Term
| What are other names for an infundibular VSD? |
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Definition
| Supracristal, subarterial, subpulmonic. The preferred term is "infundibular" |
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Term
| What are the complications of non-restrictive VSDs? |
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Definition
LV volume overload
PA hypertension
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Term
| Why doesn't a non-restrictive VSD cause RV dilatation? |
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Definition
Most of the shunt takes place in systole and is directed out the PA. Pulmonary hypertension will result in RVH.
RV dilatation may occur if the RV fails due to pulmonary hypertension |
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Term
| What are the complications of restrictive VSDs? |
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Definition
Aortic insufficiency
Tricuspid regurgitation
LVOT obstruction (VSD is associated with tissue tags in the LVOT. Sometimes accessory AV valve tissue may obstruct the LVOT.) |
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Term
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Definition
| Surgically through the right atrium. For muscular and membranous VSD with sufficiently large rims, closure devices may be used. |
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Term
| What should echoes performed after VSD closure look for? |
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Definition
Patch leaks
Aortic regurgitation
tricuspid regurgitation
LV size and function
PA hypertension
LVOT obstruction
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Term
| After VSD, when is IE prophylaxis indicated? |
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Definition
For 6 months after repair
If there is a patch leak
Prior IE |
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Term
| What features make pregnancy high risk in women with VSD? |
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Definition
L to R shunt >1.7
LV dysfunction
arrhythmia
poor exercise capacity
Elevated PA pressure |
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Term
| When is pregnancy contraindicated, or at least, highly inadvisable? |
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Definition
LVEF <40%
PA pressure >3/4ths Aortic
Severe RVOT obstruction |
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