1. Principal Groups of CHD
Acyanotic CHD
L't-to-R't shunt group
Obstruction group
Cyanotic CHD
Obstruction group
Venous mixture group

2. Three Basic Lesions of CHD
Defect
e.g. : ASD , VSD
Obstruction
e.g. : AS , PS
Congenital malformation (Transposition ,Hypoplasia) e.g. : TGA , HLHS

3. Acyanotic CHD c L't-to-R't Shunt
ASD (atrial septal defect)
VSD (ventricular septal defect)
CAVC (Complete Atrioventricular
Canal )
PDA (patent ductus arteriosus)

4. Acyanotic CHD c Obstruction
CoA (Coarctation of Aorta)
Congenital AS (Aortic Stenosis)
Congenital PS (Pulmonary Stenosis)

5. Cyanotic CHD c Obstruction
ToF (Tetralogy of Fallot)
Tricuspid Atresia
Ebstein's anomaly

6. Cyanotic CHD c Venous Mixture
TAPVR (Tatal anomalous pulmonary venous Return)
Truncus Arteriosus
TGA (Transposition of Great Artery)
HLHS (Hypoplastic Left Heart Syndrome)
Single Ventricle Variants
Common Atrium

7. Acyanotic CHD c L-to-R Shunt
e.g. : ASD ,VSD ,CACV ,PDA
Main lesion : Defect
Pulmonary blood flow
Ventricular volume load

8. Acyanotic CHD c Obstruction
e.g. : CoA , AS , PS
Main lesion : Obstruction
Ventricular Pressure Load

9. Cyanotic CHD c Obstruction
e.g.: ToF , Tricuspid atresia ,
Ebstein's anomaly
Main lesion : Obstruction
Associated lesion : Defect
Pulmonary Blood Flow

10. Cyanotic CHD c Venous Mixture
e.g.: TGA , TAPVR , Truncus Arteriosus,
Common Atrium , Single V. ,HLHS
Main lesion: Congenital Malformation
(Transposition , Hypoplasia)
Associated lesion:Defect and/or obstruction
Pulmonary Blood Flow
Ventricular volume load

11. Palliative Surgery ( I )
Pulmonary Blood Flow
PA Banding
Blalock-Taussig shunt (Modified or Classical)
Waterston shunt
Pott's shunt
Central shunt

12. Palliative Surgery ( II )
Venous Mixing
Blalock-Hanlon shunt
Balloon Atrial Septostomy
Blade Atrial Septectomy

13. Closed Heart Surgery PDA ( ligation or division ) CoA repair
Interrupted Aorta repair
Pulmonary Valvotomy
(Brock Procedure)

14. Open Heart Surgery 1953, Dr. Gibbon in USA
Cardiopulmonary bypass support
Intracardiac repair of ASD under direct vision

15. Acyanotic CHD c Shunt Indications of Surgery Timing of Surgery
Failure to thrive
Congestive heart failure
Qp/Qs >1.5
Progressive Pulmonary vascular change
Timing of Surgery
At any age
Prevent Eisenmenger's complex
Perimembranous VSD varied
(30% spontaneous closure)

16. Acyanotic CHD c Obstruction
Indications of Surgery
Pressure gradient > 50mmHg
Progressive heart failure
Timing of Surgery
At any age
Mostly during infancy

17. Cyanotic CHD c Obstruction
Indications of Surgery
Symptoms and signs
Depends on size of PA
Timing of Surgery
Primary repair during infancy
Staged repair before school age

18. Cyanotic CHD c Venous Mixture
Indications of Surgery
Failure to thrive
Varied in single ventricle variants
Timing of Surgery
Primary repair during infancy
Staged repair before school age