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Fetal aortic isthmus

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https://www.readbyqxmd.com/read/29094424/fetal-sheep-central-hemodynamics-and-cardiac-function-during-ascending-aorta-occlusion
#1
Heikki Huhta, Juulia Junno, Mervi Haapsamo, Tiina Erkinaro, Pasi Ohtonen, Lowell E Davis, A Roger Hohimer, Ganesh Acharya, Juha Rasanen
Fetal aortic isthmus (AoI) allows communication between left (LV) and right (RV) ventricular outputs and represents arterial watershed between the brachiocephalic (brain) and subdiaphragmatic (placenta) circulations. To understand the capability of AoI to maintain the balance between upper and lower body circulations, we performed a complete fetal ascending aorta occlusion in 9 chronically instrumented sheep at near term gestation. We hypothesized that the occlusion would significantly decrease LV output and concomitantly increase RV output in order to maintain adequate systemic cardiac output and perfusion pressure to the fetal brain circulation through retrograde filling of the AoI...
November 2, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28918426/aortic-isthmus-flow-recording-predicts-the-outcome-of-the-recipient-twin-after-laser-coagulation-in-twin-twin-transfusion-syndrome
#2
France Leduc, Amélie Delabaere, Roxanne Gendron, Florent Fuchs, Sandrine Wavrant, Marie-Josée Raboisson, Jean-Claude Fouron, François Audibert
INTRODUCTION: The objective was to assess the prognostic value of the systolic flow through the aortic isthmus in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS) treated by placental laser ablation. MATERIAL AND METHODS: Fetal echocardiography and outcome data of 105 cases of TTTS treated by laser photocoagulation of placental anastomoses were reviewed. Hemodynamic parameters were collected before and after treatment. The isthmic systolic index (ISI) was calculated as the peak systolic velocity/systolic nadir ratio...
September 16, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28833523/modeling-of-coarctation-of-aorta-in-human-fetuses-using-3d-4d-fetal-echocardiography-and-computational-fluid-dynamics
#3
Zhuo Chen, Yue Zhou, Jingying Wang, Xiaowei Liu, Shuping Ge, Yihua He
OBJECTIVES: We sought to develop a hemodynamic model of aortic and ductal arches using computational fluid dynamics (CFD) and 3D/4D spatio-temporal image correlation (STIC) fetal echocardiography and to investigate the hemodynamics of coarctation of aorta (CoA) in human fetuses using this approach. METHODS: We obtained 3D/4D STIC fetal echocardiographic images of the aortic and ductal arches (DA) in five normal fetuses. Based on these images, we simulated the hemodynamics in the two arches using CFD...
August 22, 2017: Echocardiography
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#4
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta, middle cerebral artery, and ductus venosus and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS + sIUGR; and 8 uncomplicated)...
July 11, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28668226/sustained-chronic-maternal-hyperoxygenation-increases-myocardial-deformation-in-fetuses-with-a-small-aortic-isthmus-at-risk-for-coarctation
#5
Shi Zeng, Jiawei Zhou, Qinghai Peng, Wen Deng, Ming Zang, Tao Wang, Qichang Zhou
BACKGROUND: We aimed to assess differences in myocardial deformation in fetuses at risk for coarctation (CoA) and the effects of maternal hyperoxygenation on deformation. METHODS: Fetal echocardiography and velocity vector imaging were performed prospectively and serially in 48 fetuses with a small aortic isthmus and 48 gestation age-matched normal fetuses. Fetuses with a small aortic isthmus were randomly divided into two groups: one group with and the other group without maternal supplemental oxygen administration...
October 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28627028/common-findings-in-late-gestation-fetal-echocardiography
#6
Lauren Tague, Mary T Donofrio, Amanda Fulgium, Robert McCarter, Catherine Limperopoulos, David N Schidlow
OBJECTIVES: Fetal echocardiography provides detailed information about cardiac structure and function in utero. Limited information is available regarding normal findings late in pregnancy. We therefore sought to identify and describe common cardiac findings in late gestation. METHODS: Fetuses with structurally normal hearts were identified in mid gestation within a subset of pregnant women in a prospective study. The atrioventricular valves, right and left atria, aortic isthmus and ductus arteriosus dimensions and flow abnormalities, aneurysm of the septum primum, and presence and grade of tricuspid regurgitation were assessed throughout pregnancy...
June 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27982102/sustained-maternal-hyperoxygenation-improves-aortic-arch-dimensions-in-fetuses-with-coarctation
#7
Shi Zeng, Jiawei Zhou, Qinghai Peng, Wen Deng, Ming Zhang, Yili Zhao, Tao Wang, Qichang Zhou
The aim was to investigate the impact of maternal hyperoxygenation (HO) on cardiac dimensions in fetuses with isolated Coarctation (CoA). Fetal echocardiography was performed serially in 48 fetuses with CoA and gestation age matched normal fetues. The Z-scores for the mitral valve (MV), tricuspid valve (TV), aortic valve (AV), ascending aorta (AAo), isthmus, pulmonary valve (PV), main pulmonary artery (MPA), and descending aorta (DAo) were measured and compared among normal fetuses, CoA fetuses with oxygen and CoA fetuses with air...
December 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27943499/prenatal-diagnosis-and-prognosis-of-accelerate-idioventricular-rhythm
#8
Jean-Claude Fouron, Ariane McNeal-Davidson, Sylvia Abadir, Anne Fournier, Jean-Luc Bigras, Christine Boutin, Myriam Brassard, Marie-Josée Raboisson, Nicolaas van Doesburg, Annie Berger, Sophie Brisebois, Roxanne Gendron
OBJECTIVES: Since postnatal identification of accelerated idioventricular rhythm (AIVR) is essentially based on specific electrocardiographic patterns, its prenatal diagnosis is challenging and its genuine incidence undetermined. Therefore the objectives of this study are: 1) To evaluate the performance of specific ultrasonographic approaches in intrauterine identification of cardiocirculatory events linked to electrocardiographic signs of AIVR, including its left or right ventricular origin, and 2) To assess the prenatal prognosis of the arrhythmia...
December 10, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27665417/fetal-echocardiography-reference-values-for-the-chinese-population
#9
Xiaoyan Gu, Yihua He, Ye Zhang, Lin Sun, Ying Zhao, Jiancheng Han, Xiaowei Liu
OBJECTIVE: Global racial variability in human development can lead to differences in size of fetal cardiac structures during gestation. Our objective is to establish normal reference ranges of fetal cardiac dimensions between 20 and 34 weeks from fetal echocardiograms recorded at a single center in China. METHODS: A prospective cross-sectional study was undertaken on single pregnancies with normal fetuses of varying gestational ages (GAs). A total of 4396 normal fetuses were divided into 15 groups from 20 to 34 weeks according to the GA...
February 1, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27514305/vein-of-galen-aneurysmal-malformation-vgam-in-the-fetus-retrospective-analysis-of-perinatal-prognostic-indicators-in-a-two-center-series-of-49-cases
#10
D Paladini, B Deloison, A Rossi, G E Chalouhi, C Gandolfo, P Sonigo, S Buratti, A E Millischer, G Tuo, Y Ville, A Pistorio, A Cama, L J Salomon
OBJECTIVE: Vein of Galen aneurysmal malformation (VGAM) is a rare fetal anomaly, the neurological outcome of which can be good with appropriate perinatal management. However, most fetal series are too small to allow reliable statistical assessment of potential prognostic indicators. Our aim was to assess, in a two-center series of 49 cases, the prognostic value of several prenatal variables, in order to identify possible prenatal indicators of poor outcome, in terms of mortality and cerebral disability...
August 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27379710/the-aortic-isthmus-a-significant-yet-underexplored-watershed-of-the-fetal-circulation
#11
REVIEW
Dominique Tynan, Jennifer Alphonse, Amanda Henry, Alec W Welsh
The aortic isthmus (AoI) is a unique fetal watershed with a waveform reflecting its complex haemodynamic physiology. The systolic component represents left and right ventricular systolic ejection, and the diastolic component represents comparative downstream vascular impedance between the brachiocephalic and subdiaphragmatic fetal circulations. Several indices have been devised to quantify different components of the waveform, including the pulsatility index, resistance index, isthmic flow index, and recently the isthmic systolic index...
2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27084383/persistent-left-superior-vena-cava-connected-to-the-coronary-sinus-in-the-fetus-effects-on-cardiac-structure-and-flow-dynamics
#12
Xiaowei Liu, Yihua He, Zhiyun Tian, Jack Rychik
Ventricular size discrepancy may be due to a persistent left superior vena cava (PLSVC) in utero. We sought to investigate for differences in cardiac structure measures and hemodynamics between fetuses with isolated PLSVC connected to the coronary sinus (CS) and normal. Fetuses diagnosed with isolated PLSVC in the second and third trimester were enrolled. We defined two groups: group 1, twenty-five fetuses in the second trimester (22-27 W + 6d); group 2, twenty-two fetuses in the third trimester (28-39 W + 6d)...
August 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/26946193/ventricular-outputs-central-blood-flow-distribution-and-flow-pattern-through-the-aortic-isthmus-of-fetuses-with-simple-transposition-of-the-great-arteries
#13
Julie Blanc, Jean-Claude Fouron, Sven-Erik Sonesson, Marie-Josée Raboisson, Ian Huggon, Roxanne Gendron, Annie Berger, Sophie Brisebois
INTRODUCTION: Our objective was to determine the impact of simple transposition of the great arteries (TGA) on fetal left ventricular (LV) and right ventricular (RV) performances and central circulatory dynamics including the aortic isthmus. MATERIAL AND METHODS: Ventricular stroke volumes were calculated as the product of the cross-sectional area of the corresponding semi-lunar valve and the flow velocity integral through these valves. Volume flow in ductus arteriosus (QDA ) was evaluated using the same technique...
2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/26906235/understanding-the-aortic-isthmus-doppler-profile-and-its-changes-with-gestational-age-using-a-lumped-model-of-the-fetal-circulation
#14
Patricia Garcia-Canadilla, Fatima Crispi, Monica Cruz-Lemini, Brenda Valenzuela-Alcaraz, Paula A Rudenick, Eduard Gratacos, Bart H Bijnens
OBJECTIVE: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation. METHODS: A validation of the model was performed by fitting patient-specific data from two normal fetuses...
2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/26736425/cfd-analysis-of-unsteady-flow-through-conjoining-aorta-and-aortic-isthmus
#15
Amy-Lee Gunter, Zahra Keshavarz-Motamed, Rocco Portaro, Lyes Kadem, Hoi Dick Ng
The initial stages of fetal development require that blood oxygenation occur through the placenta rather than the non functioning lungs. As a result the fetal circulatory system develops a temporary shunt between the aorta and pulmonary artery, known as the ductus arteriosis (DA). This study utilizes CFD techniques to analyze the flow behavior in the aortic isthmus neighboring the DA. The geometry used to represent these structures is equivalent to that of a 25 week old fetus. The effect of aortic and pulmonary pressure pulse wave delay is examined for producing flow disturbances in the fetal circulatory system...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26709133/respiratory-sinus-arrhythmia-in-growth-restricted-fetuses-with-normal-doppler-hemodynamic-indices
#16
R Arias-Ortega, J C Echeverría, M Guzmán-Huerta, L Camargo-Marín, M J Gaitán-González, H Borboa-Olivares, E Portilla-Islas, S Camal-Ugarte, C Vargas-García, M R Ortiz, R González-Camarena
BACKGROUND: The autonomic behavior of growth-restricted fetuses at different evolving hemodynamic stages has not been fully elicited. AIM: To analyze the respiratory sinus arrhythmia (RSA) of growth-restricted fetuses that despite this severe condition show normal Doppler hemodynamics. SUBJECTS: 10 growth-restricted fetuses (FGR group) with normal arterial pulsatility indices (umbilical, uterine, middle cerebral, ductus venosus and aortic isthmus), and 10 healthy fetuses (Control group), 32-37weeks of gestation...
February 2016: Early Human Development
https://www.readbyqxmd.com/read/26649342/the-role-of-ventricular-disproportion-aortic-and-ductal-isthmus-ultrasound-measurements-for-the-diagnosis-of-fetal-aortic-coarctation-in-the-third-trimester-of-pregnancy
#17
Claudiu Mărginean, Cristina Oana Mărginean, Iolanda Muntean, Rodica Togănel, Septimiu Voidăzan, Liliana Gozar
AIM: To analyze the role of ventricular disproportion, aortic, and ductal isthmus ultrasound measurements for the diagnosis of fetal aortic coarctation (AoCo) and to evaluate the prediction of a needed neonatal surgical intervention in the presence of a diagnosis of AoCo. MATERIAL AND METHODS: We performed a prospective study on 41 fetuses (pregnancy age- 32 to 39 weeks, median 36 weeks) evaluated for left ventricle (LV) < right ventricle (RV) disproportion. Four fetuses were lost from evidence and five fetuses with complex cardiac malformations were excluded...
December 2015: Medical Ultrasonography
https://www.readbyqxmd.com/read/26635349/retrograde-lower-body-arterial-reservoir-discharge-underlies-rapid-reversal-of-ductus-arteriosus-shunting-after-early-cord-clamping-at-birth-in-preterm-lambs
#18
Joseph J Smolich, Kelly R Kenna, Jonathan P Mynard
Arterial reservoir ("windkessel") function, whereby a part of left ventricular (LV) output is stored in elastic arteries during systole and discharged in diastole, is a well-established physiological phenomenon. However, its role in rapid reversal (to left-to-right) and a systolic-to-diastolic shift of shunting across the ductus arteriosus after birth is unknown. To address this question, ductal and aortic isthmus flows were measured with high-fidelity transit-time probes in six anesthetized preterm fetal lambs before and after cord clamping and subsequent early mechanical ventilation and for 30 min postbirth...
February 15, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/26630206/utility-of-novel-fetal-echocardiographic-morphometric-measures-of-the-aortic-arch-in-the-diagnosis-of-neonatal-coarctation-of-the-aorta
#19
Bhawna Arya, Aarti Bhat, Margaret Vernon, Jeffrey Conwell, Mark Lewin
OBJECTIVES: Prenatal diagnosis of neonatal coarctation of the aorta (CoA) is challenging; there is a high false-positive rate, yet 60-80% are not identified prenatally. We aimed to identify novel fetal echocardiographic measures to improve prenatal identification of CoA. METHODS: A retrospective review was conducted of subjects seen from 1/2007-1/2014 with prenatal suspicion for CoA and postnatal follow-up. The last fetal echocardiogram prior to delivery was evaluated for right/left ventricular dimensions, ascending (AAo), transverse (TAo), descending aorta (DAo), aortic isthmus (AoI), ductus arteriosus (DA), and main pulmonary artery diameters, and AoI and DA spectral Doppler...
February 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/26381327/genetics-pregnancy-and-aortic-degeneration
#20
Jeffrey D Crawford, Cindy M Hsieh, Ryan C Schenning, Matthew S Slater, Gregory J Landry, Gregory L Moneta, Erica L Mitchell
We present a case of familial thoracic aortic aneurysm and dissection (FTAAD) in a pregnant female. FTAAD is an inherited, nonsyndromic aortopathy resulting from several genetic mutations critical to aortic wall integrity have been identified. One such mutation is the myosin heavy chain gene (MYH11) which is responsible for 1-2% of all FTAAD cases. This mutation results in aortic medial degeneration, loss of elastin, and reticulin fiber fragmentation predisposing to TAAD. Aortic disease is more aggressive during pregnancy as a result of increased wall stress from hyperdynamic cardiovascular changes and estrogen-induced aortic media degeneration...
January 2016: Annals of Vascular Surgery
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