OBSTRUCTIVE CARDIAC LESIONS
Tetralogy of Fallot (TOF) is an eponym for a large VSD, dynamic right
ventricular outflow tract obstruction (RVOT), right ventricular hypertrophy (RVH),
smaller PA and overriding aorta. There are many different variations of this theme
including:
TOF with stenotic shunt
DORV with subpulmonary pulmonary stenosis
SV with submembranous stenosis
Post operatively, restrictive
A Ross procedure implants the pulmonary artery to the LVOT.
After post-operative repair of coarctation of the aorta, hypertension can occur.
In the first 24 hours after surgery, the hypertension is due to a catecholamine surge
and should be treated with sympatholytics such as labetalol. Beyond 24 hours, the
hypertension is due to renin-angiotension system and would require ACE-inhibitors