Ventricular Septal Defect

TSDA Congenital Curricula for the Week of July 21, 2014
Week 2 of 32
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The Congenital Curricula is based on a 32-week lesson plan, and you can expect to receive e-mail messages
every Thursday for the upcoming week, with the exception of holiday weekends. The weekly assignments are a
supplement to your program curriculum and include basic readings for congenital fellows, faculty, and others
interested in congenital heart surgery. TSDA hopes the Congenital Curricula expands your current knowledge base
and enhances your learning experience.
Topic: Ventricular Septal Defect
I.
Morphology
a. VSD Morphology
i. Supracristal VSD
ii. Perimembranous VSD
iii. Inlet VSD
iv. Muscular VSD
v. Multiple VSDs/Swiss Cheese Septum
b. Conduction system
c. Associated Lesions
i. Double Chamber Right Ventricle
ii. Aortic Insufficiency
II. Pathophysiology/Natural History
a. Left-to-right shunt
b. Pulmonary Vascular Disease
c. Eisenmenger’s syndrome
d. Diagnosis/Determination of operability
i. Echocardiogram
ii. Cardiac Catheterization
1. Qp:Qs calculation
2. PVR calculation
3. Pulmonary vasoreactivity
III. Surgical repair
a. Indications/Timing
b. Conduct of Operation ( Including Cannulation, CPB, Myocardial Protection, Approach)
i. Patch Closure VSD
ii. Primary Closure VSD
iii. Transaortic VSD Closure with Aortic Valve Resuspension
iv. Pulmonary Artery Banding
c. Post-operative management
d. Outcomes
IV. Controversies
a. Percutaneous Device Closure
b. Perventricular Device Closure
c. Management of Multiple VSDs/Swiss Cheese Septum
Talk:
Anatomy of Atrial & Ventricular Septal Defects - Richard Van Praagh (Children’s Hospital Boston)
Readings:
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Ventricular Septal Defect, Chap 17, pp 311-341, Pediatric Cardiac Surgery, 4th Edition, Mavroudis and
Backer (ed), c2013.
Congenital Heart Surgery Nomenclature and Database Project: ventricular septal defect. Jacobs JP et al.
The Annals of Thoracic Surgery 2000; 69:S25-S35.
Predictive value of intraoperative diagnosis of residual VSD by transesophageal echocardiogram. Hanna
BM, El-Hewala AA, Gruber PJ, Gaynor JW, Spray TL, Seliem MA. The Annals of Thoracic Surgery. 2010
Apr;89(4):1233-7.
Contemporary outcomes of surgical ventricular septal defect closure. Anderson BR, et al. The Journal of
Thoracic and Cardiovascular Surgery. 2013;145:641-7.
Treatment of isolated ventricular septal defects in children: Amplatzer versus surgical closure. Oses P et al.
The Annals of Thoracic Surgery. 2010 90:1593-8.
Outcomes of radial incision of the tricuspid valve for ventricular septal defect closure. Hyde M, et al. The
Annals of Thoracic Surgery. 2011;92:685-90.
Techniques and results in the management of multiple ventricular septal defects. Kitagawa T, et al. The
Journal of Thoracic and Cardiovascular Surgery. 1998;115:848-56.
ADDITIONAL TSDA RESOURCES
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Visit TSRA Resources for Residents to view resources written by residents for residents, including TSRA
Review of Cardiothoracic Surgery; TSRA Primer of Cardiothoracic Surgery; TSRA Clinical Scenarios; and
TSRA Journal Club.
The McGraw-Hill Companies, Inc., publishers of The Johns Hopkins Manual of Cardiothoracic Surgery, has
graciously made available sections of this important textbook to TSDA Weekly Curricula subscribers. TSDA
will post three chapters for a three month period over the course of one year. Check back frequently for
new postings. The Johns Hopkins Manual of Cardiothoracic Surgery can be ordered at Amazon.com.
Attention program directors, faculty, residents, and fellows: If you know of a congenital curriculum topic for
which you would like to create a talk, the TSDA Curriculum Committee encourages such contributions.
Instructions for creating a talk can be found on TSDA.org.
NEWS & INFORMATION
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Contact TSDA at [email protected] if you have comments or suggestions for the TSDA Congenital Curricula.
The next message will be sent on July 24 for the week of July 28.
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Phone: 312.202.5854 | Fax: 773.289.0871 | [email protected] | www.tsda.org
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