1. Adult with operated congenital heart disease: what should we check for? January 15 th, 2016 16h-17h30

2. A) There is an increased risk of sudden death due to sinus dyfunction and paroxysmal atrioventricular block B) Implantable cardioverter defibrillator (ICD) indications are well establish and rely mainly on electrophysiological explorations. C) The risk of supraventricular rhythm disorders is much higher > 40 years old D) Aortic root dilation is frequent E) A prophylactic aortic surgery is recommended when the aortic root diameter is > 50 mm Which of the following proposition(s) about Tetralogy of Fallot is/are correct?

3. A) There is an increased risk of sudden death due to sinus dyfunction and paroxysmal atrioventricular block B) Implantable cardioverter defibrillator (ICD) indications are well establish and rely mainly on electrophysiological explorations. C) The risk of supraventricular rhythm disorders is much higher > 40 years old D) Aortic root dilation is frequent E) A prophylactic aortic surgery is recommended when the aortic root diameter is > 50 mm Which of the following proposition(s) about Tetralogy of Fallot in adults is/are correct?

4. A) Pulmonary re-valvulation is indicated in case of severe pulmonary regurgitation whatever the right ventricle volume B) Pulmonary re-valvulation is currently always performed through percutaneous approach C) A coronary artery compression during test balloon angioplasty is a contra-indication to transcatheter pulmonary valve implantation D) There are less infective endocarditis with the Melody® valve through percutaneous approach than with surgically implanted valves in the pulmonary position. E) Pulmonary stenosis is a contra-indication to percutaneous valvotomy and valve implantation Which of the following proposition(s) about Tetralogy of Fallot in adults is/are correct?

5. A) Pulmonary re-valvulation is indicated in case of severe pulmonary regurgitation whatever the right ventricle volume B) Pulmonary re-valvulation is currently always performed through percutaneous approach C) A coronary artery compression during test balloon angioplasty is a contra-indication to transcatheter pulmonary valve implantation D) There are less infective endocarditis with the Melody® valve through percutaneous approach than with surgically implanted valves in the pulmonary position. E) Pulmonary stenosis is a contra-indication to percutaneous valvotomy and valve implantation Which of the following proposition(s) about Tetralogy of Fallot in adults is/are correct?

6. A) Echocardiography allows for a reliable follow-up of the right ventricle volume B) Diastolic reflux in pulmonary arteries is a marker of a severe pulmonary regurgitation C) Normal S wave and TAPSE (tricuspid annular plane systolic excursion) are sufficient markers of preserved right ventricle systolic function D) Systolic function of the left ventricle is always preserved E) A tricuspid V max ≥ 4.5 m/s with a trivial tricuspid regurgitation is a marker of pulmonary hypertension Which of the following proposition(s) about Tetralogy of Fallot in adults is/are correct?

7. A) Echocardiography allows for a reliable follow-up of the right ventricle volume B) Diastolic reflux in pulmonary arteries is a marker of a severe pulmonary regurgitation C) Normal S wave and TAPSE (tricuspid annular plane systolic excursion) are sufficient markers of preserved right ventricle systolic function D) Systolic function of the left ventricle is always preserved E) A tricuspid V max ≥ 4.5 m/s with a trivial tricuspid regurgitation is a marker of pulmonary hypertension Which of the following proposition(s) about Tetralogy of Fallot in adults is/are correct?

8. A) Isolated complete AVSD in adults is an aetiology of Eisenmenger syndrome B) In case of pulmonary stenosis or banding, it may be still surgically correctable C) In case of Eisenmenger syndrome, specific medical therapy increases life expectancy D) Mitral clip is a good percutaneous option for atrio-ventricular valve regurgitation E) Sub aortic stenosis is a potential evolutive complication of AVSD Which of the following proposition(s) about Complete Atrio-Ventricular Septal defect in adults is/are correct?

9. A) Isolated complete AVSD in adults is an aetiology of Eisenmenger syndrome B) In case of pulmonary stenosis or banding, it may be still surgically correctable C) In case of Eisenmenger syndrome, specific medical therapy increases life expectancy D) Mitral clip is a good percutaneous option for atrio-ventricular valve regurgitation E) Sub aortic stenosis is a potential evolutive complication of AVSD Which of the following proposition(s) about Complete Atrio-Ventricular Septal defect in adults is/are correct?

10. A) It may be diagnosed during adulthood B) It is the association of ostium secundum ASD and mitral cleft C) Cyanosis is a symptom that may lead to diagnosis D) Percutaneous closure is the treatment of choice of the ostium primum Atrial septal defect E) Definitive epicardial leads are often implanted during AVSD surgical repair Which of the following proposition(s) about Partial Atrio-Ventricular Septal defect is/are correct?

11. A) It may be diagnosed during adulthood B) It is the association of ostium secundum ASD and mitral cleft C) Cyanosis is a symptom that may lead to diagnosis D) Percutaneous closure is the treatment of choice of the ostium primum Atrial septal defect E) Definitive epicardial leads are often implanted during AVSD surgical repair Which of the following proposition(s) about Partial Atrio-Ventricular Septal defect is/are correct?

12. A) Right ventricle dysfunction is a frequent long term complication of atrial switch B) Sinus dysfunction is a frequent dysfonction of atrial switch C) Baffle leaks can sometimes be closed percutaneously D) Pace maker leads increase the risk of baffle stenosis E) Stenting should be avoided in symptomatic patients with baffle stenosis and surgery is the preferred option Which of the following proposition(s) about Transposition of the great arteries in adults is/are correct?

13. A) Right ventricle dysfunction is a frequent long term complication of atrial switch B) Sinus dysfunction is a frequent dysfonction of atrial switch C) Baffle leaks can sometimes be closed percutaneously D) Pace maker leads increase the risk of baffle stenosis E) Stenting should be avoided in symptomatic patients with baffle stenosis and surgery is the preferred option Which of the following proposition(s) about Transposition of the great arteries in adults is/are correct?

14. A) Loss of sinus rhythm may precipitate rapid haemodynamic decline and should be considered a medical emergency B) Electrical cardioversion is the mainstay of treatment as drug therapy is often ineffective C) There should be a low threshold for radiofrequency ablation D) These arrhythmias are easy to treat in the rhythm. Lab. And no specific experience is required E) If atrio and/or ventricular pacing is needed, endocardial leads are the preferred option Which of the following proposition(s) about Single Ventricle in adults is/are correct?

15. A) Loss of sinus rhythm may precipitate rapid haemodynamic decline and should be considered a medical emergency B) Electrical cardioversion is the mainstay of treatment as drug therapy is often ineffective C) There should be a low threshold for radiofrequency ablation D) These arrhythmias are easy to treat in the rhythm. Lab. And no specific experience is required E) If atrio and/or ventricular pacing is needed, endocardial leads are the preferred option Which of the following proposition(s) about Single Ventricle in adults is/are correct?

16. A) It is associated with multisystemic disorder B) Atrio-pulmonary connection may be converted to a more efficient bi-cavo-bi pulmonary connection in selected cases C) Sildenafil may be efficient to treat Fontan failure in selected cases D) Catheterization may be useful to search for abnormalous vascular connections in case of unexplained cyanosis E) Mechanical assistance is highly effective in this setting and is preferred to cardiac transplantation Which of the following proposition(s) about Fontan repair in adults is/are correct?

17. A) It is associated with multisystemic disorder B) Atrio-pulmonary connection may be converted to a more efficient bi-cavo-bi pulmonary connection in selected cases C) Sildenafil may be efficient to treat Fontan failure in selected cases D) Catheterization may be useful to search for abnormalous vascular connections in case of unexplained cyanosis E) Mechanical assistance is highly effective in this setting and is preferred to cardiac transplantation Which of the following proposition(s) about Fontan repair in adults is/are correct?