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Pulmonary Valve Regurgitation and Branch Pulmonary Artery Stenosis

Erkut Ozturk, Ibrahim Cansaran Tanidir, Pelin Ayyildiz, Selman Gokalp, Hasan Candas Kafali, Murat Sahin, Yakup Ergul, Sertac Haydin, Alper Guzeltas
AIM: Our aim was to evaluate the findings and the role of intraoperative epicardial echocardiography (IEE) in the management of pediatric cardiac surgery patients. METHODS: Patients evaluated with IEE between December 2015 and December 2017 were analyzed retrospectively. Demographic data, preoperative transthoracic echocardiography (TTE), and IEE reports were evaluated. RESULTS: A total of 410 patients evaluated by IEE were included in the study...
March 25, 2018: Echocardiography
Christopher R Broda, Svetlana B Shugh, Rohan B Parikh, YunFei Wang, Tobias R Schlingmann, Cory V Noel
After an arterial switch operation (ASO), serial imaging is necessary to monitor for maladaptive changes. We compared cardiac magnetic resonance imaging (CMR) to 2-D transthoracic echocardiography (TTE) in assessing post-operative ASO patients. We performed a retrospective review of patients at a single tertiary care center who underwent an ASO and subsequently had a CMR performed from 7/2010 to 7/2016. Those with single ventricle anatomy, congenitally corrected transposition of the great arteries, or previous atrial switch operation were excluded...
March 22, 2018: Pediatric Cardiology
Tariq Waqar, Muhammad Usman Riaz, Tania Mahar
OBJECTIVE: To determine the early surgical outcomes of Tetralogy of Fallot (TOF) repair in children and young adults operated after the age of one year. METHODS: In this retrospective study, 307 cases of primary repair of Tetralogy of Fallot were done between September 2012 to February 2017, at CPE Institute of cardiology, Multan. Out of 307 operated patients, 4 (1.3%) patients had previous modified Blalock Taussig shunts, 2 (0.6%) associated ASD with TOF, 3 (0...
July 2017: Pakistan Journal of Medical Sciences Quarterly
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
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)...
December 2016: Catheterization and Cardiovascular Interventions
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
Weichun Wu, Kunjing Pang, Qiongwen Lin, Ani Zhang, Wugang Wang, Minghui Zhang, Jianrong Li, Hao Wang
Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease that is easily misdiagnosed as tetralogy of Fallot (TOF). We herein discuss the echocardiographic features of APVS, compare its two subtypes, and clarify some differences between APVS and TOF. From July 1998 to October 2011, 31 patients diagnosed with APVS at Fuwai Hospital underwent echocardiography, computed tomography, or cardiac angiography. APVS was clinically categorized as either infant-type or child-type. We compared the echocardiographic similarities and differences between APVS and TOF and between the two subtypes of APVS...
October 2015: International Journal of Cardiovascular Imaging
Yoshihiro Honda, Shoji Suzuki, Shigeaki Kaga, Yukiyo Yoshida, Mitsuhiro Kimura, Kentaro Kamiya, Kenji Sakakibara, Masatake Katsu
The patient was diagnosed with tetralogy of Fallot associated with absent pulmonary valve syndrome and a low birth weight of 1,912 g. He suffered from respiratory distress on day 14 and received non-invasive positive pressure ventilation. At 5 months of age and 4.1 kg, he underwent intracardiac repair including right ventricular outflow repair with a monocusp patch, patch closure of the ventricular septum defect and right pulmonary transposition to the anterior of the ascending aorta following the Lecompte maneuver for airway decompression...
May 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Hanjun Pei, Yongjian Wu, Yuejin Yang, Siyong Teng, Haitao Zhang, Lei Zhang, Hongxia Niu, Wenjia Zhang, Guannan Niu, Jie Qian, Shubin Qiao, Bo Xu, Runlin Gao
OBJECTIVE: To explore the procedural feasibility and early clinical outcomes of percutaneous balloon aortic valvuloplasty (PBAV) in patients with severe aortic stenosis, who were considered transiently unsuitable for surgical aortic valve replacement (sAVR) and transcatheter aortic valve replacement (TAVR). METHODS: Between March 2011 and January 2014, datas of 20 patients underwent PBAV in Fuwai Hospital were retrospectively analyzed. Mean patients age was (72 ± 8) years...
January 2015: Zhonghua Xin Xue Guan Bing za Zhi
Deepa Sasikumar, Bijulal Sasidharan, Jaganmohan A Tharakan, Baiju S Dharan, Thomas Mathew, Jayakumar Karunakaran
BACKGROUND AND OBJECTIVES: Repair of tetralogy of Fallot (TOF) with monocusp pulmonary valve reconstruction prevents pulmonary regurgitation (PR) for a variable period. Since postoperative outcome is governed by PR and right ventricular function, we sought to assess the severity of pulmonary regurgitation and right ventricular outflow (RVOT) gradient in the immediate postoperative period and at 1 year and attempted to identify the anatomical substrates responsible for adverse outcomes...
January 2014: Annals of Pediatric Cardiology
Sylvia S M Chen, Philip J Kilner
BACKGROUND: We sought to improve understanding of the diastolic prolongation of forward flow seen through a unilateral branch pulmonary artery (PA) stenosis. METHODS AND RESULTS: Of patients studied by cardiovascular magnetic resonance (CMR) for congenital heart disease, we reviewed right and left PA flow to find 10 cases with a diastolic prolongation of flow in a stenosed branch PA. They were aged 20 years (median, range = 14-40 years, 7 males). Seven had transposition of the great arteries corrected by arterial switch (TGA-AS) and 3 had repaired tetralogy of Fallot (rToF)...
October 9, 2013: International Journal of Cardiology
Ashish Katewa, Ashutosh Marwah, Vishal Singh, Arun Ramaswamy, Rajesh Sharma
Biventricular repair in right atrial isomerism is rarely feasible due to associated anomalies of venous connection, ventricular imbalance, nonroutabilty of the interventricular communication, a common atrioventricular junction, and inadequate pulmonary arterial branches. These patients are also often not ideal for univentricular repair due to some of the above associations. We describe a novel surgical technique that was utilized in such a patient for biventricular repair of a child with right atrial isomerism with total anomalous pulmonary venous connection, regurgitant common atrioventricular valve, hypoplastic left ventricle, nonroutable ventricular septal defect, and pulmonary stenosis...
July 1, 2012: World Journal for Pediatric & Congenital Heart Surgery
Heather Y Sun, Justin Boe, Erika Rubesova, Richard A Barth, Theresa A Tacy
In tetralogy of Fallot with absent pulmonary valve, pulmonary stenosis and regurgitation results in significant pulmonary artery dilatation. Branch pulmonary artery dilatation often compresses the tracheobronchial tree, causing fluid trapping in fetal life and air trapping and/or atelectasis after birth. Prenatal diagnosis predicts poor prognosis, which depends on the degree of respiratory insufficiency from airway compromise and lung parenchymal disease after birth. Fetal magnetic resonance imaging (MRI) has been useful in evaluating the effects of congenital lung lesions on lung development and indicating severity of pulmonary hypoplasia...
July 2014: Congenital Heart Disease
Shiraz A Maskatia, Joseph A Spinner, Shaine A Morris, Christopher J Petit, Rajesh Krishnamurthy, Arni C Nutting
Right ventricular (RV) volume overload secondary to pulmonary regurgitation is common in patients after initial repair of tetralogy of Fallot (TOF) and is associated with adverse long-term outcomes. The objective of the present study was to determine the effect of branch pulmonary artery stenosis on the RV volume in patients with repaired TOF. We reviewed 178 cardiac magnetic resonance imaging studies in patients with repaired TOF. We defined bilateral stenosis as a Nakata index of ≤200 mm(2)/m(2) and concordant branch pulmonary artery cross-sectional area, unilateral stenosis as 1 branch pulmonary artery cross-sectional area ≤100 mm(2)/m(2) and 1 branch pulmonary artery cross-sectional area >100 mm(2)/m(2), and restrictive physiology as prograde main pulmonary artery diastolic flow...
May 1, 2013: American Journal of Cardiology
Rajesh Puranik, Victor Tsang, Philip Lurz, Vivek Muthurangu, Sophie Offen, Alessandra Frigiola, Wendy Norman, Fiona Walker, Philip Bonhoeffer, Andrew M Taylor
OBJECTIVE: Chronic pulmonary regurgitation (PR) has deleterious effects on right ventricular (RV) function in repaired tetralogy of Fallot (ToF). However, there are little data regarding right ventricular outflow tract (RVOT) contractile dysfunction in response to chronic PR and on both RV and LV volumes and function. METHODS: We retrospectively identified consecutive patients with PR who were referred for magnetic resonance imaging quantification of "free PR" detected on echocardiography between 2003 and 2008...
May 2012: Journal of Thoracic and Cardiovascular Surgery
F Windhausen, S M Boekholdt, B J Bouma, M Groenink, A P C M Backx, R J de Winter, B J M Mulder, M G Hazekamp, D R Koolbergen
After having undergone surgical correction at an early age, many patients with tetralogy of Fallot develop long-term complications including progressive pulmonary regurgitation and peripheral pulmonary stenosis. A high percentage of these patients need to undergo a second operation in their adolescence or early adulthood. If simultaneous treatment of both pulmonary regurgitation and peripheral pulmonary stenosis is warranted, a complete surgical approach has several disadvantages. We describe four cases of Fallot patients with severe pulmonary regurgitation and peripheral pulmonary stenosis who were treated using a hybrid approach involving surgical implantation of a pulmonary homograft and peroperative stenting of the pulmonary artery...
October 2011: Netherlands Heart Journal
Matthew A Harris, Kevin K Whitehead, Matthew J Gillespie, Timothy Y Liu, Michael T Cosulich, David C Shin, Elizabeth Goldmuntz, Paul M Weinberg, Mark A Fogel
OBJECTIVES: We sought to investigate whether differential branch pulmonary artery (BPA) regurgitation correlates with differences in BPA anatomy and physiology. BACKGROUND: Patients with repaired conotruncal anomalies such as Tetralogy of Fallot frequently have residual BPA stenosis or BPA size differences. Previous reports have demonstrated an increased left pulmonary artery (LPA) regurgitant fraction (RF) in these patients. METHODS: We retrospectively reviewed 76 consecutive cardiac magnetic resonance (CMR) studies for BPA size and phase-contrast magnetic resonance data, including 13 consecutive patients who underwent both CMR and catheterization...
May 2011: JACC. Cardiovascular Imaging
D Theisen, R D Dalla Pozza, E Malec, M F Reiser
With prevalences ranging from 0.26 to 0.8‰ of all live births tetralogy of Fallot (TOF) is the most common congenital heart disease with primary cyanosis. Due to improvements in surgical techniques, nearly all patients can nowadays expect to reach adulthood. After surgical repair, pulmonary regurgitation (PR) occurs in almost every child and is an important contributing factor in long-term morbidity and mortality. Cardiac magnetic resonance imaging is well established for functional assessment and flow measurements and is an ideal tool for serial post-surgical follow-up examinations, as it is non-invasive and does not expose patients to ionizing radiation...
January 2011: Der Radiologe
J Daniel Robb, Matthew A Harris, Masahito Minakawa, Evelio Rodriguez, Kevin J Koomalsingh, Takashi Shuto, David C Shin, Yoav Dori, Andrew C Glatz, Jonathan J Rome, Robert C Gorman, Joseph H Gorman, Matthew J Gillespie
BACKGROUND: Transannular patch (TAP) repair of tetralogy of Fallot often results in significant right ventricular outflow tract (RVOT) dilation and distortion. We hypothesized that insertion of Melody valves into the proximal right and left branch pulmonary arteries (PAs) would reduce pulmonary regurgitation fraction (PRF) in an ovine model of pulmonary insufficiency and dilated RVOT. METHODS AND RESULTS: Ten sheep underwent baseline cardiac catheterization, surgical pulmonary valvectomy, and TAP placement...
February 1, 2011: Circulation. Cardiovascular Interventions
Pierangelo Renella, Jamil Aboulhosn, Derek G Lohan, Praveen Jonnala, J Paul Finn, Gary M Satou, Ryan J Williams, John S Child
BACKGROUND: The grading of pulmonary regurgitation (PR) severity by two-dimensional (2D) and Doppler echocardiography is not standardized. Cardiovascular magnetic resonance imaging is the clinical gold standard for PR quantification. The purpose of this study was to determine the best 2D and Doppler echocardiographic predictors of severe PR. METHODS: Thirty-six patients with tetralogy of Fallot or pulmonary valve stenosis with prior pulmonary valvuloplasty or transannular or subannular patch repair underwent 2D and Doppler echocardiography and cardiovascular magnetic resonance...
August 2010: Journal of the American Society of Echocardiography
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