Explain Tetralogy of fallot repair and Transposition of arteries?
Tetralogy of Fallot Repair: This involves RV outflow resection, closure of the VSD and enlargement of the RV outflow tract.
Transposition of great Arteries: (TGA) The problem here is that the ventricular Tetralogy connections have been reversed with the RV giving rise to the aorta and the LV giving rise to the PA. This could be associated with a VSD, PDA Pulmonary stenosis or Coarctation1 Aortic arch interruptions.
Timing of surgical corrections depend on the absence or presence of a VSD or a large PDA. The LV will regress in its ability to support a systemic afterload once the PVR starts to come down in the perinatal period. This will be delayed in the presence of a large VSD 01. PDA as these lesions will continue to subject the LV to a systemic pressure and retain its ability to handle the systemic afterload.
Corrective surgeries are usually planned in the neonatal/infant age groups as the rate of attrition and development of PAH is very early in these children.