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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