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https://www.readbyqxmd.com/read/29338918/filling-pressures-in-fontan-revisited-comparison-between-pulmonary-artery-wedge-ventricular-end-diastolic-and-left-atrial-pressures-in-adults
#1
William R Miranda, Alexander C Egbe, Donald J Hagler, Nathaniel W Taggart, Rick A Nishimura, Heidi M Connolly, Carole A Warnes
BACKGROUND: Pulmonary artery wedge pressure (PAWP) has been shown to correlate better with left atrial pressure (LAP) than ventricular end-diastolic pressure (VEDP) in acquired heart disease. The correlation between VEDP and PAWP and their performance as surrogates for LAP in Fontan patients is unknown. METHODS: Offline single-beat simultaneous measurement of PAWP and VEDP was performed in 50 adult Fontan patients and non-simultaneous hemodynamic data abstracted for calculation of pulmonary vascular resistance (PVR)...
December 28, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29314335/late-results-of-right-ventricular-outflow-tract-reconstruction-with-a-bicuspid-expanded-polytetrafluoroethylene-valved-conduit
#2
Kwang Ho Choi, Si Chan Sung, Hyungtae Kim, Hyoung Doo Lee, Geena Kim, Hoon Ko
BACKGROUND AND AIM TO READ: We report the results of a bicuspid expanded polytetrafluoroethylene (ePTFE) valved conduit used for right ventricular outflow tract reconstruction (RVOTR). METHODS: Between November 2005 and February 2009, 12 conduits were used for RVOTR. The mean age and weight of patients were 43.5 ± 46.4 months and 13.4 ± 8.6 kg. The main diagnosis was tetralogy of Fallot with pulmonary atresia in eight patients. The most common conduit size was 18 mm...
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29310560/staged-palliation-of-cyanotic-obstructive-lesions-with-a-modified-right-ventricular-outflow-procedure
#3
Sarosh P Batlivala, Mary K Hood, Jannika Dodge-Khatami, Divya Shakti, Mary B Taylor, Makram R Ebeid, Jorge D Salazar, Ali Dodge-Khatami
BACKGROUND: Traditional palliation for biventricular cyanotic congenital heart lesions often involves staging with systemic-to-pulmonary arterial shunts to secure pulmonary blood flow (PBF) in the newborn period prior to complete repair. However, shunts may lead to life-threatening events secondary to shunt occlusion or acute coronary steal. They may be associated with morbidity secondary to diastolic runoff, systemic steal and volume loading, and do not provide pulsatile flow which has the potential to promote pulmonary artery (PA) growth...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29305732/anatomy-of-the-retro-oesophageal-major-aortopulmonary-collateral-arteries-in-patients-with-pulmonary-atresia-with-ventricular-septal-defect-results-from-preoperative-cta
#4
Qianjun Jia, Jianzheng Cen, Jinglei Li, Jian Zhuang, Hui Liu, Qun Zhang, Xiaoqing Liu, Meiping Huang, Changhong Liang
OBJECTIVES: To assess the frequency and anatomy of retro-oesophageal aortopulmonary collateral arteries (REMs) in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA-VSD-MAPCAs). METHODS: A total of 130 consecutive PA-VSD-MAPCA patients with preoperative CT angiography (CTA) data who underwent cardiac surgery were included. A detailed analysis of MAPCA anatomy was performed using CTA. RESULTS: A REM was identified in 82/130 included patients (63 %)...
January 5, 2018: European Radiology
https://www.readbyqxmd.com/read/29288155/association-between-tetralogy-of-fallot-and-tracheobronchial-branching-abnormalities-a-new-clue-for-pathogenesis
#5
Guillaume Chassagnon, Bruno Lefort, Mathilde Meot, Elodie Carpentier, Dominique Sirinelli, Alain Chantepie, Baptiste Morel
BACKGROUND: In our practice, we noticed an increased frequency of tracheobronchial branching abnormalities (TBAs) in patients with tetralogy of Fallot (ToF). This study aimed to determine whether an association exists between congenital TBAs and ToF with or without pulmonary atresia. METHODS AND RESULTS: The frequency of TBAs on chest computed tomography was assessed in 55 patients with ToF without pulmonary atresia, 34 patients with ToF with pulmonary arteria, and 100 control patients...
December 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29287139/fetal-interventions-for-structural-heart-disease
#6
David N Schidlow, Lindsay Freud, Kevin Friedman, Wayne Tworetzky
Fetal cardiac intervention (FCI) offers the potential to alter in utero anatomy and physiology. For aortic stenosis with evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum with evolving hypoplastic right heart syndrome, FCI may result in maintenance of a biventricular circulation, thus avoiding single-ventricle palliation and its attendant complications. In the case of hypoplastic left heart syndrome with intact atrial septum, FCI may ameliorate in utero pathophysiology and portend a more favorable postnatal prognosis...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29287136/cerebrovascular-hemodynamics-in-fetuses-with-congenital-heart-disease
#7
Tingting Man, Yihua He, Ying Zhao, Lin Sun, Xiaowei Liu, Shuping Ge
BACKGROUND AND OBJECTIVE: It is hypothesized that diminished cerebral vascular resistance or the "brain sparing effect" is associated with fetuses with complex congenital heart defects (CHD) and may affect their neurodevelopmental outcome. An alternative explanation is that it is related to the location, cardiac output, pressure, and resistance in left heart obstructive CHDs. We sought to determine the effects of various left and right heart obstructive defects on the cerebral and placental hemodynamics and to evaluate the utility of these variables for the assessment and prognosis of CHDs...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29287135/pulmonary-hypoplasia-in-fetuses-with-congenital-conotruncal-defects
#8
Qian Wang, Ying Zhao, Ling Han, Ye Zhang, Shuping Ge, Yihua He
OBJECTIVES: We sought to investigate pulmonary hypoplasia (PH) and associated risk factors in fetuses with congenital conotruncal defect (CTD). METHODS: A total of 75 fetuses with CTD (gestational age (GA): 22-32 weeks) and 150 normal GA-matched fetuses as the control group were studied. We measured diameters of aorta (Ao); main, left, and right pulmonary artery (PA); and their Z-scores by fetal echocardiography (FE). We also measured the lung area, lung area/chest area ratio (LCR), lung-to-head circumference ratio (LHR), right lung area/head circumference2 (quantitative lung index, QLI), and Z-scores...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29277931/percutaneous-pulmonary-valve-implantation-in-grown-up-congenital-heart-disease-patients-insights-from-the-zurich-experience
#9
Luca Oechslin, Roberto Corti, Matthias Greutmann, Oliver Kretschmar, Oliver Gaemperli
OBJECTIVES: The aim of the study was to assess indications, procedural success, complications, echocardiographic, and clinical outcomes of percutaneous pulmonary valve implantation (PPVI) in adult patients with congenital heart disease (CHD). BACKGROUND: PPVI offers a non-surgical treatment option for failing prosthetic conduits in pulmonary position. However, efficacy and clinical outcomes after PPVI are still underreported. METHODS: From January 2008 to March 2016, 25 adult CHD patients with right ventricular outflow tract (RVOT) stenosis and/or pulmonary regurgitation underwent PPVI in our institution...
December 25, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29249497/chylothorax-and-pleural-effusion-in-contemporary-extracardiac-fenestrated-fontan-completion
#10
Mauro Lo Rito, Osman O Al-Radi, Arezou Saedi, Yasuhiro Kotani, V Ben Sivarajan, Jennifer L Russell, Christopher A Caldarone, Glen S Van Arsdell, Osami Honjo
BACKGROUND: We hypothesized that chylothorax could be a sign of intolerance to the Fontan physiology, and thus patients who develop chylothorax or pleural effusion have worse medium-term to long-term survival. METHODS: A total of 324 patients who underwent the Fontan operation between 2000 and 2013 were included. Chylothorax was defined as ≥5 mL/kg/day of chylomicron-positive chest drainage fluid no earlier than postoperative day 5 or drainage with >80% lymphocytes...
November 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29244964/outpatient-negative-pressure-dressing-therapy-for-pretibial-lacerations-in-a-patient-with-high-anaesthetic-risk-a-case-study
#11
L Sutton, D Edwards, M McColl
Pretibial lacerations are a common cause of presentation to accident and emergency departments. The management of these wounds is contentious with a variation in practise between individual institutions. We present the case of a 49-year-old female with a background of pulmonary atresia and associated pulmonary hypertension, who underwent successful outpatient negative pressure wound therapy (NPWT) for three pretibial lacerations. We would propose that this therapy is an effective option for the management of these wounds in independently mobile patients who are at high-risk when under anaesthetic...
December 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29241451/energetic-performance-analysis-of-staged-palliative-surgery-in-tricuspid-atresia-using-vector-flow-mapping
#12
Mao Kinoshita, Koichi Akiyama, Keiichi Itatani, Ayahiro Yamashita, Maki Ishii, Atsushi Kainuma, Yoshinobu Maeda, Takako Miyazaki, Masaaki Yamagishi, Teiji Sawa
BACKGROUND: Staged palliative surgery markedly shifts the balance of volume load on a single ventricle and pulmonary vascular bed. Blalock-Taussig shunt necessitates a single ventricle eject blood to both the systemic and pulmonary circulation. On the contrary, bidirectional cavopulmonary shunt release the single ventricle from pulmonary circulation. CASE PRESENTATION: We report a case of tricuspid atresia patient who underwent first palliative surgery and second palliative surgery...
December 14, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29233233/chromosome-22q11-deletion-in-a-patient-with-pulmonary-atresia-intact-ventricular-septum-and-confluent-branch-pulmonary-arteries
#13
Varun Aggarwal, Michaki Imamura, Carlos Acuna, Antonio G Cabrera
In this study, we report a patient with pulmonary atresia with intact ventricular septum (PA/IVS), confluent pulmonary arteries supplied by an arterial duct, and chromosome 22q11.2 microdeletion. The 22q11.2 deletion syndrome has been associated with anomalies of the outflow tracts, such as tetralogy of Fallot with either pulmonary stenosis or atresia, but we are aware of a solitary case described with pulmonary atresia when the ventricular septum is intact. The presence of genetic malformations can have long-term co-morbidities...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29224761/direct-tracheobronchopexy-via-left-lateral-thoracotomy-for-severe-tracheobronchomalacia
#14
Evan J Propst, Faisal Zawawi, Roxanne E Kirsch, Osami Honjo
An infant with pulmonary atresia/ventricular septal defect/major aortopulmonary collateral arteries underwent unifocalization, ventriculoseptal defect closure and placement of a right ventricle to pulmonary artery conduit via median sternotomy. Aortopexy and pulmonary arteriopexy via redo sternotomy were insufficient to allow weaning of continuous positive airway pressure and he required direct tracheobronchopexy via left lateral thoracotomy to alleviate posterior trachealis intrusion along the length of the trachea and left main bronchus...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29207800/right-pulmonary-venous-atresia-a-rare-cause-for-recurrent-unilateral-pneumonia
#15
Prashant P Patil
Recurrent unilateral pneumonia poses a diagnostic dilemma for all paediatricians. Isolated pulmonary venous atresia is an uncommon entity, which presents with recurrent unilateral pulmonary infections, dyspnoea on exertion and haemoptysis. It is associated with significant mortality and morbidity. Owing to rarity of condition, there may be some difficulties in the diagnosis and therapy. Pulmonary angiography is the investigation of choice. However, the current multislice CT scanners may obviate the need for pulmonary angiography...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29199861/stenting-the-complex-patent-ductus-arteriosus-in-tetralogy-of-fallot-with-pulmonary-atresia-challenges-and-outcomes
#16
Rizwan Rehman, Mood Che Marhisham, Mazeni Alwi
Patent ductus arteriosus (PDA) stenting has gained acceptance for palliation in cyanotic congenital heart disease. The PDA in tetralogy of Fallot with pulmonary atresia (ToF-PA) arises, in the left aortic arch, from underneath the arch and connects to the proximal left pulmonary artery, often resulting in stenosis. The PDA is usually elongated and tortuous, making stent implantation challenging. Shorter duration of palliation, aggravation of branch pulmonary artery stenosis resulting in poor growth and difficulty at surgery makes ductal stenting controversial...
December 4, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29181862/perforation-and-right-ventricular-outflow-tract-stenting-alternative-palliation-for-infants-with-pulmonary-atresia-ventricular-septal-defect
#17
David Aurigemma, John W Moore, Gabrielle Vaughn, Nasser Moiduddin, Howaida G El-Said
BACKGROUND: Right ventricular outflow tract (RVOT) stents have been used as palliation in patients with severe tetralogy of Fallot (TOF). Radiofrequency perforation of the RVOT has also been described in patients with pulmonary atresia (PA)/ventricular septal defect (VSD). However, RVOT stenting in conjunction with radiofrequency perforation as a means for establishing reliable pulmonary blood flow in patients with PA/VSD has not previously been reported. OBJECTIVES: Our aim is to report our experience with using perforation of plate-like pulmonary valve atresia combined with stenting of RVOT as an alternative and equally efficacious intervention for infants with PA/VSD, as compared to a surgical pulmonary artery shunt (SPS)...
November 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29169330/comparing-levocardia-and-dextrocardia-in-fetuses-with-heterotaxy-syndrome-prenatal-features-clinical-significance-and-outcomes
#18
Xiaofang Wang, Yifan Shi, Shi Zeng, Jiawei Zhou, Jia Zhou, Hongxia Yuan, Lin Wang, Weiyuan Shi, Qichang Zhou
BACKGROUND: To investigate the differences in cardiovascular disease, extracardiac anomalies and outcomes between fetuses with levocardia and dextrocardia. METHODS: Clinical demographics, prenatal features, postnatal characteristics and the outcomes of fetuses with levocardia or dextrocardia were recorded and analyzed. RESULTS: Sixty-five fetuses with dextrocardia and thirty-eight fetuses with levocardia were enrolled. Right ventricle outlet obstruction, atrioventricular septal defect and intestinal malrotation were common in both groups...
November 23, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29111286/role-of-computed-tomography-angiography-in-the-differentiation-of-feline-truncus-arteriosus-communis-from-pulmonary-atresia-with-ventricular-septal-defect
#19
Lauren E Markovic, Brian A Scansen, Brianna M Potter
Two domestic shorthair cats, a 6-month-old castrated male and a 7-month-old intact female, were diagnosed with complex congenital heart disease. Transthoracic echocardiography in both cats revealed a dilated arterial trunk overriding the interventricular septum with a large ventricular septal defect. The pulmonary trunk and branch pulmonary arteries were not visible using standard echocardiographic views in either cat. The differential diagnosis for both cats included truncus arteriosus communis vs. pulmonary atresia with ventricular septal defect...
October 27, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29095737/long-term-right-ventricular-assist-device-therapy-in-an-adult-with-pulmonary-atresia-intact-ventricular-septum
#20
Joshua L Hermsen, Karen K Stout, April Stempien-Otero, Edward D Verrier, Nahush A Mokadam
Durable ventricular assist device (VAD) support is uncommonly employed in adult congenital heart disease and often involves supporting a systemic right ventricle (RV). Ventricular assist device support of a subpulmonic RV is even more unusual.
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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