Surgery>>>>>Congenital Heart Disease
Question 3#

Which of the following is NOT an acceptable treatment for aortic valve stenosis with a hypoplastic left ventricle (LV)?

a. Balloon valvotomy
b. Intubation and initiation of prostaglandin
c. Surgical valvotomy
d. Norwood procedure

Correct Answer is A

Comment:

In patients with critical aortic stenosis, the degree ofleft ventricular hypoplasia is assessed and based on this the decision for biventricular and univentricular repair is made. Urgent intervention is needed in these critically ill neonates including intubation, inotropic support, and prostaglandin to maintain ductal patency for systemic blood flow. In the presence of hypoplastic LV, isolated aortic valvotomy should not be performed because studies have demonstrated high mortality in the population following isolated valvotomy. The Norwood procedure is the first part of the staged single ventricle pathway.