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Cardiac valve anatomy

Deepak Ameta, Rajiv Bharat Kharwar, Pallavi Aga, Rishi Sethi, Sharad Chandra, Sudhanshu Kumar Dwivedi, Varun Shankar Narain, Ram Kirti Saran
Bicuspid aortic valve (BAV) is a common congenital cardiac anomaly, and rarely, it is associated with sinus of Valsalva aneurysms (SOVAs). And very infrequently, these SOVAs rupture into left side of heart. We hereby report a case of 12-year-old male with BAV with severe aortic stenosis with a large SOVA that ruptured into the left side of the heart. The anatomy was delineated with multimodality imaging; initially with two-dimensional trans-thoracic echocardiography (TTE), and later on with three-dimensional TTE and with multi detector computed tomography...
September 2016: Indian Heart Journal
Michael Esser, Sergios Gatidis, Matthias Teufel, Inés Ketelsen, Konstantin Nikolaou, Jürgen F Schäfer, Ilias Tsiflikas
OBJECTIVE: The aim of this study was to compare image quality of anatomical cardiac details without electrocardiography triggering, sedation, or heart rate-regulating drugs in contrast-enhanced pediatric chest computed tomography (CT), using high-pitch CT (HPCT) versus conventional pitch-mode technique (multidetector CT [MDCT]). METHODS: After written informed consent, 55 patients (median age, 11 years; range, 3-17 years) were prospectively included in this institutional review board-approved study...
September 27, 2016: Journal of Computer Assisted Tomography
Rosanne C Schoonbeek, Satoshi Takebayashi, Chikashi Aoki, Toru Shimaoka, Matthew A Harris, Gregory L Fu, Timothy S Kim, Yoav Dori, Jeremy McGarvey, Harold Litt, Wobbe Bouma, Gerald Zsido, Andrew C Glatz, Jonathan J Rome, Robert C Gorman, Joseph H Gorman, Matthew J Gillespie
BACKGROUND: Pulmonary insufficiency is the nexus of late morbidity and mortality after transannular patch repair of tetralogy of Fallot. This study aimed to establish the feasibility of implantation of the novel Medtronic Harmony transcatheter pulmonary valve (hTPV) and to assess its effect on pulmonary insufficiency and ventricular function in an ovine model of chronic postoperative pulmonary insufficiency. METHODS AND RESULTS: Thirteen sheep underwent baseline cardiac magnetic resonance imaging, surgical pulmonary valvectomy, and transannular patch repair...
October 2016: Circulation. Cardiovascular Interventions
Aimee E Moores, Michael S Cahill, Todd C Villines
Aortic mycotic aneurysms are a rare but life-threatening potential complication of infective endocarditis. Rapid deterioration of the vascular wall in highly focal areas makes these pseudoaneurysms particularly prone to rupture, resulting in uncontrolled aortic hemorrhage. While computed tomography angiography (CTA) is the imaging modality of choice for the evaluation of mycotic aneurysms, it is not routinely performed in patients with known or suspected infective endocarditis (IE). However, current valvular heart disease guidelines support the use of cardiac CTA in cases of IE and suspected perivalvular extension when there is inadequate or ambiguous visualization on echocardiography...
2016: Case Reports in Medicine
Danny Dvir, John Webb
There is a growing practice of transcatheter treatment of failed mitral valves after cardiac surgery, including valve-in-valve and valve-in-ring. Although commonly successful, these procedures can be associated with device malposition (including delayed malposition) and elevated post-procedural gradients (especially when performed inside small surgical valves). Valve-in-ring procedures have elevated risks of left ventricular outflow tract obstruction and post-procedural regurgitation. Careful patient selection and meticulous evaluation of patient anatomy and surgical implant characteristics are essential to achieve optimal clinical results with mitral valve-in-valve and valve-in-ring implantation...
September 18, 2016: EuroIntervention
Nicolo Piazza, Darren Mylotte, Pascal Theriault Lauzier
Interventional cardiologists have traditionally relied upon fluoro-scopic imaging for percutaneous coronary interventions. Transcatheter structural heart interventions, however, require additional imaging modalities such as echocardiography and multislice computed tomography (MSCT) for pre-, intra- and post-procedural assistance. MSCT has emerged as the critical imaging modality for patient and device selection prior to transcatheter structural heart interventions. MSCT is unique as it provides a complete 3-dimensional (3D) dataset of the heart and vasculature that is amenable to multiplanar reconstruction for 2-dimensional (2D) or volume-rendered interpretations...
September 18, 2016: EuroIntervention
Jeremy P Moore, Blandine Mondésert, Michael S Lloyd, Stephen C Cook, Ali N Zaidi, Robert H Pass, Anitha S John, Frank A Fish, Kevin M Shannon, Jamil A Aboulhosn, Paul Khairy
BACKGROUND: Sudden cardiac death is a major contributor to mortality for adults with congenital heart disease. The subcutaneous implantable cardioverter-defibrillator (ICD) has emerged as a novel tool for prevention of sudden cardiac death, but clinical performance data for adults with congenital heart disease are limited. METHODS AND RESULTS: A retrospective study involving 7 centers over a 5-year period beginning in 2011 was performed. Twenty-one patients (median 33...
September 2016: Circulation. Arrhythmia and Electrophysiology
Elena Surkova, Denisa Muraru, Patrizia Aruta, Gabriella Romeo, Jurate Bidviene, Diana Cherata, Luigi P Badano
Advances in ultrasound, computer, and electronics technology have permitted three-dimensional echocardiography (3DE) to become a clinically viable imaging modality, with significant impact on patient diagnosis, management, and outcome. Thanks to the inception of a fully sampled matrix transducer for transthoracic and transesophageal probes, 3DE now offers much faster and easier data acquisition, immediate display of anatomy, and the possibility of online quantitative analysis of cardiac chambers and heart valves...
November 2016: Current Cardiology Reports
Krzysztof Wilczek, Rafał Reguła, Kamil Bujak, Piotr Chodór, Michał Długaszek, Mariusz Gąsior
Transcatheter aortic valve implantation (TAVI) has become a safe and efficient alternative to cardiac surgery in patients with severe aortic stenosis. In many countries the number of performed TAVI procedures equals the number of surgical implantations. Indications for TAVI are becoming more liberal, allowing a wider spectrum of patients to benefit from the advantages of transcatheter therapy. Due to its invasive nature, TAVI is associated with some complications such as conduction disturbances. Although these disturbances are usually not lethal, they have a great influence on patients' state and long term-survival...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
James Jones, Robert Liotta, Maureen Hood, Alexander Bustamante
We report a case of a 35-year-old active duty male with a rare quadricuspid aortic valve identified via transthoracic echocardiography following the detection of an incidental grade I/VI diastolic murmur. Further characterization of the anatomical findings and aortic valve flow dynamics were evaluated with cardiac magnetic resonance imaging. Accurate assessment of the various valve morphologies is essential, as it guides surgical treatment options to correct the defect. Our case highlights the complimentary role of cardiac magnetic resonance imaging in defining the anatomy and functional consequences of a quadricuspid aortic valve...
September 2016: Military Medicine
Aref Rashed, Karoly Gombocz, Janos Fulop, Nasri Alotti
INTRODUCTION: Iatrogenic ventricular septal defect is a rare complication after the surgical replacement of cardiac valves. Small defects may have no hemodynamic significance or remain unremarked at the end of the surgical procedure. Understanding of the valvular anatomy alone is not always enough to avoid such complications, especially in the hands of young surgeons. PRESENTATION OF CASE: We present a case of iatrogenic ventricular septal defect that developed early after the surgical closure of a hemodynamically significant mitral paravalvular leak...
2016: International Journal of Surgery Case Reports
Roberto Di Bartolomeo, Alessandro Leone, Luca Di Marco, Davide Pacini
Acute type A aortic dissection (AAAD) remains one of the most challenging diseases in cardiothoracic surgery and despite numerous innovations in medical and surgical management, early mortality remains high. The standard treatment of AAAD requires emergency surgery of the proximal aorta, preventing rupture and consequent cardiac tamponade. Resection of the primary intimal tear and repair of the aortic root and aortic valve are well-established surgical principles. However, the dissection in the aortic arch and descending untreated aorta remains...
July 2016: Annals of Cardiothoracic Surgery
Guyue Hu, Ying Zhang, Miao Fan, Meilian Wang, Faiza Amber Siddiqui, Yu Wang, Wei Sun, Feifei Sun, Dongyu Zhang, Wenjia Lei, Xue Sun
BACKGROUND: Prenatal diagnosis of cardiac valve anomalies challenged most screening sonographers. The purpose of the study was to evaluate the use of four-dimensional echocardiography with spatiotemporal image correlation (4DSTIC) in detecting normal and abnormal fetal cardiac valves. METHODS: Forty-three cases of confirmed cardiac valve anomalies identified by two-dimensional echocardiography (2DE) were retrospectively reviewed in this study. Additional 121 confirmed normal fetuses were included as controls...
August 22, 2016: Echocardiography
Stefania Scarsoglio, Andrea Saglietto, Fiorenzo Gaita, Luca Ridolfi, Matteo Anselmino
BACKGROUND: Although atrial fibrillation (AF), a common arrhythmia, frequently presents in patients with underlying valvular disease, its hemodynamic contributions are not fully understood. The present work aimed to computationally study how physical conditions imposed by pathologic valvular anatomy act on AF hemodynamics. METHODS: We simulated AF with different severity grades of left-sided valvular diseases and compared the cardiovascular effects that they exert during AF, compared to lone AF...
2016: PeerJ
Kinza Sentissi, Mandeep S Sawhney, Douglas Pleskow, Paul Sepe, Jose M Mella, Benjamin Kwittken, Gyanprakash Ketwaroo, Balachundhar Subramaniam
In this prospective observational study, conducted at an academic medical center, we evaluated the feasibility of performing a basic transesophageal echocardiography (TEE) examination using endoscopic ultrasound (EUS) technology to determine what cardiac structures could be assessed. This may be potentially beneficial during hemodynamic emergencies in the endoscopy suite resulting from hypovolemia, depressed ventricular function, aortic dissection, pericardial effusions, or aortic stenosis. Of the 20 patients enrolled, 18 underwent EUS with a linear echoendoscope for standard clinical indications followed by a cardiac assessment performed under the guidance of a TEE-certified cardiac anesthesiologist...
September 2016: Anesthesia and Analgesia
Zheng Jinghao, Luo Kai, Huang Yanhui, Zhu Zhongqun, Gao Botao, Du Xinwei, Xu Zhiwei, Liu Jinfen
Objective Ebstein anomaly is a rare type of tricuspid malformation. The present surgical methods to resolve this anomaly include tricuspid valvuloplasty, palliative surgery, and tricuspid valve replacement. The purpose of this study was to evaluate the short- and midterm outcomes of different surgical treatments among children with Ebstein anomaly. Methods This was a retrospective study of 136 Ebstein anomaly patients undergoing surgery at our institution from January, 2006 to August, 2015. This cohort included 118 patients receiving tricuspid valvuloplasty, 14 patients receiving palliative surgery and 4 patients receiving tricuspid valve replacement...
August 10, 2016: Thoracic and Cardiovascular Surgeon
Venkatraman Bhat, Vinay Belaval, Karthik Gadabanahalli, Vimal Raj, Sejal Shah
Acyanotic heart disease constitutes a significant majority of patient who may present with non-cardiac symptoms. Either they are detected incidentally or present with respiratory complaints. Equipped with knowledge of anatomy by echocardiography and radiographic methods described in previous part of this presentation, diagnosis may be confidently attempted. On plain radiography acyanotic congenital heart diseases have variable appearance depending upon severity of disease. Cardiac size, chamber enlargement and pulmonary vascular pattern are key elements...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Patrick Mathieu, Yohan Bossé, Gordon S Huggins, Alessandro Della Corte, Philippe Pibarot, Hector I Michelena, Giuseppe Limongelli, Marie-Chloé Boulanger, Arturo Evangelista, Elisabeth Bédard, Rodolfo Citro, Simon C Body, Mona Nemer, Frederick J Schoen
Bicuspid aortic valve is the most prevalent cardiac valvular malformation. It is associated with a high rate of long-term morbidity including development of calcific aortic valve disease, aortic regurgitation and concomitant thoracic aortic aneurysm and dissection. Recently, basic and translational studies have identified some key processes involved in the development of bicuspid aortic valve and its morbidity. The development of aortic valve disease and thoracic aortic aneurysm and dissection is the result of complex interactions between genotypes, environmental risk factors and specific haemodynamic conditions created by bicuspid aortic valve anatomy...
October 2015: Journal of Pathology. Clinical Research
Meena Narayanan, Uri Elkayam, Tasneem Z Naqvi
The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves...
September 2016: Current Cardiology Reports
Alison B Nair, Peter Oishi
There is new and growing experience with venovenous extracorporeal life support (VV ECLS) for neonatal and pediatric patients with single-ventricle physiology and acute respiratory distress syndrome (ARDS). Outcomes in this population have been defined but could be improved; survival rates in single-ventricle patients on VV ECLS for respiratory failure are slightly higher than those in single-ventricle patients on venoarterial ECLS for cardiac failure (48 vs. 32-43%), but are lower than in patients with biventricular anatomy (58-74%)...
2016: Frontiers in Pediatrics
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