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Congenital 3

By David Blitzer / February 4, 2023

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Question 1 of 20

1. Question
While enlarging the VSD in DORV with subaortic stenosis, the direction of enlargement should be
- Anterosuperiorly
- Posteriorly
- Inferiorly
- Poster inferiorly
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Question 2 of 20

2. Question
Risk factors for RVOT obstruction from the baffle in subaortic DORV repair include
- Short distance between the aortic and pulmonary annuli
- Side by side position of the great vessels
- Use of RVOT patch
- Excising infundibular septum
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Question 3 of 20

3. Question
Differential diagnosis for cardiomegaly in infancy are all the following except:
- Anomalous left coronary artery from the pulmonary artery
- Dilated cardiomyopathy
- Ebstein's anomaly
- Aortopulmonary window
- Transposition of the great arteries
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Question 4 of 20

4. Question
The operative mortality of surgical repair for anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is?
- <5%
- < 10%
- < 20%
- < 30 %
- < 40 %
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Question 5 of 20

5. Question
All of the following are surgical repair options for anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) except:
- Ligation of anomalous coronary
- Anomalous coronary direct re-implantation into the aorta
- Left subclavian to LCA anastomosis
- Takeuchi procedure
- Unroofing of the intramural segment of the coronary artery
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Question 6 of 20

6. Question
You are performing a complete repair of tetralogy of Fallot. As soon as you perform the right ventriculotomy, you encounter significant bleeding. The most likely reason for this is:
- numerous coronary arterial collaterals
- transection of an anomalous coronary artery
- elevated right ventricular pressure
- poor venous drainage
Correct

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Question 7 of 20

7. Question
All of the following may be used in the acute treatment of “tet spells” EXCEPT:
- supplemental oxygen
- intravenous phenylephrine
- placing the patient’s knees to their chest
- inotropes
- sedation
Correct

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Question 8 of 20

8. Question
Which of the following is a notable, significant complication of patch-repair of a VSD that one must consult his or her patient about:
- Late patch degradation or dehiscence requiring reoperation
- Complete heart block
- RV failure
- Failure to thrive/CHF
Correct

Incorrect
Question 9 of 20

9. Question
What is most predictive of poor outcome following VSD repair?
- Elevated pre-operative Qp:Qs (>2)
- Size of VSD pre-operatively
- Elevated PVR post VSD repair
- Failure to thrive pre-operatively
Correct

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Question 10 of 20

10. Question
The factor most influencing flow across a systemic to pulmonary artery shunt is
- Site on the systemic artery
- Diameter of the shunt
- Length of the shunt
- Resistance in the pulmonary arteries
Correct

Incorrect
Question 11 of 20

11. Question
Cone technique of tricuspid valve repair in Ebstein’s anomaly.
- Has the longest follow up
- Runs the risk of causing tricuspid stenosis
- Is the least anatomical repair
- Causes eccentric diastolic flow across the tricuspid valve
Correct

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Question 12 of 20

12. Question
Regarding sinus of Valsalva aneurysms, which is true?
- Rupture of a sinus of Valsalva aneurysm from the non-coronary sinus results in most cases of fistula into the right ventricle
- Sinus of Valsalva aneurysm of the right coronary sinus is the most common form.
- Sinus of Valsalva aneurysm of the non-coronary sinus is the most common form.
- Rupture of a sinus of Valsalva aneurysm from the non-coronary sinus results in most cases of fistula into the right atrium.
- Sinus of Valsalva aneurysm of the non-coronary sinus is more common than the left coronary sinus.
Correct

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Question 13 of 20

13. Question
Which of the following treatments is/are efficacious in treating junctional ectopic tachycardia after tetralogy of Fallot repair?
- amiodarone
- mild hypothermia (33-35°C)
- reducing exogenous catecholamine administration
- amiodarone and reducing exogenous catecholamine administration
- All of the choices
Correct

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Question 14 of 20

14. Question
Which of the following is not a cyanotic heart lesion found at birth?
- Truncus Arteriosus
- Tricuspid Atresia
- Transposition of the Great Arteries
- Ventricular Septal Defect
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Question 15 of 20

15. Question
Which of the following reasons is the primary indication for endovascular or surgical closure of a small PDA in an asymptomatic adult?
- increased risk of aneurismal dilatation and rupture
- increased risk for developing endocarditis
- imminent risk of congestive heart failure
- increased risk of ventricular arrhythmias and sudden death
Correct

Incorrect
Question 16 of 20

16. Question
Atrial Septostomy was initially designed to palliate which of the following?
- Tetralogy of Fallot
- Hypoplastic left heart syndrome
- Transposition of the great arteries
- All of the choices
Correct

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Question 17 of 20

17. Question
Regarding the VSD in DORV, the following statement is incorrect
- Relation to the great vessels determines the type of DORV
- It is always non-restrictive
- May be associated with multiple VSDs
- The VSD may have to be enlarged during repair of the DORV
Correct

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Question 18 of 20

18. Question
A cyanotic 5-week-old infant has a room air oxygen saturation of 82%. There is no associated tachypnea. His right ventricular angiogram shows a large VSD with right-to-left shunt, overriding aorta and multilevel pulmonary stenosis. Knowledge of which associated anatomic feature is most important in planning surgical management?
- ASD
- Bicuspid pulmonic valve
- Coronary artery anatomy
- Mitral valve cleft
- right sided aortic arch
Correct

Incorrect
Question 19 of 20

19. Question
Which of the following additional cardiac defects is NOT associated with tetralogy of Fallot?
- right sided aortic arch
- ASD
- additional VSDs
- congenital aortic stenosis
- genetic syndromes
Correct

Incorrect
Question 20 of 20

20. Question
Which of the following statements is TRUE regarding the management of PDA in the adult?
- Medical therapy is superior to surgical repair.
- VATS techniques have yielded superior short and long term results compared to open surgical techniques
- Adults often require sternotomy for complete closure.
- Antibiotic prophylaxis is recommended even after complete closure.
Correct

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