TYK193

Atrial septostomy is palliative in:

a) Ebstein’s Anomaly

b) Tetralogy of Fallot

c) Severe pulmonary hypertension

d) Transposition of the Great Arteries with adequate ventricular mixing

e) Truncus Arteriosus

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Answer

Answer c. Ebstein’s anomaly results in significant tricuspid regurgitation and enlargement of the right atrium. The condition results from an abnormally located tricuspid valve, and is associated with a PFO or ASD in 50% of cases. Cyanosis results from this right-to-left shunt. TGA without adequate mixing at arterial, atrial or ventricular level will need an emergent balloon atrial septostomy. Truncus arteriosus and Tetralogy of Fallot do not require an atrial septostomy. In severe PHT, elevated RA pressure can be palliated via decompression with an atrial septostomy.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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