A 2-day-old newborn presents with cyanosis (SpO2 82%), tachypnea (RR 58/min), and tachycardia (HR 165/min). Echocardiography confirms all four pulmonary veins drain anomalously into the right atrium instead of the left atrium. Chest X-ray shows a normal cardiac silhouette without pulmonary edema. The infant has not received prostaglandin E1 infusion. Which of the following additional anatomic findings is required for survival in this patient?
- A)Complete closure of the ductus arteriosus
- B)An intact ventricular septum
- C)A route for blood to reach the left side of the heart such as an atrial septal defectGABARITO
- D)Calcification of the mitral valve
- E)Severe left ventricular outflow obstruction
Explicação
In total anomalous pulmonary venous return, oxygenated pulmonary venous blood returns to the right side of the heart. Survival requires an interatrial communication, usually an ASD, so blood can reach the left heart and systemic circulation. Without such mixin... Ver explicação completa e trilha adaptativa →