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NIGERIAN CARDIAC SOCIETY, 2005 UPDATE COURSE. VENUE: UNTH, ENUGU. TOPIC: UPDATE IN MANAGEMENT OF NEONATES WITH CRITICAL PULMONARY AND AORTIC STENOSIS LECTURER: DR. J.C EZE FWACS DATE: MARCH 21, 2005. SEVERE PULMONARY STENOSIS WITHOUT VSD. Symptoms and Signs:. 1. Cyanosis

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Nigerian cardiac society 2005 update course

NIGERIAN CARDIAC SOCIETY,2005 UPDATE COURSE.

VENUE: UNTH, ENUGU.

TOPIC: UPDATE IN MANAGEMENT OF NEONATES WITH CRITICAL PULMONARY AND AORTIC STENOSIS

LECTURER: DR. J.C EZE FWACS

DATE: MARCH 21, 2005


Severe pulmonary stenosis without vsd

SEVERE PULMONARY STENOSIS WITHOUT VSD

Symptoms and Signs:

1. Cyanosis

2. R sided C.H.F

3. R.V. lift

4. Systolic ejection click

5. Widely split S2

6. Grade I-VI/VI Systolic murmur


Problems of neonates
PROBLEMS OF NEONATES

  • Supportive Care

  • Medical Therapy at ICU


Pathology
PATHOLOGY

(i) Cusp Fusion

(ii) 20 infundibular Stenosis


Investigations
INVESTIGATIONS

I C X R

ii ECG

iii 2D Echo/3D Echo

iv Cardiac Catherterization

v Angiography


Definitive treatment
DEFINITIVE TREATMENT

  • Immediate Surgery when indicated

  • Transventricular Valvotomy {closed heart surgery}

  • Resection and insertion of an outflow prosthetic patch {Extracorporeal circulation}


Aortic stenosis
AORTIC STENOSIS

I. Anatomic

a. Valvular

b. Discrete membranous subvalvular

c. Supravalvular

d. Hypertrophic muscular subaortic

ii. Physiologic


Pathology1
PATHOLOGY

  • Effects of obstruction

  • 02 demand

  • L.V.H.F

  • Coronary insufficiency etc.


Symptoms and signs
SYMPTOMS AND SIGNS

  • L.V thrust at apex

  • Systolic thrill at the base etc.

  • Aortic type ejection click

  • Split 2nd Hs

  • Grade iii - v/vi, ejection systolic murmur


Investigations1
INVESTIGATIONS

i CXR

ii ECG

iii ECHO

iv Cardiac Catheterization

v Angio cardiography


Treatment
TREATMENT

i Patient stabilization preoperatively

ii Indication for surgery

iii Operative technique


Complications of surgery
COMPLICATIONS OF SURGERY

- Regurgitation

- Death


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