Ebstein's Anomaly A&P
What is Ebstein's Anomaly?
CHD characterized by downward displacement of the tricuspid valve into the right ventricle.
What is cyanosis?
ASD creates R to L shunting = Mixed!
What are prostaglandins?
Keep PDA open to maintain blood flow through heart and to rest of body
What is "A, B and C"?
A- Suction control, provided by provider order, B-water seal chamber, C-air leak monitor
What is banding?
Keeps CT secure to chamber
What is the tricuspid valve?
The tricuspid valve forms lower than normal, with only 2 leaflets instead of 3.
What is "box-shaped" heart?
What is a BT shunt?
Infants with severe Ebstein's may need a BT shunt.
-Pulmonary artery to aorta
What supplies are needed for setting up a new chamber?
New chamber, CT clamps, gloves
What happens if CT dislodges?
Vaseline gauze, NOTIFY
What is regurgiation?
-enlarged RA
What is childhood presentation?
-Mild cyanosis, exercise intolerance, respiratory infections, murmur
What is cone procedure?
Separates the heart muscle from the tissue that should have formed a TV, then is used to create a working TV.
What is the emergency equipment?
-1 chest tube clamp per CT, vaseline gauze
What is "D, E, and F"?
D-collection chamber, E-Suction monitor F- Suction port
What is "atrialized"?
Part of the RV tissue lies above the tricuspid valve and serves as the atrium.
What is a murmur?
Holosystolic murmur at the left sternal border due to tricuspid regurgitation.
What is tricuspid valve replacement?
Removal of the damaged TV, replaced with a biologic valve
When assessing, what do you look for?
1. The dressing
2. Chamber (output, tubing, bubbling, suction=order)
3. Banding
4. Suction
5. Emergency supplies
What is post CT removal?
Suture=Out 7 days
What are the key concepts?
1. Tricuspid valve forms lower (2 instead of 3)
-enlarged RA
-small RV
2. ASD
What is a common rhythm associated with Ebsteins?
WPW
-Malformation and displacement of the tricuspid valve can create abnormal AV connections =accessory pathways
Who is Wilhelm Ebstein?
First described the anomaly in 1866.
1. Tegaderm
2. Gauze
3. Steri-strips
4. CHG
5. Mastisol
6. Border Tegaderm
What is a dressing change procedure?
1. remove
2. sutures intact
3. tegaderm over insertion site
4. chevron
5. border teg and pants