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Aortic valvar stenosi

Nikunj Vaidhya, Amit Mishra, Sumbul Siddiqui, Harshil Joshi, Hardik Patel
Ventricular septal defect (VSD) with valvar pulmonary stenosis (PS) is a combination of cardiac defects for which treatment by means of percutaneous catheter-directed intervention is sometimes considered. Septal occluder device embolization is a rare but potentially dreadful complication. Adequate precautions are of great importance, as operator-related and anatomical factors can contribute to the risk of device embolization. In this report, we present a case of a five-year-old patient with a perimembranous VSD and valvar PS with infundibular muscle hypertrophy...
May 19, 2016: World Journal for Pediatric & Congenital Heart Surgery
Viktor Hraška
Neonates with critical aortic stenosis represent a challenging group of patients with severe obstruction at a valvar level and with symptoms of heart failure. If biventricular repair is chosen, open valvotomy (OV) has been firmly established as the most effective initial treatment. In comparison with blind ballooning, OV, with exact splitting of fused commissures and shaving of obstructing nodules, can produce a better valve with a maximum valve orifice, without causing regurgitation. Thus, predictable and consistent early and longer-lasting results in any type of valve morphology are provided...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Yidong Wang, Bingruo Wu, Emily Farrar, Wendy Lui, Pengfei Lu, Donghong Zhang, Christina M Alfieri, Kai Mao, Ming Chu, Di Yang, Di Xu, Michael Rauchman, Verdon Taylor, Simon J Conway, Katherine E Yutzey, Jonathan T Butcher, Bin Zhou
AIMS: Congenital anomalies of arterial valves are common birth defects, leading to valvar stenosis. With no pharmaceutical treatment that can prevent the disease progression, prosthetic replacement is the only choice of treatment, incurring considerable morbidity and mortality. Animal models presenting localized anomalies and stenosis of congenital arterial valves similar to that of humans are critically needed research tools to uncover developmental molecular mechanisms underlying this devastating human condition...
October 21, 2015: European Heart Journal
Kwang Ho Choi, Si Chan Sung, Hyungtae Kim, Hyung Doo Lee, Gil Ho Ban, Geena Kim, Hee Young Kim
The surgical management of transposition complex with aortic arch obstruction remains technically demanding due to anatomic complexity. Even in the recent surgical era, there are centers that address this anomaly with a staged strategy. This report presents our experiences with a one-stage repair of transposition complexes with aortic arch obstructions more than the last 10 years. Since 2003, 19 patients with a transposition of the great arteries (TGA, 2 patients) or a double outlet of the right ventricle (DORV, 17 patients) and aortic arch obstruction have undergone one-stage repair of their anomalies...
January 2016: Pediatric Cardiology
Marcos Danillo Peixoto Oliveira, Fernando Roberto de Fazzio, José Mariani Junior, Carlos M Campos, Luiz Junya Kajita, Expedito E Ribeiro, Pedro Alves Lemos
Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. We present herein the case of a 70-year-old man with symptomatic severe aortic valvar stenosis whose preoperative coronary angiogram revealed a so far unreported coronary anomaly circulation pattern.
2015: Case Reports in Cardiology
Kevin G Friedman, Lindsay Freud, Maria Escobar-Diaz, Puja Banka, Sitaram Emani, Wayne Tworetzky
Fetal aortic valvuloplasty (FAV) has shown promise in averting the progression of fetal aortic stenosis to hypoplastic left-heart syndrome. Altered loading conditions due to valvar disease, intrinsic endomyocardial abnormalities, and procedures that alter endomyocardial mechanics may place patients with biventricular circulation (BiV) after FAV at risk of abnormal LV remodeling and function. Using the most recent echo data on BiV patients after technically successful FAV (n = 34), we evaluated LV remodeling pattern, risk factors for pathologic LV remodeling, and the association between LV remodeling pattern and LV function...
October 2015: Pediatric Cardiology
Laura Gellis, Puja Banka, Audrey Marshall, Sitaram Emani, Diego Porras
BACKGROUND: Valve-sparing repair in patients with tetralogy of Fallot (TOF) carries the risk of residual or recurrent right ventricular outflow tract (RVOT) obstruction, which is often treated with transcatheter balloon dilation (BD). The outcomes and associated complications of BD of the RVOT in this scenario remain unknown. METHODS: Retrospective review of the records of the Department of Cardiology at Boston Children's Hospital from 2000 to 2013 was performed...
October 2015: Catheterization and Cardiovascular Interventions
Constantine Mavroudis, Constantine D Mavroudis, Jeffrey P Jacobs
Operations for left ventricular outflow tract abnormalities are centred on hemodynamic conditions that relate to subvalvar stenosis, valvar stenosis/regurgitation, aortic annular hypoplasia, and supravalvar aortic stenosis. Operative interventions over the years have evolved because the intervening outcomes proved to be unsatisfactory. The resection for subvalvar aortic stenosis has progressed from a fibrous "membrane" resection to a more extensive fibromuscular resection. Operative solutions for valvar aortic stenosis and regurgitation have resulted in operative interventions that depend on simple commissurotomy, leaflet extensions, prosthetic mechanical valve replacement, biologic valve replacement, including the pulmonary autograft, and operations to treat aortic annular stenosis...
December 2014: Cardiology in the Young
Gary E Stapleton
Neonatal aortic valvar stenosis can be challenging to treat because of the varied morphology of the valve, the association with hypoplasia of other left heart structures, and the presence of left ventricular systolic dysfunction or endomyocardial fibroelastosis. Balloon valvuloplasty and surgical valvotomy have been well described in the literature for the treatment of neonatal aortic stenosis. Transcatheter therapy for neonatal aortic stenosis is the preferred method at many centres; however, some centres prefer a surgical approach...
December 2014: Cardiology in the Young
Jeremy T Affolter, Nancy S Ghanayem
Neonatal critical aortic stenosis is a rare form of CHD that often presents with cardiogenic shock. Although surgical and cardiac catheterisation-based interventions have been successful in alleviating left ventricular outflow tract obstruction, it remains associated with high morbidity and mortality. Critical aortic stenosis results in elevated left ventricular wall stress, which ultimately increases myocardial oxygen consumption and disrupts coronary artery perfusion during diastole, leading to ventricular dysfunction and cardiogenic shock...
December 2014: Cardiology in the Young
Hasan Jilaihawi, Raj R Makkar, Mohammad Kashif, Kazuaki Okuyama, Tarun Chakravarty, Takahiro Shiota, Gerald Friede, Mamoo Nakamura, Niraj Doctor, Asim Rafique, Kentaro Shibayama, Hirotsugu Mihara, Alfredo Trento, Wen Cheng, John Friedman, Daniel Berman, Gregory P Fontana
AIMS: We sought to optimize a method for quantification of the calcium in the aortic-valvar complex for the prediction of significant paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: All patients had severe symptomatic aortic stenosis and were treated with balloon-expandable TAVI (Sapien/Sapien-XT, Edwards Lifesciences LLC, Irvine, CA, USA). In order to correct for precise annular sizing, only patients with available contrast computed tomography (CT) data for measurements were included (n = 198)...
December 2014: European Heart Journal Cardiovascular Imaging
Jasminkumar Patel, Fernanda Kupferman, Susana Rapaport, Jeffrey H Kern
This study aimed to determine current practices regarding prophylaxis against infective endocarditis among pediatric cardiologists in the United States 5 years after publication of the most recent American Heart Association (AHA) recommendations. A descriptive, analytical, cross-sectional study was conducted from June 2012 to November 2012 in the format of an anonymous self-administered e-mailed questionnaire among pediatric cardiologists across the United States. The questionnaire inquired about demographic information of cardiologists and their current practices of prescribing preprocedure antibiotic prophylaxis against endocarditis to patients with specific preexisting cardiac conditions...
October 2014: Pediatric Cardiology
Lars G Svensson, Adil H Al Kindi, Alessandro Vivacqua, Gösta B Pettersson, A Marc Gillinov, Tomislav Mihaljevic, Eric E Roselli, Joseph F Sabik, Brian Griffin, Donald F Hammer, Leonardo Rodriguez, Sarah J Williams, Eugene H Blackstone, Bruce W Lytle
BACKGROUND: Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, occurring in 1% to 2% of the population. Eventually, 20% develop clinically important valvar regurgitation requiring surgical intervention. Aortic valve repair avoids anticoagulation and prosthetic valve-related complications. This study evaluated long-term durability of BAV repair. METHODS: From 1985 to 2011, 728 patients, mean age 42±12 years, underwent BAV repair at Cleveland Clinic...
May 2014: Annals of Thoracic Surgery
Olivier Metton, Walid Ben Ali, Olivier Raisky, Pascal R Vouhé
The modified Konno operation is designed to provide relief of diffuse subaortic stenosis, while preserving the native aortic valve. The aorta and the right ventricular infundibulum are opened. The upper part of the subaortic stenosis is incised through the aortic orifice. The conal septum is incised and the septotomy is extended across the stenotic area. The obstructive tissue is removed (mainly from the left-handed rim of the septotomy) and the conal septum is enlarged with a prosthetic patch. The aorta is closed and the right ventricular infundibulum is enlarged...
January 1, 2008: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Tetsuko Ishii, Doff B McElhinney, David M Harrild, Edward N Marcus, David J Sahn, Uyen Truong, Wayne Tworetzky
OBJECTIVE: The impact of prenatal intervention on fetal cardiac function has not been well defined. We assessed standard ventricular function parameters and strain in fetuses with evolving hypoplastic left heart syndrome (HLHS) treated with fetal aortic valvuloplasty (fAVP). METHODS: Fetuses with valvar aortic stenosis that underwent fAVP were studied. Echocardiographic images prior to intervention (Pre), within 1 week after fAVP (Post), and at the last prenatal follow-up examination (FU) were analyzed...
2014: Fetal Diagnosis and Therapy
Martijn H T den Dekker, Martijn G Slieker, A Christian Blank, Felix Haas, Matthias W Freund
BACKGROUND: Hypoplastic left heart complex (HLHC) is characterized by a mitral valve or an aortic valve annular Z score < -2, antegrade flow in the ascending aorta, ductal dependency, coarctation or aortic arch hypoplasia, and absence of significant (sub)valvar stenosis. The Z scores of the mitral and aortic valve annuli are major determinants of HLHC. Therefore, the algorithm for Z-score calculation is essential for diagnosis. However, no single universal method of calculation is in use...
November 2013: Journal of the American Society of Echocardiography
Patrick Vargo, Constantine Mavroudis, Robert D Stewart, Carl L Backer
The arterial switch operation has been the principal treatment for transposition of the great arteries and its variants for the last 25 years. Early mortality has decreased significantly over time, but long-term complications include pulmonary artery stenosis, coronary artery obstruction, neoaortic valvar insufficiency, arrhythmia, and aortic arch obstruction. This article provides an overview of the history, anatomic patterns, surgical results, and possible operative solutions discussed in the literature for patients with transposition of the great arteries who undergo arterial switch operations that result in late complications...
January 2011: World Journal for Pediatric & Congenital Heart Surgery
Daisuke Kobayashi, Salaam Sallaam, Sanjeev Aggarwal, Harinder R Singh, Daniel R Turner, Thomas J Forbes, Srinath T Gowda
BACKGROUND: The number of low birth weight infants with congenital heart disease is increasing and catheterizations may have an increased risk for mortality and morbidity. OBJECTIVES: We investigate the outcome and complications of cardiac catheterizations in infants weighing < 2.5 kg. METHODS: Retrospective review of catheterization records from 1995 to 2010 in infants weighing < 2.5 kg. The demographics, procedure, outcome, and follow-up data were collected...
November 1, 2013: Catheterization and Cardiovascular Interventions
Alvin C C Ho, Anthony P Y Liu, K S Lun, W F Tang, Kelvin Y K Chan, Elizabeth Y T Lau, Mary H Y Tang, T Y Tan, Brian H Y Chung
While deletion of chromosome 17p13.3 (encompassing PAFAH1B1 and YWHAE genes) is known to result in Miller-Dieker syndrome (OMIM 247200), 17p13.3 microduplication gives rise to a condition commonly associated with developmental delay and autism spectrum disorder. We report a Chinese newborn presenting with dysmorphic features, microcephaly and valvar aortic stenosis, who was confirmed to have a 790 kb microduplication in chromosome 17p13.3 by array comparative genomic hybridization (aCGH). The patient passed away at 4 months of age with presumably life-threatening event associated with his cardiac condition...
December 2012: European Journal of Medical Genetics
Hideshi Tomita, Noriyuki Haneda, Takashi Higaki, Koichi Kataoka
BACKGROUND: Providing care for children with cardiac disease remains a challenge in developing countries. MATERIALS AND METHODS: Since 2001, a team of paediatric cardiologists has been visiting Mongolia to perform children's cardiac catheterisation, as well as screening children for cardiac disease. Considering the limited medical resources, as well as cost, risk, and benefit, we focused our activities on diagnostic consultation by echocardiography, transcatheter closure of persistent arterial duct, balloon dilation of valvar pulmonary stenosis and aortic coarctation, and diagnostic catheterisation...
June 2013: Cardiology in the Young
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