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Pediatrics General 2cef7a33

Ductus dependent blood flow is required for all of these congenital hea diseases except

A
Persistent truncus aeriosus
B
Hypoplastic left hea syndrome
C
Pulmonary stenosis
D
TGA with intact ventricular septum
High-Yield Explanation
Persistent truncus aeriosus Congenital hea disease in the newborn can be broadly categorized by the relationship between the patient's cardiac defect and the patent ductus aeriosus and this categorization yields four distinct groups. First are newborns dependent on a patent ductus aeriosus (PDA) for pulmonary blood flow. Second are newborns dependent on the PDA for systemic blood flow. Third are those dependent on the patent ductus for proper mixing of oxygenated blood Fouhly are neonates with a non- ductal dependent circulation. For the ductal dependent group, "intravenous prostaglandin" (E-1) is used as necessary to maintain ductal patency and is the single most impoant step in suppoing these patients to diagnosis and definitive therapy. Neveheless, all newborns ductal dependent for systemic or pulmonary blood flow require an intervention, surgical or cardiologic to eliminate ductal dependence prior to discharge. 1. Pulmonary flow ductal dependence - Newborns with congenital hea disease who are dependent on the patency of their ductus for pubnonary blood .flow present with varying degrees of cyanosis. - Critical Pulmonary Valve Stenosis with Intact Ventricular Septum - Tricuspid AtresiaQ - Tetralogy of Fallote 2. Systemic flow ductal dependence - These newborns are dependent on their ducats aeriosus for systemic blood flow and unlike the babies who are pulmonary flow dependent, these newborns present with severely decreased cardiac output. - This decreased systemic .flow is characterized by pallor, diminished peripheral pulses, low urine output, cool extremities and varying degrees of metabolic acidosis. Included are newborns born with left ventricular outflow tract obstruction at various levels. Congenital Valvular Aoic Stenosis Coarctation of the Aoa - Interruptued Aoic Arch Hypoplastic Left Hea Syndrome (HLHS) 3. Oxygenation ductal dependence - These are babies who are born with congenital hea disease that requires a patent ductus ,for adequate mixing of saturated and desaturated blood. - Transposition of great aeries 4. Ductal independence -These are neonates who are not dependent on a patent ductus but still require urgent operation - Total anomalous pulmonary venous return (TAPVR) - Truncus Aeriosus - Anomalous origin of the left main coronary aery from the pulmonary aery.

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