0:00

So the next next case belongs to four different

0:03

individuals who have four different types of

0:06

atrial sample defects. Can you bring

0:09

up the poll again? I'm going to put put four different cases

0:12

here and we'll have a poll of what type of asd's.

0:15

It's four different asd's which are being shown sinus Windows ASD

0:18

second ASD.

0:20

And atrioventricular defect in unroot coronary sinus.

0:24

This is case number a we're going to go to

0:27

all the four cases. Don't come back to case a case number

0:30

B.

0:31

Another form of atrial simplification. So all these four patients have different

0:34

types of atrial sample defects shown on city

0:37

bright blood Imaging.

0:38

Case number c and finally case

0:41

number D. So can we start

0:44

probably have to take individual polls again as we did before case number

0:47

a match what type of atrial Supply effect

0:50

the audience thinks is

0:54

we have the choices are sinus phenosis second and

0:57

a Visa Canal or atrientical supplementary

1:00

factor of coronary sinus.

1:02

Okay. Second ome wonderful. Excellent. Excellent

1:05

choice the diagnosis not a nature

1:08

of ventricular sample defect and I'll tell you why don't want

1:11

to give the answer away for for subsequent cases. This defect is

1:14

in the is in the middle of the integral septum or

1:17

the central part of the a of the interatrial septum in

1:20

the center in the second number region. This is a patient with a second

1:23

and ASD.

1:26

Next case and Paul again, please. This is

1:29

a neonate who presents within atrial

1:32

simply effect. The correct answer would be one of these four.

1:35

Okay, the correct answer is an atrioventical subtle defect excellent

1:38

notice that the defect is large and was a distal part of

1:41

the integral septum Associated extends into the approximal interventricular

1:44

septum associated with the AV canal canal

1:47

region. This is an atrial ventricular separate effect

1:50

or a primum ASD because in the more distal

1:53

part of the integral septum and can involve

1:56

the interventricular septum and the atrio ventricular valves. This is an AV Canal

1:59

defect associated with can be Associated Down syndrome.

2:02

Hventricular sample defect.

2:04

case number three or c

2:07

Once again, the four choices are either of these three

2:10

second. I'm sinus phenosis a

2:13

resupply effect on roof chronic sinus. The correct

2:16

answer is a sign is phenosis. Atrial Supple defect notice that

2:19

this defect is between the SVC and the left atrium and

2:22

associated with where the pulmonary vein comes

2:25

into the left atrium. This this defect is

2:28

a sinus phenosis defect it because hind the interatrial septum between

2:31

the SVC and the left atrium and it

2:34

can be associated with partial enormous polymer Venus Return of

2:37

the right upload to the SVC. This is a sinus

2:40

phenosis defect high in the integral septum the region of

2:43

the SVC right atrium and left atrium conference.

2:47

The last atrial sample day function is shown in this case

2:50

in this particular example. Once again, when you have a pole it's either of

2:53

these four the correct answer is unroof current

2:56

science. Excellent notice the current sinus comes

2:59

in the right atrium. And the wall of the coronary sinus between the left

3:02

atriums and sorry it comes into the right atrium the wall

3:05

of the coronary sinus between the left atrium and and the coronocide itself

3:08

is deficient. So there's a left right shunt between

3:11

the left atrium chronic sinus right atrium. So rare

3:14

form of atrial simply fact known as a coronary sinus

3:17

ASD, so four types of atrial Supple defects the

3:20

coronary sinus ASD sinus venosis ASD

3:23

Prime Ministry on atrioventricular sample defect

3:26

in the second term ASD commonness is second in

3:29

ASD, but the role of

3:32

MRI in HL Central defects is significant in

3:35

that it can identify the atrial sample defect the

3:38

sinus Windows AST and the coronary sinus ASD can be difficult

3:41

to identifying a car geography because of the location notice the

3:45

Coronary science AST located along the posterior aspect

3:48

of the heart difficult to see by Echo car geography indirect evidences

3:51

officiant maybe present in the form of right ventricular dilatation

3:54

or dysfunction, but to identify the

3:57

precise Anatomy measure the right ventricular size quantitatively and

4:00

to quantify qp-back us MRI is

4:03

needed.

4:04

And furthermore in a sinus Windows defect MRI

4:07

can clearly identify the deficiency in the wall between

4:10

the SVC right atrium and left. Hm

4:13

conference and also identify their normal spawn routine vein.

4:17

Draining into the superior vena cava from the upper lobe

4:20

of the right lung sinus Windows is defects and

4:23

coronary sinus defects. Those are two asd's that MRI has

4:26

a very important role and furthermore in the other defects primarily effect.

4:29

And secondly effect. MRI can guide closure see

4:33

whether the rims are adequate critical and second of ASD which require which

4:36

may be treated by Catherine interventions

4:39

and to also to measure the right ventricular size function and to

4:42

quantify the cubic us when the cubic uses large

4:45

over 1.5 indicates that there's a significant shunt a problem

4:48

ASD typically found in neonates where young children

4:51

can be recognized by echocon geography

4:54

young patients are a better Windows for geography and

4:57

for the more it can be closed. But if there's any associative normalities

5:00

MRI is a better chance to diagnose

5:03

to identify associative demand such

5:06

as hraventricular valve programities abnormalities of the

5:09

ventricles all the great festivals and the common remains so different types

5:12

of atrial Central defects shown in this particular case.