The diagnosis

7:01 am CST December 1, 2008
Double Outlet Right Ventricle is a congenital heart defect in which both the aorta and the pulmonary artery exit from the right ventricle. In the normal heart, the aorta leaves the left ventricle and the pulmonary artery leaves the right ventricle. In addition, there is a large ventricular septal defect (VSD), or hole in the muscle wall (septum) that separates the right and left ventricles. Photobucket In some cases, open-heart surgery will be performed (the Rastelli Operation) to close the VSD (see Ventricular Septal Defect) and separate the heart-to-lungs and heart-to-body circulations. In cases of double outlet right ventricle where either the right or left ventricle is hypoplastic (very small), or when the VSD cannot be committed to the aorta, then the sequence of single ventricle surgeries culminating in the Fontan Operation will be applied.current=ventricule_double_issue.jpg" ********************************************** In Pulmonary Atresia, there is no Pulmonary Valve, or opening through which blood may enter the pulmonary artery (PA) and be carried to the lungs. (An atresia is a blockage that separates a tube or passage into two separate sections.) Because the pulmonary valve (red arrow in diagram) does not form during pregnancy, the right ventricle (RV), which normally pumps blood through this valve, may not develop normally and remain small (hypoplastic). There are two main types of Pulmonary Atresia, distinguished by whether or not there is also a hole in the muscle wall (ventricular septum (VS)) that separates the right and left ventricles. This hole (not present in the diagram) is known as a Ventricular Septal Defect (VSD). If a Ventricular Septal Defect is present, it may promote growth of the right ventricle during fetal development as there is increased blood flow into this chamber through the hole in the septum. A small hole in the muscle wall between the heart's upper chambers may also be present, known as an Patent Foramen Ovale (PFO). This is actually a feature of the fetal heart, which usually closes soon after birth but may remain open in this disorder. Photobucket Immediately after birth, it is imperative to keep the Patent Ductus Arteriosus open. Medications, such as Prostaglandin E1, may be given for this purpose.(jasper is on this med now) In most cases, a tube, or shunt, made of a synthetic material called Gore-Tex, will be inserted between the pulmonary artery and the aorta or their branches to ensure continued blood flow to the lungs. This is known as a modified Blalock-Taussig Shunt. ********************************************** Transposition of the Great Arteries, D-Type In this defect, which accounts for 5% of the cases of congenital heart disease, the two main arteries (aorta and pulmonary artery) are connected to the wrong chambers of the heart. This condition is more common among males, affecting 3 boys to every 1 girl. In TGA, the aorta leaves the right ventricle (RV) (rather than the left as in a normal heart) and takes blue (unoxygenated) blood to the body while the pulmonary artery (PA) leaves the left (rather than right) ventricle (LV) and takes red (oxygenated) blood to the lungs. This defect will require surgery, usually in the first week of life After birth, the infant is kept alive by the mixing of oxygenated blood from the left atrium with unoxygenated blood in the right atrium. This is possible because of an opening called the Foramen Ovale (1) in the atrial septum (the muscle wall that divides the two atria). The Foramen Ovale provides one way for blood to mix, but it is often not enough. The Ductus Arteriosus (2), which connects the aorta and pulmonary artery in the fetal and newborn heart, also provides a way for deoxygenated (blue blood) to mix with the oxygenated (red blood). The Foramen Ovale and Ductus Arteriosus are features of the fetal heart that usually close soon after birth. Though these may allow enough mixing of blood to keep an infant alive initially, Transposition of the Great Arteries would still prove fatal if measures are not taken to increase the amount of this mixing of the two circulations. Photobucket 1) Patent (open) Foramen Ovale 2) Transposition of the Pulmonary Artery and Aorta 3) Patent (open) Ductus Arteriosus

all clean from his bath

POSTED BY JaspersMom

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