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Pulmonary stenosis

Brian A Scansen
There remain areas of uncertainty in optimal technique, preferred candidates, and expected outcome for small animal patients undergoing cardiac intervention. This article highlights issues within interventional cardiology that are in need of study and offers the author's opinion and experience on topics such as variants of pulmonary valve anatomy and alternatives to conventional balloon dilation for pulmonary valve stenosis, patient selection for cutting or high-pressure balloon dilation of aortic valvar or subaortic stenosis, occlusion of patent ductus arteriosus in very small dogs, ductal stenting in conditions with reduced pulmonary blood flow, and alternative considerations for vascular access and closure...
June 16, 2018: Veterinary Clinics of North America. Small Animal Practice
Pairoj Chattranukulchai, Jule Namchaisiri, Monravee Tumkosit, Sarinya Puwanant, Yongkasem Vorasettakarnkij, Suphot Srimahachota, Smonporn Boonyaratavej
BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. The enlarged right coronary artery provides retrograde collaterals to supply the left ventricle then preferentially directs into the lower pressure pulmonary artery system causing coronary steal phenomenon. Few patients who survive through adulthood without surgery must have abundant, well-formed functioning collaterals with adequate perfusion of the left ventricle...
June 18, 2018: Journal of Cardiothoracic Surgery
Alberto Cresti, Massimiliano Cantinotti, Stefania Stefanelli, Marco Solari, Incoronata D'Aiello, Susanna Falorni, Silvia Favilli, Ugo Limbruno
BACKGROUND: The epidemiological data on the incidence of congenital heart defects derive from retrospective registries based on birth discharge codes with methodological limits and different selection criteria. Our aim was to determine the actual incidence of congenital heart defects in the first year of life in a population of residents in a province of Tuscany, Italy. METHODS: This prospective study was conducted in 31 185 newborn residents in the province, enrolling a consecutive population throughout the first year of life and followed up at least for one year...
June 2018: Giornale Italiano di Cardiologia
Chen Dror, Amanda Sinai, Doron Gothelf
BACKGROUND: Williams syndrome (WS) is a neurogenetic syndrome characterized by a variety of medical conditions and cognitive deficits along with distinct psychiatric and behavioral characteristics. To the best of our knowledge, no studies to date have comprehensively reported the prevalence of medical, cognitive deficits, and psychiatric disorders in one cohort of people with WS in one study. OBJECTIVES: To detail the prevalence of the various clinical features of WS in a large nationwide Israeli cohort...
June 2018: Israel Medical Association Journal: IMAJ
Ibrahim Aliyu, Zainab Fumilayo Ibrahim
Cor-triatriatum is uncommon and cor-triatriatum dexter is rarer, and patients may remain asymptomatic in isolated cases especially if the partitioning is mild and nonobstructing. There may be other cardiac defects associated with it which are mostly right-sided cardiac defects such as atrial septal defect, Ebstein anomaly, and pulmonary stenosis. However, left-sided heart anomaly such as aortic regurgitation has been associated with it, but its association with transposition of the great vessels has not been documented before now...
April 2018: Journal of Cardiovascular Echography
Kurtulus Karauzum, Irem Yilmaz Karauzum, Tayfun Sahin, Teoman Kilic
Myocardial non-compaction (NC) is a rare genetic cardiomyopathy commonly believed to develop an intrauterine arrest of endomyocardial morphogenesis. NC is characterized by markedly hypertrabeculations in left ventricle or both ventricles with deep intertrabecular recesses. NC is usually seen isolated, but sometimes other congenital heart abnormalities may accompany to the myocardial NC. In this article we have presented an adult patient with biventricular myocardial NC cardiomyopathy accompanied by severe valvular pulmonary stenosis and patent foramen ovale...
April 2018: Journal of Cardiovascular Echography
Jean-Philippe Collet, Sergio Berti, Angel Cequier, Eric Van Belle, Thierry Lefevre, Pascal Leprince, Franz-Josef Neumann, Eric Vicaut, Gilles Montalescot
BACKGROUND: Antithrombotic treatment regimen following transcatheter aortic valve replacement (TAVR) is not evidence-based. Apixaban, a non-vitamin K direct anticoagulant (NOAC) was shown to be superior to VKA and superior to aspirin to prevent cardioembolic stroke in non-valvular atrial fibrillation. It may have the potential to reduce TAVR-related thrombotic complications including subclinical valve thrombosis along with a better safety than the standard of care. DESIGN: ATLANTIS is a multicenter, randomized, phase IIIb, prospective, open-label, superiority study comparing standard of care (SOC Group) versus an apixaban-based strategy (Anti-Xa Group) after successful TAVR (ClinicalTrials...
June 2018: American Heart Journal
Kiri A Sandler, Fereidoun Abtin, Robert Suh, Ryan R Cook, Carol Felix, Jay M Lee, Edward B Garon, Jeffrey Wu, Elaine M Luterstein, Nzhde Agazaryan, Stephen E Tenn, Chul Lee, Michael L Steinberg, Percy Lee
PURPOSE: Stereotactic body radiation therapy (SBRT) and heat-based ablation (HBA) are both potentially safe and effective treatments for primary and metastatic lung tumors. Both are suboptimal for centrally located tumors, with SBRT having a higher risk of significant toxicity and HBA having lower efficacy. This study evaluates the safety and efficacy of combination SBRT-HBA to determine whether combined treatment can result in superior outcomes to each treatment alone. METHODS AND MATERIALS: Patients with 1 or 2 primary or metastatic lung tumors ≤ 5 cm in size were enrolled in a prospective phase 2 trial and treated with SBRT in 3 fractions followed by HBA...
July 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Erika Marroquín-Fabián, Natllely Ruiz, Jorge Mena-Zúñiga, Luis Felipe Flores-Suárez
OBJECTIVES: Granulomatosis with polyangiitis-a primary systemic vasculitis-most frequent manifestations are respiratory. Airway disease can present with stenosis, and although subglottic stenosis (SGS) is well described, narrowing distal to the glottis has been more recently the focus of reporting. Our objectives, therefore, are to describe the frequency, characteristics, and treatment of tracheobronchial stenoses (TBS) in granulomatosis with polyangiitis (GPA) at our institution, a national referral center for respiratory diseases...
May 16, 2018: Seminars in Arthritis and Rheumatism
Pastora Gallego, María José Rodríguez-Puras, Pilar Serrano Gotarredona, Israel Valverde, Begoña Manso, Antonio González-Calle, Alejandro Adsuar, Jose M Cubero, Luis Díaz de la Llera, Antonio Ordoñez, Amir-Reza Hosseinpour
BACKGROUND: Prevalence and prognostic significance of pulmonary artery (PA) dilatation in congenital heart disease (CHD) have never been studied systematically. METHODS: Chest X-rays of 1192 consecutive adults with CHD were reviewed. Major diameter of the PA was determined by imaging techniques in those with PA dilatation. A value >29 mm was considered abnormal. Data on anatomy, hemodynamics, residual lesions and outcomes were retrospectively collected. RESULTS: Overall prevalence of PA dilatation was 18%...
June 2, 2018: International Journal of Cardiology
Yuki Nakamura, Bijoy Thattaliyath, Marco Ricci
A combination of hypoplasia of the left side of the heart, a hypoplastic aortic arch, a large patent ductus arteriosus, and valvular pulmonary stenosis is very rare. The severity of the valvular pulmonary stenosis in this setting is difficult to judge preoperatively. Here, we describe a newborn with borderline hypoplasia of the left side of the heart, a hypoplastic aortic arch, a large patent ductus arteriosus, and valvular pulmonary stenosis, who underwent the Norwood procedure successfully. The purpose of this report is to share the perioperative course of the patient and our decision-making process that was not straightforward...
June 8, 2018: Annals of Thoracic Surgery
K Wang, B Jia
As the primary treatment of aortic valve stenosis in children, surgical aortic valvotomy (SAV) and balloon aortic valvuloplasty (BAV) are widely used. With the similar early curative effect to BAV, SAV performs better in long-term follow-up. But the first choice for aortic valve stenosis is still controversial. These years, aortic valve repair is valued and different repair techniques have been reported and achieved good results. The complex repair techniques, as leaflet extension, leaflet replacement or valve reconstruction, are effective in treating diseased valves that cannot be repaired before...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
C C Pang, W Pan, Z W Zhang, C B Zhou, Y F Li, X Zhang, F Z Han, Y X Sun, S Wang, J Zhuang
Objectives: Two cases who underwent fetal pulmonary valvuloplasty (FPV) for pulmonary atresia with intact ventricular septum (PA-IVS) or critical pulmonary stenosis with intact ventricular septum (CPS-IVS) successfully were reported. The aim of the report was to explore the criteria for case selection, the technical essentials of FPV, and the postpartum outcome of the fetus. Methods: One case with PA-IVS and the other with CPS-IVS were enrolled in September 2016 and February 2017 in Guangdong General Hospital, and both cases were diagnosed with severe right ventricular dysplasia and tricuspid regurgitation by fetal echocardiogram...
June 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Fahad Mahmood Ahmad, Roshan Ali, Adnan Mahmood Gul
The current study was planned to determine the effect of percutaneous transvenous mitral commissurotomy (PTMC) on brain natriuretic peptide (BNP) levels in mitral stenosis patients. It was conducted at the Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, and Rehman Medical Institute Laboratory, Peshawar, Pakistan, from December 2013 to June 2014. Of the 100 patients, 63(63%) were females. The patients' age ranged from 14 to 58 years. Patients diagnosed with isolated mitral valve stenosis or with grade 1 or with grade 2 mitral regurgitation were randomly selected...
May 2018: JPMA. the Journal of the Pakistan Medical Association
Soichiro Kitamura
BACKGROUND: Pediatric coronary artery bypass surgery (PCABS) for congenital heart disease has become increasingly important in infants and children undergoing modern cardiac surgery, because of its life-saving potential in unsuccessful coronary transfer surgery. This review summarizes the current surgical role of PCABS for treating congenital heart diseases. METHODS: Databases, mainly PUBMED, were searched for relevant publications regarding coronary bypass surgery in the pediatric population, from 1970 (commencement) to March 2018...
June 5, 2018: Annals of Thoracic Surgery
Sean M Lang, R Lee Crawford, Pushpa Shivaram, Joshua A Daily, Elijah H Bolin, Xinyu Tang, R Thomas Collins
Pulmonary artery (PA) stenosis is the most common late sequela following arterial switch for d-transposition of the great arteries. The purpose of this study was to assess the effectiveness of transthoracic echocardiography in evaluating the pulmonary arteries following repair. This was a retrospective, cross-sectional analysis of all echocardiograms performed on patients following arterial switch operation. A numerical scoring system was devised and used to quantify PA visualization based on 2D images, color mapping, and spectral Doppler...
June 7, 2018: Pediatric Cardiology
Stephen P Wright, Alexander R Opotowsky, Tayler A Buchan, Sam Esfandiari, John T Granton, Jack M Goodman, Susanna Mak
Aims: The assumption of equivalence between right ventricular and pulmonary arterial systolic pressure is fundamental to several assessments of right ventricular or pulmonary vascular hemodynamic function. Our aims were to 1) determine whether systolic pressure gradients develop across the right ventricular outflow tract in healthy adults during exercise, 2) examine the potential correlates of such gradients, and 3) consider the effect of such gradients on calculated indices of right ventricular function...
June 6, 2018: Cardiovascular Research
Filippo Russo, Anita Paggi, Giuseppe De Nittis, Mario Galli
Coronary artery fistula (CAF) is a rare, abnormal connection between one or more coronary arteries and a cardiac chamber, or great vessel.We describe the case of a male patient with worsening effort angina referred for coronary angiography. The examination revealed the presence of a CAF between the proximal left anterior descending (LAD) and pulmonary arteries, with mid LAD subocclusive stenosis. Ad hoc PCI with stenting was performed in the mid LAD, followed by CAF embolization with coils and plugs. Angiography and computed tomography scan at follow-up showed complete CAF occlusion, stent patency, and normal flow reserve of the LAD...
March 2018: Giornale Italiano di Cardiologia
Alberto Dominguez-Rodriguez, Jennifer T Thibodeau, Colby R Ayers, Alejandro Jimenez-Sosa, Pilar Garrido, Javier Montoto, Pablo C Prada-Arrondo, Pedro Abreu-Gonzalez, Mark H Drazner
OBJECTIVES: Bendopnea is a recently described symptom of advanced heart failure. Its prevalence and prognostic utility in other cardiac conditions are unknown. METHODS: We prospectively enrolled 108 consecutive patients (75 ± 3 years, 68% men) with severe symptomatic aortic stenosis referred for surgical aortic valve replacement (SAVR). Preoperatively, patients were tested for bendopnea, which was considered to be present when dyspnoea occurred within 30 s of bending forward...
June 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Rui Zhang, Zhi-Jun Zhu, Li-Ying Sun
OBJECTIVES: This study aimed to investigate the outcomes of adult liver transplant procedures using grafts from pediatric donors after circulatory death. MATERIALS AND METHODS: We retrospectively analyzed the data of 19 pediatric-to-adult liver transplant procedures from July 2013 to May 2016 in our hospital. Nineteen adult liver transplant procedures were performed using livers from pediatric donors after circulatory death. RESULTS: We performed 18 orthotopic and 1 piggyback liver transplant procedure...
June 1, 2018: Experimental and Clinical Transplantation
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