Communication in the CICU is an often intimidating blend of efficient abbreviations and stubborn history.  Here is a non-comprehensive list to get you started.  Think of one that we forgot?  Please email it to us!  

And click here to find some of the original papers that describe these findings and procedures.

AAAortic valve atresia, a disorder in which the aortic valve orifice is atretic (does not open).
AAIA common mode of atrial pacing in which the pacemaker senses the only the atrium and paces it at the set rate unless inhibited by a sensed p wave.
ALCAPAAnomalous origin of the left coronary artery arising from the pulmonary artery. Patients typically present at ~3-6 months of age with clinical heart failure, severe ventricular dysfunction, and mitral regurgitation.
APCAortopulmonary collateral. Abnormal vessel arising from the aorta and perfusing the lung (or airway).
AR or AIAortic regurgitation or insufficiency
ASAortic stenosis
AsAoAscending aorta
ASDAtrial septal defect. A hole between the left and right atrium. This is a physiologic term and does not specify where the defect in the atrial septum is anatomically. When used colloquially, it is often refers to ASD2.
ASD1Ostium primum atrial septal defect. A defect in septum primum which forms from endocardial cushions; commonly associated with atrioventricular canal. Sometimes called an AV canal septal defect.
ASD2Ostium secundum atrial septal defect. Defect in (usually) ostium primum that creates one or more fenestrations (holes) in the fossa ovalis.
ASOArterial switch operation. Modern treatment of dTGA in which the coronaries and aorta are transferred to the pulmonary root, and the MPA brought anterior to the aortic root (LeCompte maneuver).
Automatic tachycardiaA tachycardia caused by repetitive discharges (automaticity) from outside the SA node, distinct from a reentrant tachycardia. Examples include JET, EAT. Treatment is generally to decrease catecholamines
AVCAtrioventricular canal defect. May be partial (not all components of complete defect) or CAVC.
AVNRTAtrioventricular nodal reciprocating tachycardia. A re-entry tachycardia with 2 pathways, one of which is in or around the AV node.
AVVRAtrioventricular valve regurgitation
BACHBoston Adult Congenital Heart program, a group of subspecialists with expertise in CHD across the age spectrum.
BaffleAs a verb, it means to direct blood to a certain place (e.g. ‘the LV was baffled to the aorta’ means that a patch was placed that closed a VSD and directs all blood to the aorta). As a noun, a baffle is a sheet (or tube graft) of material used to divert blood to a single location where it previously did not (exclusively) go.
BentallOperative procedure in which the aortic root and ascending aorta are replaced with homograft and a prosthetic valve.
BDBalloon dilation, the act of inflating a balloon filled with saline/contrast to widen a narrowing within a valve or vessel. See ‘waist’ for more detail.
BDGBidirectional Glenn. See Glenn. Classic Glenn shunt was SVC to RPA anastamosis (i.e. unidirectional).
Bovine trunkA common pattern of aortic arch anatomy in which the left carotid artery arises from the base of innominate artery (which also gives off the right subclavian and right carotid artery).
BTS or mBTS(Modified) Blalock-Taussig shunt. Classically, a right subclavian to RPA anastamosis used to palliate patients with TOF with severe cyanosis.. Now always ‘modified’ to use a 3-3.5 mm GoreTex tube graft. May be part of S1P. Credit also to Vivien Thomas who taught Blalock how to do the operation.
BVFBulboventricular foramen. Anatomic connection between a single LV and the outflow chamber, leading to either the PA or Ao (in transposition). Tend to become restrictive over time.
CACommon atrium. A right and left atrium not separated by an atrial septum. This can occur natively (e.g. large ASDs) or be surgically created (e.g. following S1P).
CAVCComplete (or common) atrioventricular canal defect.
CCHDCritical congenital heart disease, defined as heart disease that is PGE-dependent at birth.
CMRCardiac MRI, often used to define 3D anatomy, flow, ejection fraction, regurgitant fractions, and ventricular volumes with confidence in operative planning.
CoACoarctation of the aorta
Critical ASCritical aortic stenosis. A disorder in which the aortic valve is thought (or rarely, known to be if the patient presented in shock) to be too small to sustain a circulation and is PGE-dependent until an intervention is performed. Colloquially, the term is generally reserved for situations in which the aortic valve is thought to be the primary limiter (i.e. patients with HLHS are not referred to as having critical AS although most do).
Critical PSCritical pulmonary stenosis. A disorder in which the pullmonary valve is thought to be too small to sustain adequate oxygenation, and is PGE-dependent until intervention is performed.
CRTCardiac resynchronization therapy. Pacing strategy in which ventricular leads are placed on both the right and left ventricle to decrease interventricular condution delay.
CRRTContinuous renal replacement therapy.
CWContinuous wave Doppler. A specific echo technique used to assess for a gradient somewhere along the sound pathway at a non-specific site. Contrast with PW.
DAoDescending aorta
DDDA common synchronous pacing mode in which the pacemaker senses both the atrium and ventricle, and paces the atrium when it falls below the lower rate limit and paces the ventricle when it does not contract in time.
DILVDouble inlet left ventricle
DKSDamus-Kaye-Stansel. An anastamosis between the pulmonary artery and aorta proximally. Part of S1P, which also includes distal aortic arch reconstruction. These 3 men all described the same operation in separate papers in 1974 for treatment of dTGA., hence the triple eponym. Can also be called a ‘Stansel’, occasionally a ‘Damus,’ but almost never a ‘Kaye.’
DOOAn asynchronous pacing mode in which both the atrium and ventricles are paced without regard to native rhythm or conduction. Often used for internal pacers during electrocautery.
DORVDouble outlet right ventricle. Defect in which both great arteries are associated with the RV. Clinical pathway depends on relation of the VSD to aorta, size of aorta, and size of LV. Classified as subpulmonary, subaortic, doubly committed based on position of VSD relative to the great arteries.
Double runA 1 mEq/kg dose of potassium chloride, double the usual dose.
Double switchAn operation in which the IVC and SVC are baffled to the left side of the heart (usually via Mustard) and the LV is directed to the aorta, either via ASO or Rastelli. Often used in L-TGA patients.
dTGAD-looped transposition of the great arteries, can occur with (dTGA/VSD) or without (dTGA/IVS) a VSD. There have been many historical treatments of this defect: DKS, Mustard, Senning, and now ASO.
DuctSee PDA
EATEctopic atrial tachycardia. An automatic tachycardia originating from the atrium but outside the SA node. Often a marker of severe heart disease.
ECMOExtracorporeal membrane oxygenation
EFEEndocardial fibroelastosis. A rubbery, fibrous lining of the endocardium found in patients with left heart obstructive lesions thought to restrict LVEDV.
FenestrationA surgically created hole in a patch or tube graft that allows blood to cross an otherwise intact pathway. Often, fenestrations are left in a Fontan baffle to permit blood to pass from the Fontan to the common atrium, or in an ASD to allow blood to pass from RA to LA as a ‘pop-off.’
Flow accelerationA change in Doppler flow velocities on echo that generally indicates a relative narrowing of a vessel at location being interrogated.
FontanConnection between inferior vena cava and pulmonary artery. May be performed using a lateral tunnel (through the body of the right atrium) or extracardiac conduit.
Fossa ovalisThin fibrous region within the center of the atrial septum. If open, it is the site of PFO.
GlennConnection between one (or both) SVCs and the pulmonary arteries. May be a second stage of single ventricle palliation.
HCM (or HOCM)Hypertrophic (obstructive) cardiomyopathy. A pathologic state in which the thickness of the ventricles is excessive. Although commonly heritable, obstructive lesions can also cause ventricular hypertrophy. These patients are susecptible to subendocaridal ischemia and dynamic outflow tract obstruction (e.g. with hypovolemia or vasodilation).
HFNCHigh flow nasal cannula
Holmes heart [Original description]Double inlet LV with normally related great arteries and pulmonary valve arising from a bulboventricular formamen. Significant as first recorded clinical description of a single ventricle in 1824.
HomograftTissue from a human donor. Typically a segment of the ascending aorta and aortic valve or PA and pulmonary valve. May be used as a conduit or as tissue to augment small structures.
HTXHeterotaxy. A complex constellation of heart defects that include the heart, great vessels, lungs, and spleen.
InfundibulotomyA linear incision placed in the infundibulum, usually to access a VSD.
InfundibilumMuscular connection between the body of the right ventricle and the pulmonary valve.
Innominate arterySegment of artery that connects the transverse aorta to the right subclavian and right carotid artery. Commonly discussed around placement of a BT shunt, which can be taken off the innominate artery or more distally off of the subclavian artery, which is a higher resistance vessel.
Innominate veinCentral vein that drains the left subclavian and jugular veins to the SVC.
Isolated CoACoarctation of the aorta in which there are no additional defects, notably the absence of a VSD.
Isolated LPA/RPAAnatomic situation in which one of the branch PAs becomes anatomically disconnected from the circulation following closure of the PDA. Typically there is echocardiographic concern for this prior to ductal closure and is an indication for PGE and an operation.
IsthmusPortion of the aorta between the most distal brachiocephalic artery (normally the left subclavian) and the insertion of the PDA. Typically the most hypoplastic portion of the arch in paitents with CoA.
IVCInferior vena cava. Vein carrying venous return from the lower half of the body to the right atrium; partially covered by the eustachian valve that directs blood towards the PFO.
JateneSee ASO, first described by Jatene in 1975.
JETJunctional ectopic tachycardia. An exclusively postoperative automatic tachycardia originating from the AV node or proximal bundle of His. Often treated with hypothermia or Procainamide and temporary atrial pacing.
LA HTNLeft atrial hypertension. May be caused by left ventricular or mitral valve disease and results in pulmonary edema, impaired lung mechanics and gas exchange.
LeCompte maneuverA maneuver performed while the aorta is transected in which the RPA, which normally passes through the underside of aortic arch, is brought anterior to the aorta, typically as part of ASO. A mild degree of flow acceleration (obstruction) at the branch PAs is typical.
LLPA/LLPVLeft lower pulmonary artery/vein
LPALeft (main) pulmonary artery
L-TGALevo-tranposition of the great arteries. Most commonly, this is {S,L,L}, an anatomy in which the RA–>LV–>PA and LA–>RV–>aorta. Over time, the systemic RV fails, and we treat these patients with a ‘double switch.’
LUPA/LUPVLeft upper pulmonary artery/vein
LVEDVLeft ventricular end diastolic volume. Volume of blood in the LV at the end of diastole, an important determinant of stroke volume.
LVOTLeft ventricular outflow tract. Depending on the situation, a gradient of >30 mmHg may be considered significant.
LVOTOLeft ventricular outflow tract obstruction
MAMitral valve atresia
ManougianOperative technique for enlarging a narrow aortic annulus by incising the non-coronary cusp of the aortic valve and extending it onto the posterior leaflet of the mitral valve.
MSMitral valve stenosis
MustardVenous baffle of SVC and IVC across the atrium to the left side of the heart, typically to a left sided TV.
neo-AIReurgitation (or insufficiency) of the neo-aortic valve.
neo-AVNeo-aortic valve. Called ‘neo’ as the valve in the aortic position (i.e. connected to the aorta) was not the morphologic aortic valve (i.e. connected to the aorta and coronary arteries at birth). For example, the valve in the aortic position following ASO is the morphologic pulmonary valve in the aortic position, so is called the neo-AV. This communicates both that we are talking about the valve in the aortic position and that it is non-native, which is important because the morphologic PV has different mechanical properties than the morphologic AV.
NikaidohOperative procedure in which the aortic root is translocated to be closer to an otherwise remote VSD to enable ventricular septation.
NIPPVNon-invasive positive pressure ventilation (e.g. CPAP)
NIRSNear infrared spectroscopy. A light-based probe that uses absorbance spectroscopy (like a pulse oximeter or co-oximeter) to provide a surrogate for volume-averaged tissue oxyhemoglobin saturation. Can be monitored on the forehead (cerebral) or flank (somatic). Although sometimes considered a surrogate for SvO2, it is known to be very insensitive to low SvO2 and should therefore not be considered reassuring if normal.
NorwoodSee S1P, an operation first performed at BCH.
NRGANormally related great arteries, with the pulmonary artery arising anterior and leftward of the aorta.
OHTOrthotopic heart transplant.
OzakiA recent technique used to replace one or more diseased aortic valve leaflets with leaflets made from native tissue, cut from a template, and sewn into place.
PA/IVSPulmonary atresia with intact ventricular septum. Spectrum of heart diseases which may result in 1 or 2 ventricle circulation.
Pace terminationThe act of interrupting (terminating) a reentrant tachycardia through rapid atrial pacing, which creates a refractory period within a tachycardia circuit.
Papillary muscle of LancisiPapillary muscle that supports the anterior leaflet of the TV. Significant as the point of bifurcation between the right and left bundle branches.
PaO2Partial pressure of oxygen dissolved in the plasma phase of blood. Useful in determining the A-a gradient in patients without oxyhemoglobin desaturation and without right to left shunting.
Partial anomalous pulmonary venous return (or connection). A defect in the tissue that usually separates the right pulmonary veins from the right atrium and SVC. Also known as a sinus venosus septal defect.
Parachute mitral valveMitral valve in which the chordae converge onto a single papillary muscle, taking the shape of a parachute’s harness. Blood must pass through chordal structures rather than, as is normal, between two widely spaced papillary muscles at the ventricular apex.
PBFPulmonary blood flow
PDAPatent ductus arteriosus. Vascular connection between the proximal LPA and descending aorta. Patency maintained by PGE infusion. Colloquially called a ‘duct’ or ‘ductus’ for short.
PentalogySome cardiologists refer to TOF with the addition of an atrial level defect (ASD or PFO) as a Pentalogy (of Fallot). Should not be confused with Pentalogy of Cantrell.
Pentalogy of CantrellA congenital defect that includes a midline supraumbilical abdominal defect, a defectof the lower sternum, a deficiency of the diaphragmatic pericardium, deficiency of the anterior diaphragm, and a congenital heart defect. In some cases this is TOF.
PFOPatent foramen ovale. Normal interatrial communication in fetal life (during which time it flows right to left). For left (atrial) to right (atrial) flow, the PFO must be distended or ‘sprung’.
PGE1Prostaglandin E1. Also known as PGE.
Pop-offA term used to explain that an anatomic connection between two chambers if the pressure in one chamber becomes excessively high. Most commonly, this is used to refer to an atrial level defect that permits RA to LA (or Fontan to CA) flow during high PVR, preserving cardiac output while causing increased cyanosis.
PottsOperative anastamosis between the descending aorta and LPA. First described to treat TOF.
PPMPermanent pacemaker. An indewlling pacemaker. May be epicardial or transvenous. May (or not) have 1 or 2 ventricular leads and/or atrial leads.
PR or PIPulmonary (valve) regurgitation or insufficiency
PVRPulmonary valve replacement, an operation in which a (usually) prosthetic valve is placed in the position of a previously native valve or within an RVPAC.
PVSPulmonary vein stenosis. A disease of intimal hyperplasia of the pulmonary veins. Can cause pulmonary edema and lung disease.
PWPulse wave Doppler, a specific echo technique that uses rapid bursts (pulses) of sound to accurately measure the velocity of blood in a precise location Used to identify the precise location of flow acceleration (obstruction).
QpPulmonary blood flow. This can sometimes be estimated based on the Fick principle as Qp = VO2/(SpvO2-SpaO2). Dissolved oxygen should be considered when SpvO2 is >95%.
QsSystemic blood flow. This can sometimes be estimated based on the Fick principle as Qs = VO2/(SaO2-SvO2), so long as PaO2<100.
Qp/QsConceptual framework in single ventricle physiology describing the ratio of pulmonary to systemic blood flow.
RAA (with MIB)Right aortic arch (with mirror image branching). A common abnormality in which the aorta courses over the right mainstem bronchus (rather than left); the dorsal (posterior) aorta lies to the right of the spine rather than left. Commonly has brachiocephalic branching that is mirror image of normal (i.e. a left innominate artery first, then right carotid, then right subclavian). Present in 25% of TOF and 30% of truncus. Can create a vascular ring when combined with an aberrant left subclavian.
RAARight atrial appendage.
RAPRight atrial pressure. Normal value 3-5 mmHg.
RastelliOperative technique in which the VSD is baffled to the aortic valve and RVPAC is placed.
Reentrant tachycardiaA type of arrhythmia characterized by the presence of abnormal conduction tissue (called a pathway) that allows the recirculation of electrical impulses that cause tachycardia. This causes abrupt onset tachycardias (i.e. in 1 beat) that can be terminated with adenosine or with rapid atrial pacing.
RLPA/RLPVRight lower pulmonary artery/vein
RmBTSRight modified Blalock-Taussig shunt. See BTS.
RPARight (main) pulmonary artery
RossOperation in which the native pulmonary root (and valve) are excised and transferred to the aortic position. Necessarily includes RVPAC placement.
Ross-KonnoRoss operation in which the aortic root is also enlarged by incising the annulus ± ventricular septum to enlarge the LVOT and aortic annulus.
RUPA/RUPVRight upper pulmonary artery or vein
RVOTORight ventricular outflow tract obstruction
RVPRight ventricular pressure. Typically, this refers specifically to the RVSP (RV systolic pressure), and may be represented as a fraction of systemic. The RV is generally less able to tolerate RV HTN due to its thin wall, which increases wall stress for a given pressure.
RVPACRight ventricular to pulmonary artery conduit. A homograft (cryopreserved donor vessel, usually from donor aorta) used to connect the right ventricle to the pulmonary artery in a number of operations.
S1PStage 1 palliation (or Norwood procedure). Often the first step in the palliation of infants with single ventricles.
Sano Ringed GoreTex conduit connecting the right ventricle and pulmonary arteries in S1P. May contain an interposition valved venous homograft.
‘Sat run’The practice of measuring SaO2 in the RA (or SVC) and PA to evaluate for a ‘step-up’. Commonly performed by direct stick during open chest procedure.
SaO2Arterial oxyhemoglobin saturation. All SaO2 on ABG are determined by co-oximetry (even when not labeled as such).
Scimitar syndromeA disorder characterized by hypoplasia of the right lung and anomalous pulmonary venous drainage of most or all of the RPVs to the IVC.
SCPCSuperior cavopulmonary connection. See Glenn.
SenningOperative technique in which the body of the RA is used to baffle SVC and IVC to left sided AVV and pulmonary veins to the right sided AVV. Now a rarely performed atrial switch procedure.
Shone’s complexA specific complex of parachute mitral valve, supramitral ring, subaortic stenosis, and CoA. Often (inaccurately) used to refer to patients with a variety of other left heart obstructive lesions.
SLSSSmall left sided (left heart) structures. Generally, patients with left heart obstructive lesions that include mitral and aortic stenosis, with or without left ventricular hypoplasia and aortic arch obstruction.
SpO2Oxygen saturation by pulse oximetry. This value correlates poorly with co-oximetry values in cyanosis (<90%).
StarnesAn operative approach that includes placement of a fenestrated patch over the TV orifice that excludes the RV from receiving preload in severe neonatal Ebsteins anomaly. PBF is through a mBTS.
Step upAn increase in oxyhemoglobin saturations from the RA (or SVC) to PA. Differences of more than 10% points indicates the presence of a significant left to right shunt. Commonly used to assess for residual VSD.
SubASSubaortic stenosis, commonly occuring as a discrete mebrane in patients with CAVC.
‘Super-Glenn’A colloquial term used locally to refer to patients with both a SCPC (Glenn) and an aortopulmonary shunt (or BTS). Often includes a septation between the right and left PA.
Sutureless repairAn operation used to treat PVS in which the native pulmonary veins are incised and filleted open, and pericardium (which natively wraps around the outside of the pulmonary vein) is used to create a closed circulation. Called sutureless because no sutures are directly placed within pulmonary veins.
SVCSuperior vena cava. Vessel receiving blood from the head and neck. Blood often sampled for ‘SVC saturation’ to determine adequacy of cerebral oxygenation.
SvO2Venous oxyhemoglobin saturation, often used as a surrogate for the adequacy of oxygen delivery. Strictly speaking, drawn from the PA in a bivenricular circulation with no intracardiac mixing. When impossible, we often use the SVC saturation as a surrogate; beware of contamination from the atrium or PAPVC.
SVRSystemic vascular resistance. A conceptual term that is calculated by MABP/cardiac output and represents impendence to systemic blood flow. Increases with hypothermia or vasocontricting agents.
TAPTransannular patch. An operative technique used in repair of TOF in which the pulmonary annulus is incised and a patch placed acorss it.
Total anomalous pulmonary venous connection (or return). A defect in which pulmonary veins return to a confluence that is not in continuity with the LA, but return to SVC, portal vein, IVC or RA. May be clinically obstructive (lung disease), constituting a surgical emergency.
Taussig-BingDORV with subpulmonary VSD. Aorta is separated from the VSD by obstructive subarterial conus.
TCPCTotal cavopulmonary connection. See Fontan.
TOFTetralogy of Fallot. A common heart defect including a ventricular septal defect over which the aorta sits and some degree of pulmonary outflow obstruction. Clinical pathway is primarily dependent on the size of the PV and pulmonary arteries. Desribed first by Steno of Denmark (1673), and named a tetralogy by Fallot of Marseilles (1888).
TOF/PSTetralogy of Fallot with pulmonary stenosis.
Tetralogy of Fallot with pulmonary atresia and multiple aortopulmonary collaterals. The most severe form of TOF in which central pulmonary arteries are diminuitive or absent altogether.
TRTricuspid valve regurgitation.
TR jetMeasured Doppler gradient across the TV, used to estimate RVP by echo (added to the RA v wave).
Triangle of KochAn anatomic location bounded by the the tricuspid valve annulus, ostium of the coronary sinus, and the tendon of Todaro. Important because it houses the AV node.
TVTricuspid valve
Unrestrictive VSDVSD without a pressure gradient across it. Generally defects that are the size of the aortic valve or larger are physiologically unrestrictive.
VADVentricular assist device, including HeartWare, Berlin pump, or external centrifugal pump (RotaFlow).
VSDVentricular septal defect. An anatomic connection between the right and left ventricle.
VSRValve-spring repair of TOF that includes (often) an infundibular and MPA patch augmentation and pulmonary valve commissurotomies.
VVCVenovenous collateral. An abnormal vessel between (often) a pulmonary artery to common atrium or pulmonary vein (in a Fontan) or IVC (in a Glenn). Causes cyanosis.
VVIA synchronous pacing mode in which only the ventricles are sensed and are paced when the ventricular rate falls below the set lower rate limit.
WaistFluoroscopically apparent Indentation on a balloon being used for catheter-based valvuloplasty or angioplasty indicating that a focal area of stenosis was balloon dilated. ‘Resolving’ a waist implies that the focal constriction was expanded.
WardenOperative procedure for treatment of PAPVC in which the SVC is transected and anastamosed to the RAA and anomalous pulmonary veins baffled to LA.
WaterstonOperative anastamosis between the ascending aorta and RPA.
Z scoreThe number of standard deviations away from the mean of age matched controls. A negative Z score indicates smaller than average, a positive indicates larger than average. The size of many anatomic features (e.g. mitral or aortic valve annulus, aortic isthmus) are assessed as a Z score. Generally, a Z score of <-3 is concerning.
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