- Echocardiographic assessment of left to right shunts: atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent arterial duct. [Review]
- EREcho Res Pract 2018 Feb 05
- This review article will guide the reader through the basics of echocardiographic assessment of congenital left to right shunts in both paediatric and adult age groups. After reading this article the...
This review article will guide the reader through the basics of echocardiographic assessment of congenital left to right shunts in both paediatric and adult age groups. After reading this article the reader will understand the pathology and clinical presentation of atrial septal defects (ASDs), ventricular septal defects (VSDs), atrioventricular septal defects (AVSDs) and patent ductus arteriosus (PDA). In times gone by the stethoscope was the primary diagnostic tool used to diagnose these lesions, but in today's clinicians those skills have been usurped by the superiority of the trans-thoracic echo probe. This article will therefore describe the echocardiographic appearances of each lesion, and point the reader towards specific features to look for echocardiographically.
- Airway Improvement with Medium-Term Compression Duration after Right Pulmonary Artery Anterior Translocation. [Journal Article]
- KJKorean J Thorac Cardiovasc Surg 2018; 51(1):57-60
- Left main bronchus compression occasionally occurs in patients with cardiac disease. A 19-month-old female patient weighing 6.7 kg was admitted for recurrent pneumonia and desaturation. She had an a ...
Left main bronchus compression occasionally occurs in patients with cardiac disease. A 19-month-old female patient weighing 6.7 kg was admitted for recurrent pneumonia and desaturation. She had an a trial septal defect (AS D) with a right aortic arch. Her left main bronchus had been compressed between the enlarged right pulmonary artery (RPA) and the descending thoracic aorta for 14 months. We conducted ASD closure and RPA anterior translocation via sternotomy. The left main bronchus compression was relieved despite the medium-term duration of compression.
- Acute Effect of Inhaled Iloprost in Children with Pulmonary Arterial Hypertension Associated with Simple Congenital Heart Defects. [Journal Article]
- PCPediatr Cardiol 2018 Feb 09
- Inhaled prostacyclin analogue iloprost is currently utilized in adult patients with pulmonary arterial hypertension (PAH), but little information is available on its use in the pediatric population. ...
Inhaled prostacyclin analogue iloprost is currently utilized in adult patients with pulmonary arterial hypertension (PAH), but little information is available on its use in the pediatric population. This study evaluated the safety and acute haemodynamic effects of inhaled iloprost in children with PAH associated with congenital heart disease (CHD). Children with PAH-CHD who underwent cardiac catheterization and iloprost administration in our catheter laboratory between June 2007 and October 2015 were included. Iloprost was administered by atomization inhalation and changes in hemodynamic parameters were recorded. In total, 100 children with PAH-CHD were enrolled. Median age was 13 [1.5-18.0] years and 34% were male. A ventricular septal defect was present in 84%, a patent duct in 12%, a complete atrioventricular septal defect in 2%, and an isolated atrial septal defect in 2%. Pulmonary vascular resistance indexed (PVRI) was above 8 WU m2in 96% and was above a third systemic (Rp/Rs > 0.33) in 97%. Iloprost was well tolerated in all patients. Following iloprost inhalation, mean pulmonary arterial pressure decreased from 78.4 ± 9.2 to 72.8 ± 10.8 mmHg (p < 0.01) and pulmonary-to-systemic blood flow ratio (Qp/Qs) increased from 1.12 ± 0.48 to 1.37 ± 0.63 (p < 0.01), with no change in cardiac index (Qs). PVRI decreased from 21.0 ± 9.0 to 16.9 ± 8.0 WU m2(p < 0.01) following inhalation but 92% patients still had a PVRI > 8 WU m2and 93% an Rp/Rs > 0.33. Acute inhalation of iloprost in children with PAH associated with CHD resulted in a significant improvement in hemodynamic parameters. Despite this, few patients achieve strict criteria of operability, underscoring the importance of early screening and timely repair of CHD.
- Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMproving Pediatric and Adult Congenital Treatment (IMPACT) registry. [Journal Article]
- AHAm Heart J 2018; 196:119-130
- CONCLUSIONS: There is measurable variation in transcatheter closure of PDA and ASD. Further research is necessary to study whether this affects outcomes or resource utilization.
- Association of Preoperatively Diagnosed Patent Foramen Ovale With Perioperative Ischemic Stroke. [Journal Article]
- JAMAJAMA 2018 02 06; 319(5):452-462
- CONCLUSIONS: Among adult patients undergoing noncardiac surgery at 3 hospitals, having a preoperatively diagnosed PFO was significantly associated with increased risk of perioperative ischemic stroke within 30 days after surgery. Further research is needed to confirm these findings and to determine whether interventions would decrease this risk.
- Is Patent Foramen Ovale a Risk Factor for Perioperative Stroke? [Editorial]
- JAMAJAMA 2018 02 06; 319(5):446-447
- A Misclassification of Pulmonary Stenosis Using Conventional Echocardiographic Methods. [Journal Article]
- BMBalkan Med J 2018 Jan 20; 35(1):105-107
- CONCLUSIONS: The planimetric calculation of the pulmonary valve (PV) opening area using three-dimensional transoesophageal echocardiographic may be helpful, especially in encounters with specialized conditions such as ASD and/or pregnancy, which can cause inaccurate recordings of the transvalvular peak gradient.
- Techniques for trans-catheter retrieval of embolized Nit-Occlud®PDA-R and ASD-R devices. [Journal Article]
- CCCatheter Cardiovasc Interv 2018 Feb 05
- CONCLUSIONS: ASD-R and PDA-R devices can be successfully retrieved in the catheterization lab. It is critical to grab the center portion of the right atrial disc of the ASD-R device or pulmonary portion of the PDA-R device and to use adequately sized sheathes.
- The frequency and importance of chest pain in midterm follow up of transcatheter closure of interatrial septal defect. [Journal Article]
- JCJ Cardiovasc Thorac Res 2017; 9(4):215-220
- CONCLUSIONS: Transcatheter closure of PFOs and secundum-type ASDs in our adult patients using ASD septal occluders was associated with a high degree of success, minimal procedural subjective and objective complication rates, and excellent short- and midterm results. Although chest pain was common after the first month following ASD closure, there was no cardiac death or aortic erosion in 11.52 months follow up.
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- Hybrid repair of pectus excavatum and congenital heart disease: A case report. [Case Reports]
- MMedicine (Baltimore) 2017; 96(51):e9503
- CONCLUSIONS: This case suggests that in carefully selected cases with concomitant PE and ASD, a combination of Nuss procedure and TEE-guided transcatheter device closure can be safely performed with less physical and no radiation trauma and theoretically better aesthetic effects and surgical outcome.