Neonatal Cardiac Surgery Quiz

Study Notes

Performed on newborns (0-30 days old) with congenital heart defects
Unique challenges:
- Small size and fragile physiology
- Limited cardiopulmonary reserve
- Immature brain development
- Higher risk of complications
Common procedures:
- Closure of patent ductus arteriosus (PDA)
- Repair of atrial septal defects (ASD)
- Repair of ventricular septal defects (VSD)
- Palliation of complex defects (e.g., hypoplastic left heart syndrome)

Goal: Optimize cardiopulmonary function and prevent complications
Key aspects:
- Hemodynamic monitoring:
  - Blood pressure
  - Central venous pressure
  - Arterial oxygen saturation
- Pain management:
  - Opioids and sedatives
  - Regional anesthesia (e.g., epidural)
- Respiratory support:
  - Mechanical ventilation
  - Oxygen therapy
- Nutrition and hydration:
  - IV fluids and electrolytes
  - Enteral nutrition (e.g., breast milk or formula)
Complications to watch for:
- Cardiac arrhythmias
- Respiratory failure
- Infection (e.g., endocarditis)
- Neurological impairment

Occur in approximately 1% of live births
Caused by genetic or environmental factors during fetal development
Classified into two main categories:
- Acyanotic defects:
  - ASD
  - VSD
  - PDA
  - Coarctation of the aorta
- Cyanotic defects:
  - Tetralogy of Fallot
  - Transposition of the great arteries
  - Truncus arteriosus
  - Hypoplastic left heart syndrome
Diagnosis:
- Physical examination
- Echocardiography
- Cardiac catheterization
- MRI or CT scans

A technique used to support the heart and lungs during surgery
Allows for:
- Stopping the heart (cardioplegia)
- Cooling the body (hypothermia)
- Diverting blood flow away from the surgical site
Components:
- Oxygenator: adds oxygen and removes carbon dioxide from the blood
- Pump: maintains blood flow and pressure
- Heat exchanger: controls body temperature
- Filters: remove air and debris from the blood
Risks and complications:
- Inflammation and oxidative stress
- Blood transfusion reactions
- Cardiovascular instability
- Neurological injury

Performed on newborns with congenital heart defects
Unique challenges due to small size, fragile physiology, limited cardiopulmonary reserve, immature brain development, and higher risk of complications
Common procedures include closure of PDA, repair of ASD, repair of VSD, and palliation of complex defects like hypoplastic left heart syndrome

Goal is to optimize cardiopulmonary function and prevent complications
Hemodynamic monitoring includes blood pressure, central venous pressure, and arterial oxygen saturation
Pain management involves opioids, sedatives, and regional anesthesia like epidural
Respiratory support includes mechanical ventilation and oxygen therapy
Nutrition and hydration involve IV fluids and electrolytes, and enteral nutrition like breast milk or formula
Complications to watch for include cardiac arrhythmias, respiratory failure, infection, and neurological impairment

Occur in approximately 1% of live births
Caused by genetic or environmental factors during fetal development
Classified into acyanotic defects (ASD, VSD, PDA, coarctation of the aorta) and cyanotic defects (tetralogy of Fallot, transposition of the great arteries, truncus arteriosus, hypoplastic left heart syndrome)
Diagnosis involves physical examination, echocardiography, cardiac catheterization, and MRI or CT scans

A technique used to support the heart and lungs during surgery
Allows for stopping the heart, cooling the body, and diverting blood flow away from the surgical site
Components include oxygenator, pump, heat exchanger, and filters
Risks and complications include inflammation and oxidative stress, blood transfusion reactions, cardiovascular instability, and neurological injury