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Branch Pulmonary Artery Stenosis

Jeffrey D Zampi, Emefah Loccoh, Aimee K Armstrong, Sunkyung Yu, Ray Lowery, Albert P Rocchini, Jennifer C Hirsch-Romano
OBJECTIVES: To describe our 20-year experience with intraoperative pulmonary artery (PA) stent placement and evaluate long-term patient outcomes, specifically the need and risk factors for reintervention. BACKGROUND: Intraoperative PA stent placement is an alternative to surgical patch arterioplasty and percutaneous angioplasty or stent placement to treat branch PA stenosis. METHODS: We performed a retrospective review of all intraoperative PA stents placed at our institution from 1994-2013...
May 4, 2017: Catheterization and Cardiovascular Interventions
Jayanta Saha, Rammohan Roy, Sudhakar Singh, Satyendra Nath Dutta
Congenital pulmonary vein stenosis is a rare entity caused due to failed incorporation of common right and/or left pulmonary vein into the left atrium. Below is a case report of a combination of predominantly left-sided pulmonary vein stenosis with right pulmonary artery branch stenosis. The patient was an adolescent boy with mild symptoms. Clinical examination revealed features of pulmonary artery hypertension. Echocardiography and computed tomography scan were done to confirm the disease.
January 2017: Journal of Cardiovascular Echography
Shreesha S Maiya, Smruti V Patel, Chinnaswamy Reddy, Suresh V Pujar
A male child, with d-transposition of great arteries, a large perimembranous ventricular septal defect, multiple additional ventricular septal defects, small muscle-bound right ventricle, and severe pulmonary stenosis with confluent, moderate-sized branch pulmonary arteries, underwent an emergency right modified Blalock-Taussig shunt on day 15 of life and réparation à l'étageventriculaire procedure with ventricular septal defect closure with takedown of the Blalock-Taussig shunt at 2.5 years of age. On follow-up, he showed a moderate residual upper ventricular septal defect and multiple apical ventricular septal defects, mild mid-right pulmonary artery stenosis, free pulmonary regurgitation, and right ventricular dysfunction...
January 2017: Cardiology in the Young
Mathilde Meot, Bruno Lefort, Jean Marc El Arid, Nathalie Soulé, Julie Lothion-Boulanger, François Lengellé, Alain Chantepie, Paul Neville
BACKGROUND: Branch pulmonary artery (BPA) stenosis is frequently associated with congenital heart disease. Management of BPA stenosis is challenging for surgeons due to a high rate of recurrence. The purpose of this study was to assess the results of intraoperative pulmonary artery stenting associated with or without surgical angioplasty. METHODS: We included 33 children from our center between January 2008 and July 2014. Patients had pulmonary atresia with ventricular septal defect (13), tetralogy of Fallot (10), troncus arteriosus (4), double outlet right ventricle (2), and single left or right ventricle (4)...
March 5, 2017: Annals of Thoracic Surgery
Hyungtae Kim, Si Chan Sung, Kwang Ho Choi, Hyoung Doo Lee, Gil Ho Ban, Geena Kim, Hee Young Kim
A patient with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries without an intrapericardial pulmonary artery (PA) underwent a one-stage total correction, including both branch PA reconstructions, with a bovine pericardial roll at the age of 42 months. She was readmitted 54 months after the operation because of extracardiac conduit bacterial endocarditis and pulmonary infarction. The bovine pericardial roll between the right and left PAs was enucleated, and the surrounding fibrotic tissue (peel) was used as a new branch PA vascular conduit...
February 2017: Journal of Cardiac Surgery
Richard D Mainwaring, Frank L Hanley
Peripheral pulmonary artery stenosis (PPAS) is a rare form of congenital heart disease that is most frequently associated with Williams and Alagille syndromes. These patients typically have systemic level right ventricular pressures secondary to obstruction at the lobar, segmental, and subsegmental branches. The current management of patients with PPAS remains somewhat controversial. We have pioneered an entirely surgical approach for the reconstruction of PPAS. This approach initially entailed a surgical patch augmentation of all major lobar branches and effectively reduced the right ventricular pressures by more than half...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
Ahmet Celebi, Ilker Kemal Yucel, Mustafa Orhan Bulut, Mehmet Kucuk, Sevket Balli
OBJECTIVE: To determine the short- and medium-term outcomes of ductal stenting (DS) in patients with functionally univentricular hearts (FUHs) and ductal-dependent pulmonary blood flow. BACKGROUND: Several studies have evaluated the outcomes of DS in a limited number of patients with FUHs. Nonetheless, there is still no consensus regarding the indications for this procedure, and no appropriate patient selection criteria have been devised. METHODS: From 2005 to 2015, cardiac catheterization for DS was performed in 68 patients with FUHs...
March 1, 2017: Catheterization and Cardiovascular Interventions
Lei Wang, Teng Ma, Yun-Tao Zhao
Takayasu arteritis is a form of vasculitis that involves the aorta, its major branches, and the pulmonary arteries. Coronary artery involvement is not uncommon, and most frequently includes the ostia and proximal segments. Early diagnosis of Takayasu arteritis is difficult since it is a rare disease and is accompanied by various nonspecific clinical symptoms. However, recent advances in imaging modalities-including magnetic resonance angiography, computed tomography (CT), sonography, and fluoro-deoxyglucose positron emission tomography (FDG-PET)/CT Isobe (2013) [2]-have facilitated earlier and more accurate diagnoses of this condition...
April 2017: American Journal of Emergency Medicine
Richard D Mainwaring, Ali N Ibrahimiye, Frank L Hanley
Surgical reconstruction of peripheral pulmonary artery stenosis is a technically challenging procedure due to the need to access all lobar and segmental branches. This paper describes our surgical approach that entails division of the main pulmonary and separation of the branch pulmonary arteries. This surgical approach can also be utilized for other complex peripheral pulmonary artery reconstructions.
August 2016: Annals of Thoracic Surgery
Ljilja Musić, Božidarka Kneževic, Ljiljana Jovović, Nebojša Bulatović
INTRODUCTION: Double orifice mitrol valve (DOMV) is a very rare congenital heart defect. CASE REPORT: We reported 20-year-old male referred to our center due to evaluation of his cardiologic status. He was operated on shortly after birth for a tracheoesophageal fistula. Accidentally, echocardiography examination at the age of 4 years revealed double orifice mitral valve (DOMV) without the presence of mitral regurgitation, as well as mitral stenosis, with normal dimensions of all cardiac chambers...
May 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Takanari Fujii, Hideshi Tomita, Kazuto Fujimoto, Shinichi Otsuki, Toshiki Kobayashi, Yasuo Ono, Satoshi Yazaki, Sung-Hae Kim, Toshio Nakanishi
BACKGROUND: Percutaneous stenting for branch pulmonary artery stenosis is an established interventional choice in congenital heart disease. The apparent morphologic change in the vessel diameter often differs from the hemodynamic result. METHODS AND RESULTS: We performed a subanalysis of the data from the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. The factors that may have contributed to morphologic effectiveness included reference vessel diameter (RVD), minimum lumen diameter (MLD) and percent diameter stenosis (%DS) and the relation between morphologic and hemodynamic effectiveness was evaluated in 206 lesions treated with stenting...
July 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Ing-Sh Chiu, Meng-Luen Lee, Shu-Chien Huang, Chung-I Chang, Yih-Sharng Chen, Mei-Hwan Wu, Robert H Anderson
When the arterial switch operation includes the Lecompte maneuver, the arterial trunks are reconnected in parallel, rather than the spiral fashion observed in the normal heart. Thus, although the ventriculo-arterial connections are hemodynamically corrected, the anatomic arrangement cannot be considered normal. We hypothesized that, if feasible, it would be advantageous to restore a spiral configuration for the arterial trunks. In 58 patients, we reconstructed the arterial trunks such that, postoperatively, the pulmonary channel spirals round the aorta, passing to either the right or the left, and branches posteriorly...
August 2016: Pediatric Cardiology
Tai Fuchigami, Masahiko Nishioka, Toru Akashige, Kazuhiro Takahashi, Taisuke Nabeshima, Nobuhiro Nagata
A neonate, born after 29 weeks and 2 days gestation (weight 1015 g), was diagnosed with truncus arteriosus and interrupted aortic arch. On postnatal day 30 (1378 g), we performed bilateral pulmonary artery banding. On postnatal day 107 (3024 g), we carried out aortic arch repair and a Rastelli-type procedure. During follow-up, branch pulmonary artery and ascending aortic stenosis was observed. At 15 months, surgical angioplasty of the ascending aorta and bilateral branch pulmonary arteries was undertaken using the Lecompte maneuver...
May 5, 2016: Asian Cardiovascular & Thoracic Annals
Kuan-Yin Ko, Yen-Wen Wu, Chia-Ju Liu, Mei-Fang Cheng, Ruoh-Fang Yen, Kai-Yuan Tzen
OBJECTIVE: Identification of right ventricular (RV) abnormalities is important in patients with suspected coronary artery disease (CAD). RV activity can be better visualized on myocardial single-photon emission computerized tomography (SPECT) using a higher sensitivity cadmium-zinc-telluride (CZT) detector. The aim of this study was to investigate the clinical significance of RV/left ventricular (LV) uptake ratios during exercise thallium-201 SPECT using CZT detectors. PATIENTS AND METHODS: A total of 102 patients underwent treadmill ECG-gated SPECT, coronary angiography, and echocardiography...
June 2016: Nuclear Medicine Communications
Sylvia Krupickova, Vivek Muthurangu, Marina Hughes, Oliver Tann, Michelle Carr, Georgi Christov, Ram Awat, Andrew Taylor, Jan Marek
Aims: This study sought to investigate diagnostic accuracy of echocardiographic measures of great vessels in patients before bidirectional cavopulmonary connection (BCPC) compared with cardiovascular magnetic resonance (CMR). Methods and results: Seventy-two patients (61% after Norwood operation) undergoing BCPC between 2007 and 2012 were assessed pre-operatively using echocardiography and CMR. Bland-Altman analysis and correlation coefficients were used for comparison of echocardiography and CMR measurements...
March 1, 2017: European Heart Journal Cardiovascular Imaging
Brian H Morray, Doff B McElhinney, Audrey C Marshall, Diego Porras
BACKGROUND: Treatment with endovascular stents has become increasingly common for the management of vascular stenosis in congenital heart disease. The use of stents in smaller patients has been tempered by concerns about the potential for stent expansion to accommodate somatic growth. One solution to limited stent diameter is the intentional fracture of maximally dilated stents, which can be accomplished using ultra-high-pressure (UHP) balloons. METHODS AND RESULTS: This retrospective cohort study compared procedural characteristics and adverse events between a cohort of patients with branch pulmonary artery (PA) stents who underwent stent fracture using UHP balloons and control patients who underwent UHP redilation of previously placed PA stents without stent fracture between 2004 and 2014...
April 2016: Circulation. Cardiovascular Interventions
Renee M Rodriguez, Jeffrey A Feinstein, Frandics P Chan
BACKGROUND: Alagille syndrome is a rare disorder commonly associated with pulmonary artery stenosis. Studies exist discussing the cardiovascular sequela but no consistent phenotype, or pattern of pulmonary artery stenosis, has been described. OBJECTIVE: The objective of this study was to characterize the distribution and severity of pulmonary artery stenosis in patients with Alagille syndrome based on computed tomography angiography. MATERIALS AND METHODS: A retrospective chart review identified patients with Alagille syndrome who had undergone CT angiography...
July 2016: Pediatric Radiology
Xiang-Bin Pan, Wen-Bin Ouyang, Shou-Zheng Wang, Yao Liu, Da-Wei Zhang, Feng-Wen Zhang, Kun-Jing Pang, Zhe Zhang, Sheng-Shou Hu
INTRODUCTION: Percutaneous patent ductus arteriosus (PDA) occlusion has become the preferred therapeutic option, which uses fluoroscopy as the guidance. To reduce the x-ray exposure, PDA occlusion using the Amplatzer Duct Occluder II (ADO II) under guidance of transthoracic echocardiography only was conducted. This single center study aims to access the safety and efficiency of this new strategy. METHODS AND RESULTS: From June 2013 to May 2015, 63 consecutive PDA patients underwent transthoracic echocardiography-guided PDA occlusion through the femoral artery...
July 2016: Echocardiography
Conall Thomas Morgan, Luc Mertens, Heynric Grotenhuis, Shi-Joon Yoo, Mike Seed, Lars Grosse-Wortmann
AIMS: The pathophysiology of branch pulmonary artery (PA) stenosis after the arterial switch operation, most commonly on the left, is incompletely understood. This study examines factors associated with left PA (LPA) obstruction. METHODS AND RESULTS: Cardiac magnetic resonance (CMR) imaging studies performed in patients after arterial switch operation (ASO) were retrospectively analysed. Blood flow was measured in both branch PAs and neo-pulmonary root position in relation to the aorta was expressed as an angle, relative to a line connecting the sternum and the spine...
February 2017: European Heart Journal Cardiovascular Imaging
Monia Khemiri, Wiem Douira, Sihem Barsaoui
Few reports on co-occurrence of Takayasu's arteritis (TA) and tuberculosis (Tb) have been published in childhood. A 12-year-old girl presented with 4-month's history of a dry cough, persistent fever, marked weakness, and weight loss. Physical examination revealed impalpable peripheral pulses and unrecordable blood pressure (BP) on upper limbs. In lower limbs, peripheral pulses were normal and BP reached respectively 160/90 and 140/87 mmHg. Laboratory investigations showed an erythrocyte sedimentation rate at 140 mm in the 1(st) h and microcytic anemia (8...
January 2016: Annals of Pediatric Cardiology
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