ASD/VSD

Question 1

Ostium Secundum ASD facts

Answer 1

• Most common
• Located in center of fossa ovalis
• Associated with mitral valve prolapse
• Amenable to closure in cath lab

Question 2

What are the 4 types of ASDs?

Answer 2

1. Ostium secundum
2. Ostium primum
3. Sinus venosus
4. Coronary sinus

Question 3

Ostium Primum ASD facts

Answer 3

• Second most common type
• Associated with cleft leaflets because located near the atrioventricular valves (cleft septal TV leaflet and anterior MV leaflet)
• Found in patients with T21
• Makes up part of an AV canal (partial, transitional, or complete)

Question 4

Sinus venosus ASD facts

Answer 4

• Third most common type
• Associated with anomalous pulmonary venous return
• Located near superior or inferior vena cava
• SVC sinus venosus ASD most common and associated with anomalous RUPV drainage
• IVC sinus venosus ASD is associated with Scimitar Syndrome

Question 5

Coronary sinus ASD facts

Answer 5

• Least common type
• Associated with persistent L SVC

Question 6

What is a partial AV canal?

Answer 6

An isolated primum ASD

Question 7

What is a transitional AV canal?

Answer 7

A primum ASD + restricted inlet VSD

Question 8

What is a complete AV canal?

Answer 8

A primum ASD + unrestricted inlet VSD

Question 9

What are the components of Scimitar Syndrome?

Answer 9

• Hypoplastic right pulmonary artery and right lung
• Displacement of cardiac structures into right hemithorax
• Anomalous arterial supply to the right lung
• Anomalous right pulmonary drainage into a Scimitar vein that drains into the IVC
• Associated with inferior sinus venosus ASD

Question 10

How to tell septum secundum from sinus venosus ASD?

Answer 10

Crista terminalis (ridge above RAA) is cephalad to the defect in a secundum ASD and caudad to it in a sinus venosus ASD

Question 11

What heart defect is associated with cleft AV valve leaflets?

Answer 11

Ostium primum ASD

Question 12

What creates a PFO?

Answer 12

Incomplete fusion of the septum primum and septum secundum, creating a flap in the fossa ovalis.

Question 13

Which VSD is associated with AV canal defects?

Answer 13

Inlet VSD

Question 14

Which ASD is associated with AV canal defects?

Answer 14

Ostium primum ASD

Question 15

Which VSDs cause prolapse of the coronary cusps?

Answer 15

Membranous and subpulmonic VSDs (RCC prolapse)

Question 16

What are the two anterior VSDs (seen in RV inflow-outflow view)?

Answer 16

Membranous VSD (adjacent to TV) and subpulmonic VSD (above the crista supraventricularis, below the PV)

Question 17

Which VSD is posterior (retroflex on ME 4C)?

Answer 17

Inlet VSD

Question 18

Which ASD is associated with mitral valve prolapse?

Answer 18

Ostium secundum ASD

Question 19

Which VSD is the most common?

Answer 19

Membranous VSD

Question 20

Which VSD is associated with an LV septal aneurysm?

Answer 20

Membranous VSD