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Heart anatomy

Gregory Pattakos, Michael Chrissoheris, Antonios Halapas, Konstantinos Papadopoulos, Panagiota Kourkoveli, Nikolaos Bouboulis, Stratis Pattakos, Konstantinos Spargias
This report presents the case of an 82 year old male with known dextrocardia and situs inversus totalis who developed increasing dyspnea on exertion and was diagnosed with severe aortic stenosis. Transcatheter aortic valve replacement was decided upon requiring deviation from standard techniques for patients with normal anatomy and left-sided aortic arch. We describe two technical differences required for patients with dextrocardia and right-sided aortic arch which facilitate transcatheter aortic valve replacement in this patient group...
June 13, 2018: Annals of Thoracic Surgery
Femke van der Stelt, Gregor J Krings, Mirella C Molenschot, Johannes M Breur
AIMS: Complex single ventricle topography, changes in vessel geometry after surgical steps and subsequent stenoses are difficult to visualise with biplane conventional angiography (CA). This study investigated the additional value of three-dimensional rotational angiography (3DRA) compared to CA for diagnostic and interventional purposes in children with univentricular hearts. METHODS AND RESULTS: Demographic data, clinical data and catheterisation details of both imaging techniques were collected retrospectively...
June 12, 2018: EuroIntervention
Federica Sacco, Bruno Paun, Oriol Lehmkuhl, Tinen L Iles, Paul A Iaizzo, Guillaume Houzeaux, Mariano Vázquez, Constantine Butakoff, Jazmin Aguado-Sierra
Computational modelling plays an important role in right ventricular (RV) haemodynamic analysis. However, current approaches employ smoothed ventricular anatomies. The aim of this study is to characterise RV haemodynamics including detailed endocardial structures like trabeculae, moderator band and papillary muscles (PMs). Four paired detailed and smoothed RV endocardium models (two male and two female) were reconstructed from ex-vivo human hearts high-resolution magnetic resonance images (MRI). Detailed models include structures with ≥1 mm2 cross-sectional area...
June 11, 2018: International Journal for Numerical Methods in Biomedical Engineering
Pastora Gallego, María José Rodríguez-Puras, Pilar Serrano Gotarredona, Israel Valverde, Begoña Manso, Antonio González-Calle, Alejandro Adsuar, Jose M Cubero, Luis Díaz de la Llera, Antonio Ordoñez, Amir-Reza Hosseinpour
BACKGROUND: Prevalence and prognostic significance of pulmonary artery (PA) dilatation in congenital heart disease (CHD) have never been studied systematically. METHODS: Chest X-rays of 1192 consecutive adults with CHD were reviewed. Major diameter of the PA was determined by imaging techniques in those with PA dilatation. A value >29 mm was considered abnormal. Data on anatomy, hemodynamics, residual lesions and outcomes were retrospectively collected. RESULTS: Overall prevalence of PA dilatation was 18%...
June 2, 2018: International Journal of Cardiology
James L Cox, Niv Ad, Andrei Churyla, S Chris Malaisrie, Duc Thinh Pham, Jane Kruse, Olga Kislitsina, Patrick M McCarthy
BACKGROUND: There is concern that the right atrial lesions of the Maze procedure lead to more permanent pacemakers postoperatively and that they provide little therapeutic advantage over left atrial lesions alone. METHODS: A discussion of the pertinent anatomy related to atrial fibrillation and the performance of the Maze procedure, the potential ways that the specialized conduction system could theoretically be damaged by the procedure, non-procedure-related causes for increased postoperative pacemaker requirements, and the basis for the efficacy of the right atrial lesions of the Maze procedure are presented...
June 5, 2018: Annals of Thoracic Surgery
Monique Garas, Mauro Vaccarezza, George Newland, Kylie McVay-Doornbusch, Jamila Hasani
Three-dimensional (3D) printing is a modern technique of creating 3D-printed models that allows reproduction of human structures from MRI and CT scans via fusion of multiple layers of resin materials. To assess feasibility of this innovative resource as anatomy educational tool, we conducted a preliminary study on Curtin University undergraduate students to investigate the use of 3D models for anatomy learning as a main goal, to assess the effectiveness of different specimen types during the sessions and personally preferred anatomy learning tools among students as secondary aim...
June 5, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Kuberan Pushparajah, Henry Chubb, Reza Razavi
Diagnostic and interventional cardiac catheterization is routinely used in the diagnosis and treatment of congenital heart disease. There are well-established concerns regarding the risk of radiation exposure to patients and staff, particularly in children given the cumulative effects of repeat exposure. Magnetic resonance imaging (MRI) offers the advantage of being able to provide better soft tissue visualization, tissue characterization, and quantification of ventricular volumes and vascular flow. Initial work using MRI catheterization employed fusion of x-ray and MRI techniques, with x-ray fluoroscopy to guide catheter placement and subsequent MRI assessment for anatomical and hemodynamic assessment...
June 2018: Topics in Magnetic Resonance Imaging: TMRI
Gerald D Buckberg, Navin C Nanda, Christopher Nguyen, Mladen J Kocica
Cardiac dynamics are traditionally linked to a left ventricle, right ventricle, and septum morphology, a topography that differs from the heart's five-century-old anatomic description of containing a helix and circumferential wrap architectural configuration. Torrent Guasp's helical ventricular myocardial band (HVMB) defines this anatomy and its structure, and explains why the heart's six dynamic actions of narrowing, shortening, lengthening, widening, twisting, and uncoiling happen. The described structural findings will raise questions about deductions guiding "accepted cardiac mechanics", and their functional aspects will challenge and overturn them...
June 4, 2018: Journal of Cardiovascular Development and Disease
Bouchra Habib Geryes, Raphael Calmon, Victoria Donciu, Diala Khraiche, Karine Warin-Fresse, Damien Bonnet, Nathalie Boddaert, Francesca Raimondi
OBJECTIVE: To demonstrate that the use of step-and-shoot (SAS) mode in paediatric cardiac CT angiography (CCTA) is possible at heart rates (HR) greater than 65 bpm, allowing low-dose acquisition with single-source 64-slices CT. METHODS: We retrospectively included 125 paediatric patients (0-6 years). CCTA was performed with SAS at diastolic phase in 31 patients (group D, HR < 65 bpm), at systolic phase in 45 patients (group S, HR ≥ 65 bpm) and with non-gated mode in 49 patients (group NG)...
May 2018: Physica Medica: PM
Koroush Khalighi, Munish Sharma, Rohit Masih, Vadim Levin
BACKGROUND: To review the procedural safety and postimplantation complications of Watchman device implanted at 2 community hospitals for primary prevention of systemic embolization in patients with nonvalvular atrial fibrillation (NVAF) who were not candidates for long-term oral anticoagulation (OAC). METHODS: This was a retrospective case series of 48 patients carried out in 2 community hospitals in the United States. Patients with NVAF who had a CHADS2 higher than 2 or CHADS2VASc2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack [TIA] or thromboembolism, vascular disease, age 65-74 years, and female gender) score of 3 or higher and were not candidates for long-term OAC...
May 29, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Cesar Gonzalez de Alba, Fernando Molina Berganza, John Brownlee, Muhammad Khan, Dilachew Adebo
Experience with cardiac magnetic resonance to evaluate coronary arteries in children and young adult patients is limited. Because noninvasive imaging has advantages over coronary angiography, we compared the effectiveness of these techniques in patients who were being considered for percutaneous pulmonary valve implantation. We retrospectively reviewed the cases of 26 patients (mean age, 12.53 ± 4.85 yr; range, 5-25 yr), all of whom had previous right ventricular-to-pulmonary artery homografts. We studied T2-prepared whole-heart images for coronary anatomy, velocity-encoded cine images for ventricular morphology, and function- and time-resolved magnetic resonance angiographic findings...
April 2018: Texas Heart Institute Journal
Rishi Parikh, Michael Eisses, Gregory J Latham, Denise C Joffe, Faith J Ross
Truncus arteriosus is a congenital cardiac lesion in which failure of embryonic truncal septation results in a single semilunar valve and single arterial trunk providing both pulmonary and systemic circulations. Most patients with this lesion are symptomatic in the neonatal period with cyanosis and/or congestive heart failure and undergo complete repair in the first weeks of life. This review will focus on the anatomy, physiology, and perioperative anesthetic management of patients with truncus arteriosus.
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Won-Keun Kim, Helge Möllmann, Christoph Liebetrau, Matthias Renker, Andreas Rolf, Philippe Simon, Arnaud Van Linden, Mani Arsalan, Mirko Doss, Christian W Hamm, Thomas Walther
OBJECTIVES: The aim of this study was to perform a comprehensive analysis of factors that affect procedural outcomes of transcatheter aortic valve replacement using the ACURATE neo prosthesis (Symetis/Boston, Ecublens, Switzerland). BACKGROUND: Predictors of procedural outcomes using the ACURATE neo prosthesis are poorly understood. METHODS: A total of 500 patients underwent transfemoral aortic valve replacement with the ACURATE neo prosthesis...
May 21, 2018: JACC. Cardiovascular Interventions
Grzegorz Tomasz Kowalik, Jennifer Anne Steeden, David Atkinson, Javier Montalt-Tordera, Kristian Havmand Mortensen, Vivek Muthurangu
PURPOSE: In this study, a golden ratio stack of spiral (GRASS) sequence that used both golden step and golden angle ordering was implemented. The aim was to demonstrate that GRASS acquisitions could be flexibly reconstructed as both cardiac-gated and time-resolved angiograms. METHODS: Image quality of time-resolved and cardiac-gated reconstructions of the GRASS sequence were compared to 3 conventional stack of spirals (SoS) acquisitions in an in silico model. In 10 patients, the GRASS sequence was compared to conventional breath hold angiography (BH-MRA) in terms of image quality and for vessel measurement...
May 25, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
G G Khubulava, S P Marchenko, D A Starchik, V V Suvorov, E V Krivoshchekov, N N Shikhverdiev, A B Naumov
AIM: To assess linear and geometric parameters of the aortic valve and to determine the changes which are associated with impaired leaflets coaptation and aortic root enlargement. MATERIAL AND METHODS: Surgical anatomy of the aortic root and its spatial relationships with surrounding heart structures were studied with plastination by using of combined silicon technologies. 123 specimens of the aortic root with preserved original geometry were created with silicone plastination technique and perfusion embalming...
2018: Khirurgiia
Richard D Mainwaring, William L Patrick, Stephen J Roth, Komal Kamra, Lisa Wise-Faberowski, Michal Palmon, Frank L Hanley
OBJECTIVE: Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries is a complex and heterogeneous form of congenital heart disease. There is a controversy regarding the optimal treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. The purpose of this study was to summarize our algorithm and surgical results for pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries...
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
Florian Berger, Christopher Hansi, Tilo Niemann
Myocardial Clefts - Incidental Findings in Parainfectious Myocarditis Abstract. We report a 23-year-old woman with parainfectious myocarditis due to gastroenteritis. A transthoracic echocardio-graphy revealed a recess in the left inferobasal ventricle. For further investigation, cardiac magnetic resonance imaging was initiated, which revealed a myocardial cleft, a harmless structural variation of the heart. Cardiac magnetic resonance is a non-invasive imaging technique with a high spatial and temporal resolution that enables a precise depiction of the cardiac anatomy and therefore allows for a differentiation between normal and pathological structural variations of the heart...
2018: Praxis
Shabnam Peyvandi, Beatrice Latal, Steven P Miller, Patrick S McQuillen
Neurodevelopmental outcomes are impaired in survivors of critical congenital heart disease (CHD) in several developmental domains including motor, cognitive and sensory outcomes. These deficits can extend into the adolescent and early adulthood years. The cause of these neurodevelopmental impairments is multi-factorial and includes patient specific risk factors, cardiac anatomy and physiology as well as brain changes seen on MRI. Advances in imaging techniques have identified delayed brain development in the neonate with critical CHD as well as acquired brain injury...
May 19, 2018: NeuroImage
Andres Enriquez, Luis C Saenz, Raphael Rosso, Frank E Silvestry, David Callans, Francis E Marchlinski, Fermin Garcia
The indications for catheter-based structural and electrophysiological procedures have recently expanded to more complex scenarios, in which an accurate definition of the variable individual cardiac anatomy is key to obtain optimal results. Intracardiac echocardiography (ICE) is a unique imaging modality able to provide high-resolution real-time visualization of cardiac structures, continuous monitoring of catheter location within the heart, and early recognition of procedural complications, such as pericardial effusion or thrombus formation...
May 22, 2018: Circulation
Costas Tsioufis, Kyriakos Dimitriadis, Panagiotis Tsioufis, Rafael Patras, Maria Papadoliopoulou, Zoi Petropoulou, Dimitris Konstantinidis, Dimitrios Tousoulis
PURPOSE OF REVIEW: To summarize the evidence regarding the distribution of renal nerves and their patterns of anatomic variations in animal and human settings. Moreover, the methodology and results of studies regarding renal nerve stimulation (RNS) in both preclinical and clinical models are presented. RECENT FINDINGS: There are differences regarding the number and the size of renal fibers, as well as their distance from the lumen in the diverse parts of the main renal arteries and the branches...
May 19, 2018: Current Hypertension Reports
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