indication for BE ppx
- prosthetic heart valve or other prosthetic material used for valve repair (ie rings or chords).
- transplanted heart with valve defect in the donor heart
- hx of BE
- CHD with
a. unrepaired cyanotic defects or repaired (including non-cyanotic) for first 6 months
b. prosthetic material used to repair a shunt but residual flow.
abx choice for ppx
amox if can take oral. othewise amoxicillin IV, if pcn allergy then cephalexin or clinda or azithro. Notecephalosporins shouldnt be used in individuals with analphylaxis or angioedema to pcns.
What are the cyanotic heart dz’s
5 T’s: 1. Tricuspid atresia (or epsteins with VSD)
- Transposition
- Tet
- Total anomolous pulmonary venous return
- Trucus arteriosis
Remember 5 T’s
The mayo way (alt way) -
What are the two high PAP Cyanotic CHDs
What are the low PAP?
How to destinguis the two
- Eisenmengers
- Single ventricles
- —————————————–
Tet
PS+ASD
Single Ventricle
Epsteins
Loud murmur in low pap by equalization
What happens to blood count
erythorcytosis (get headache and can get
- If Hb < 20 dont do anything. If > 20 then need to phelbptomize
If phlebotomize a patient with cyanotic
need to replace iron (only 1 tablet per day) so dont give too much fuel., also repelace with equal amount of fluids.
Cyanotic defects need what with IV
air filter.
3 main renal defects with CHD
- reduced GFR
- Proteinuria
- Hyperuricemia (gout)
weird prblems that are more common in ppl with cyanotic heart defects
Cerebral anuersyms, brain abcess, scoliosis
