fistula from a coronary artery to the right ventricle. In this case the dye will be seen filling the sinusoids first and then the coronary branches followed by the main coronary artery. Prominent right ventricular sinusoids are seen in pulmonary atresia with intact ventricular septum. (Source: Cardiophile MD)
Source: Cardiophile MD - July 29, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Coronary cameral fistula large ventricular septal defect Prominent right ventricular sinusoids pulmonary atresia with intact ventricular septum right ventricular injection Source Type: blogs
What is Taussig Bing anomaly?
Taussig Bing anomaly is double outlet right ventricle (DORV) with subpulmonic ventricular septal defect (VSD) and high pulmonary blood flow with pulmonary hypertension. There is a transposition of the aorta to the right ventricle and malposition of the pulmonary artery. It was described by Helen B Taussig and Richard J Bing in 1949. (Source: Cardiophile MD)
Source: Cardiophile MD - July 29, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology DORV double outlet right ventricle malposition of the pulmonary artery subpulmonic ventricular septal defect Taussig Bing anomaly transposition of the aorta VSD Source Type: blogs
If a catheter passes from the right ventricle into the descending aorta, what are the possibilities?
It could be passing through a ventricular septal defect (VSD), patent ductus arteriosus (PDA) or aortopulmonary window (AP window) into the descending aorta. In VSD and AP window, the catheter will form an open loop while in PDA the catheter will form a closed loop (closed loop catheter course in PDA) as it crosses from the pulmonary artery into the descending aorta. Read more on closed loop catheter pattern with illustrative images and video… (Source: Cardiophile MD)
Source: Cardiophile MD - July 29, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology closed loop catheter course in PDA Source Type: blogs
