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ASDs

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by

jennifer lassiter

on 7 April 2016

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Transcript of ASDs

Objectives
What suggests ASD?
Echo
How to demonstrate?..
What views? How?
Physiology
Uncomplicated: left to right shunt

RVVO

Pulmonary overcirculation
Types, part I:
Which is which?
Draw them.
Why do we need to know which is which?

Why is the embryology important?
Effects of physiology
ASDs
It's just a hole; so what?
Define ASD, identify different types, and explain the embryologic origins
Describe potential effects of ASDs, short and longterm and how these are seen by echo
Demonstrate what views or structures should be used to document an ASD
Discuss possible types of intervention for an ASD, and explain post-interventional imaging
Secundum ASD
Primum ASD
Sinus Venosus
Coronary Sinus
RVVO
Enlarged RA, RV, MPA, branch PAs
Pulmonary overcirculation leading to eventual damage of pulmonary vasculature, increasing pulmonary pressures and eventual Eisenmenger's Syndrome (shunt switches to right to left)
RAE
RVE
Flattened IVS (D-shaped LV)
Increased pulmonary flow
Dilated MPA and branch PAs
Left to right atrial level shunt
Large vs. small ASD

SC, apical 4C, RPS, basal PSAX
Multiple views
Size and location
Flow patterns (color and spectral)
Associations
SC LAX
Apical 4
SAX basal level
High RPS
PFO vs. ASD
PFO
ASD
Why do we need to know which is which?
Primum - Canal (endocardial cushion defect)
Secundum - True ASD (failure of septum primum formation)
Sinus Venosus - P/TAPVR (failure of proper connection of pulmonary veins)

Why is the embryology important?
Location of defect is caused by embryologic defects and can clue us into other potentially associated defects
SC SAX
Possible Interventions
Surgical
Patch closure
Device (Amplatzer) placement
Post Interventional Imaging
Demonstrate closure site/device
Document any residual flow from multiple views via color and spectral Doppler, 2D if possible
Document changes in right heart size and/or function
Qp:Qs
References
Types, part II
Full transcript