Practical Session 1 - Group 2

We have already started the practical sessions in Room 2.

The first part of the 4-hour session has been devoted to explaining in more detail what we expect from you in the team work so that you are able to plan ahead and prepare yourself in advance.

“Something the Lord Made”

The film “Something the Lord Made” is based on true facts that transformed the medical practice of the past surgery in the fields of traumatic shock as well as in the treatment of Tetralogy of Fallot (TOF). Alfred Blalock, Helen Taussig and Vivien Thomas defied the rules of their time to launch an unprecedented surgical technique on patients with TOF, also called “blue babies” due to the cyanosis produced by this congenital heart defect.  

The operation involved the joining of the subclavian artery to the pulmonary artery. After meeting with Taussig, Blalock and Thomas developed an experimental model in dogs that resembled the pathophysiological conditions of the babies with TOF. This allowed them to subsequently experiment in the animal model a surgical approach to alleviate the suffering and secure death of children with TOF by performing a subclavian-to-pulmonary anastomosis. 

Taken from Warner Bros – HBO® VIDEO

Tetralogy of Fallot classically involves 4 anatomical abnormalities of the heart:

1. Overriding aorta
The degree to which the aorta is attached to the right ventricle is referred to as its degree of "override." The aortic root can be displaced toward the front or directly above the septal defect, but it is always abnormally located to the right of the root of the pulmonary artery.

2. Ventricular septal defect

A hole or communication between the two ventricles of the heart leads to a low oxygenation due to the mixing of oxygenated and deoxygenated blood. Usually, the defect is centered around the superior part of the ventricular septum and in the majority of cases consists in a single and large septal defect.

3. Pulmonary stenosis

The narrowing of the right ventricular outflow tract can be caused by valvular or infundibular stenosis. The degree of stenosis varies between individuals with TOF, and is the primary determinant of symptoms and severity.

4. Right ventricular hyperthrophy

As a compensatory mechanism the right ventricular wall increases in size to overcome the increased obstruction to the outflow posed by the pulmonary stenosis.

Active participation during the practical sessions as well as during the lectures scores positively. Those students that have replied to the questions formulated, shared their opinions and contributed to discussions by explaining their views and perspectives in a reasoned and constructive way have started to earn points for their final mark. Well done!!! Continue like this!!! The rest is also encouraged to participate!