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Branch Pulmonary Artery Stenosis

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...
April 20, 2016: 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...
March 29, 2016: 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
Giandomenico Tarsia, Costantino Smaldone, Marco F Costantino
A 65-year-old woman was admitted to our institution for rest dyspnea and hypotension. EKG showed sinus tachycardia with signs of infero-posterior STEMI. 2D-echocardiogram showed severe left ventricular systolic dysfunction with a- diskynesia of the inferior and posterior walls and severe functional mitral regurgitation (MR). The patient underwent urgent coronary angiography that showed 3-vessels disease with total occlusion of both first obtuse marginal (OM) branch of the left circumflex artery and right coronary artery (RCA) and critical stenosis of left anterior descending (LAD)...
February 16, 2016: Catheterization and Cardiovascular Interventions
Travis J Wilder, Glen S Van Arsdell, Eric Pham-Hung, Michael Gritti, Sara Hussain, Christopher A Caldarone, Andrew Redington, Edward J Hickey
BACKGROUND: Potential surgical strategies for hypoplastic branch pulmonary arteries (BPAs) during tetralogy of Fallot repair include (1) extensive patch augmentation to the hilum (PATCH), (2) limited extension arterioplasty to the proximal pulmonary artery (EXTENSION), or (3) leaving the native vessels unaugmented (NATIVE). We explored the effect of these strategies on reintervention and BPA growth. METHODS: From 2000 to 2012, 434 children underwent complete tetralogy of Fallot repair...
March 2016: Annals of Thoracic Surgery
Humberto Rodríguez, Hernán Montero, Antonio Fernández, Armando Guzman, Thomas Di Sessa
An 11-year-old male with a diagnosis of truncus arteriosus (common arterial trunk) with origin of the right coronary artery anteriorly from the pulmonary segment of the common trunk underwent reparative surgery. The pulmonary trunk was long, and it had a kink with stenosis that protected the distal pulmonary vascular bed from elevated pressure. Adequate flow allowed well-developed distal branch pulmonary arteries. An oval incision was made in the pulmonary trunk, which created a flap. At its center was the right coronary artery...
May 2016: World Journal for Pediatric & Congenital Heart Surgery
Matthew J Eagleton, Matthew Follansbee, Katherine Wolski, Tara Mastracci, Yuki Kuramochi
OBJECTIVE: Thoracoabdominal aortic aneurysm (TAAA) repair remains a challenging clinical pathology. Endovascular technology, in particular the evolution of fenestrated and branched (F/B) endografts used in endovascular aneurysm repair (EVAR) has provided a less invasive method of treating these complex aneurysms. This study evaluated the technical and clinical outcomes of F/B-EVAR for extensive type II and III TAAA. METHODS: Data from 354 high-risk patients enrolled in a physician-sponsored investigational device exemption trial (2004-2013) undergoing F/B-EVAR for type II and III TAAA were evaluated...
April 2016: Journal of Vascular Surgery
Hyungtae Kim, Si Chan Sung, Kwang Ho Choi, Hyoung Doo Lee, Gil Ho Ban, Geena Kim, Hee Young Kim
BACKGROUND: Reconstruction of branch pulmonary arteries (PAs) can be demanding in redo congenital cardiac surgeries. Sutureless patch angioplasty could be a useful method to solve this problem, and we evaluated the feasibility of sutureless patch angioplasty for postoperative PA stenosis in patients who underwent congenital cardiac surgery. METHODS: We retrospectively reviewed 28 patients (19 males and 9 females) who underwent sutureless patch angioplasty for postoperative PA stenosis between November 2004 and April 2015...
March 2016: Annals of Thoracic Surgery
Katarzyna Szaflik, Piotr Kaźmierczak, Jacek Jan Moll, Jadwiga Anna Moll
Congenital obstruction of the left main coronary artery is a complicating feature of supravalvular aortic stenosis. We describe an eight-month-old female patient with Williams syndrome, supravalvular aortic stenosis, and branch pulmonary artery stenosis, with concomitant anomaly of severe obstruction of the left coronary artery orifice.
March 2016: World Journal for Pediatric & Congenital Heart Surgery
Umesh Kumar Mittal, Harmeet Kaur Rissam, Lalit Garg, Sunil Kumar Puri
We report an extremely rare case of coarctation of the aorta with associated left pulmonary artery stenosis. This violates the traditional fetal flow pattern theory. Two-dimensional echocardiography, although being the initial imaging modality for diagnosing coarctation of the aorta, is limited in the demonstration of branch pulmonary arteries. Retrospective ECG-gated multidetector CT angiography is a non-invasive imaging technique for comprehensive assessment of the site, length and severity of the stenosed aortic segment...
2015: BMJ Case Reports
Massimo Chessa, Gianfranco Butera, Luca Giugno, Angelo Micheletti, Diana G Negura, Mario Carminati
To describe preliminary experience of percutaneous pulmonary valve implantation, in a single pulmonary branch position. Two procedures in 2 patients from a single center are described, where implantation of percutaneous valves within a single pulmonary artery branch was technically successful. The procedural indication was pulmonary valve regurgitation and/or residual stenosis. The 2 patients were symptomatic. An Edwards Sapien™ valve (Patient 1), and a Medtronic Melody™ valve (Patient 2) were implanted...
October 26, 2015: World Journal of Cardiology
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