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Fetal cardiac intervention

J Tay, L Foo, C McEniery, I Wilkinson, C Lees
INTRODUCTION: This pilot study aims to compare cardiac output (CO) and total peripheral resistance (TPR) in pregnancies with fetal growth restriction (FGR) with healthy normal third trimester of pregnancies. Most studies previously done on cardiac parameters in pregnancy focused mainly on pre-eclampsia (PE) and FGR with PE, but not in normotensive FGR women. METHODS: Eight pregnancies with FGR (AC < 10th percentile with raised umbilical PI) in the third trimester (27-35 weeks gestation) compared with 42 uncomplicated ongoing pregnancies within similar gestation bands...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Rie Nishikata, Naho Kato, Miwako Suto, Mami Rinnou, Ikubumi Mizusawa, Naohito Kuroda
Ventricular septal defect (VSD) has a relatively non-aggressive clinical course; either spontaneous closure or causing congestive heart failure treatable with surgical intervention. We present two autopsy cases of sudden infant deaths from clinically undiagnosed VSDs. Case 1 was an 18-day-old boy. As the deceased coughed and became limp after feeding, he was carried to a hospital. Heart murmur was not auscultated there, so he was brought back to home. He presented severe dyspnea and then he was pronounced dead the next day...
September 2016: Legal Medicine
Aysen Boza, Barıs Boza, Murat Api
Cesarean scar pregnancy (CSP) is a rare, but life-threatening type of ectopic pregnancy. An exact and early diagnosis of CSP is very important for prognosis. The aim of the present study was to describe 4 women with CSP and discuss their clinical presentations, diagnoses, and various management options along with the published literature. Four women with a suspicion of CSP or cervical pregnancy were referred to our hospital between August 2013 and January 2014. All the patients were counseled about medical management options...
September 2016: Iranian Journal of Medical Sciences
Shi-Min Yuan, Song-Li Yan
Mitral valve prolapse is a benign condition. Mitral regurgitation is only complicated in patients with severe mitral valve prolapse. Women with mitral valve prolapse in the absence of other cardiovascular disorders tolerate pregnancy well and do not develop remarkable cardiac complications. Nevertheless, serious complications of mitral valve prolapse, including arrhythmia, infective endocarditis and cerebral ischemic events, can be present in pregnancy. Debates remain with regard to the use of prophylactic antibiotics and β-blockers in the pregnant women with mitral valve prolapse...
April 2016: Brazilian Journal of Cardiovascular Surgery
Lakha Prasannan, Matthew J Blitz, Jill M Rabin
INTRODUCTION: Acute myocardial infarction (MI) in pregnancy is a rare event, usually occurring late in gestation, either in the third trimester or in the puerperium. It is associated with significant maternal and fetal morbidity and mortality. Although diagnosis and management of MI in pregnancy has been discussed in the literature, management of pregnancy following an early antepartum MI, which may have more consequences for the fetus, has not received as much attention. CASE: A 38-year-old great grand multiparous woman presented to the emergency department complaining of acute onset chest pain...
July 2016: American Journal of Perinatology Reports
Jack Rychik, Nahla Khalek, J William Gaynor, Mark P Johnson, N Scott Adzick, Alan W Flake, Holly L Hedrick
BACKGROUND: Intrapericardial teratoma is a rare, lethal tumor often detected in fetal life. Tumor mass and pericardial effusion cause cardiac tamponade, which if relieved, could be life-saving. Optimal timing of intervention and methods for effective fetal treatment are unknown. OBJECTIVES: We describe our single center experience with fetal intrapericardial teratoma including the first report of successful in utero surgical resection with survival to term. METHODS: We reviewed our database for suspected fetal intrapericardial teratoma...
August 13, 2016: American Journal of Obstetrics and Gynecology
Marla B Ferschl, Anita J Moon-Grady, Mark D Rollins, Brian Gilliss, Scott R Schulman, Gerald Tulzer, Sheldon Stohl, Yehuda Ginosar
No abstract text is available yet for this article.
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Javier U Ortiz, Narcís Masoller, Olga Gómez, Mar Bennasar, Elisenda Eixarch, Silvia M Lobmaier, Fàtima Crispi, Eduard Gratacos, Josep María Martinez
OBJECTIVE: To evaluate the rate of pulmonary stenosis and functional pulmonary atresia (PS/PA) in recipient twins prior to fetal surgery for twin-twin transfusion syndrome (TTTS) and their pre- and postnatal outcomes. METHODS: We carried out a prospective study including 260 cases of TTTS. Echocardiography was performed before laser surgery to detect the presence of PS/PA. The outcomes of recipients with and without PS/PA were compared. The need of postnatal cardiac interventions and the survival rate at 6 months of age were also evaluated...
July 26, 2016: Fetal Diagnosis and Therapy
Lucy M Safi, Richard R Liberthson, Ami Bhatt
Ebstein's anomaly is a congenital malformation of the tricuspid valve and the right heart with a spectrum of clinical and morphologic presentations. Minor anomalies of the tricuspid valve may not be recognized until adulthood whereas major anomalies leading to heart failure and cyanosis require surgical intervention earlier in life. Echocardiography is the imaging modality of choice for both diagnosis and management of patients with Ebstein's anomaly. Surgical correction includes tricuspid valve repair or replacement and associated findings such as interatrial communications and arrhythmias should be addressed at the time of surgery...
September 2016: Current Treatment Options in Cardiovascular Medicine
Erik Michelfelder, Catherine Allen, Lindsay Urbinelli
Two-dimensional (2D) and Doppler echocardiography has become both an essential component in the assessment of anatomic anomalies of the fetal heart and an important tool in the assessment of fetal cardiac function. Various techniques for assessing fetal cardiovascular function exist and can be used to characterize systolic and diastolic ventricular function and estimate fetal cardiac output. These techniques can be utilized to assess fetuses with cardiovascular compromise due to a number of cardiac and non-cardiac conditions, including twin-twin transfusion syndrome, high-cardiac output lesions such as fetal tumors and vascular malformations, and primary fetal cardiomyopathy...
September 2016: Current Treatment Options in Cardiovascular Medicine
A Sehgal, M R Skilton, F Crispi
Intrauterine growth restriction has been noted to adversely impact morbidity and mortality in the neonatal period as well as cardiovascular well-being in adolescence and adulthood. Recent data based on a wide range of ultrasound parameters during fetal and neonatal life has noted early and persistent involvement of the cardiovascular system. Some of these measures are predictive of long-term morbidities. Assessment of vascular mechanics is a new and novel concept in this population, and opens up avenues for diagnosis, monitoring and evaluation of the likely effectiveness of interventions...
July 7, 2016: Journal of Developmental Origins of Health and Disease
Siobhan Corcoran, Kaleigh Briggs, Hugh O' Connor, Sieglinde Mullers, Cathy Monteith, Jennifer Donnelly, Patrick Dicker, Orla Franklin, Fergal D Malone, Fionnuala M Breathnach
INTRODUCTION: Congenital heart disease (CHD) is the most common major structural fetal abnormality and the benefits of prenatal detection are well described. The objective of this study was to evaluate the precision of prenatal diagnosis at a single tertiary referral unit over two three year periods (2006, 2007, 2008 and 2010, 2011, 2012), before and after a prenatal screening protocol for CHD was developed to include extended cardiac views, mandatory recall for suboptimal views, and a multidisciplinary Fetal Cardiac clinic was established...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Shi-Min Yuan, Gulimila Humuruola
Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Edgar Jaeggi, Claudia Renaud, Greg Ryan, Rajiv Chaturvedi
Percutaneous, ultrasound-guided fetal cardiac intervention (FCI) is increasingly used to alter the prognosis of specific forms of congenital heart disease. Careful patient selection and postnatal management strategy are essential for optimal outcomes. This article discusses the rationale, patient selection criteria, procedural techniques, and contemporary results of FCI. Sources of information included published patient series, the International Fetal Cardiac Intervention Registry, and the Toronto experience as the Canadian referral center...
October 2016: Trends in Cardiovascular Medicine
Yoshihiro Yonekawa, Wei-Chi Wu, Shunji Kusaka, Joshua Robinson, Daishi Tsujioka, Kai B Kang, Michael J Shapiro, Tapas R Padhi, Lubhani Jain, Jonathan E Sears, Ajay E Kuriyan, Audina M Berrocal, Polly A Quiram, Amanda E Gerber, R V Paul Chan, Karyn E Jonas, Sui Chien Wong, C K Patel, Ashkan M Abbey, Rand Spencer, Michael P Blair, Emmanuel Y Chang, Thanos D Papakostas, Demetrios G Vavvas, Robert A Sisk, Philip J Ferrone, Robert H Henderson, Karl R Olsen, M Elizabeth Hartnett, Felix Y Chau, Shizuo Mukai, Timothy G Murray, Benjamin J Thomas, P Anthony Meza, Kimberly A Drenser, Michael T Trese, Antonio Capone
PURPOSE: To determine the feasibility and safety of bilateral simultaneous vitreoretinal surgery in pediatric patients. DESIGN: International, multicenter, interventional, retrospective case series. PARTICIPANTS: Patients 17 years of age or younger from 24 centers worldwide who underwent immediate sequential bilateral vitreoretinal surgery (ISBVS)-defined as vitrectomy, scleral buckle, or lensectomy using the vitreous cutter-performed in both eyes sequentially during the same anesthesia session...
August 2016: Ophthalmology
Naser Ramadani, Kreshnike Dedushi Kreshnike, Sefedin Muçaj, Serbeze Kabashi, Astrit Hoxhaj, Naim Jerliu, Ramush Bejiçi
INTRODUCTION: Cardiac rhabdomyoma is type of benign myocardial tumor that is the most common fetal cardiac tumor. Cardiac rhabdomyomas are usually detected before birth or during the first year of life. They account for over 60% of all primary cardiac tumors. CASE REPORT: A 6 month old child with coughing and obstruction in breathing, was hospitalized in the Pediatric Clinic in UCCK, Pristine. The difficulty of breathing was heard and the pathological noise of the heart was noticed from the pediatrician...
April 2016: Acta Informatica Medica: AIM
Sura Alwan, Jan M Friedman, Christina Chambers
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant medications worldwide. However, over the past decade, their use during pregnancy, a period of extreme vulnerability to the onset of depression, has become highly concerning to patients and their healthcare providers in terms of safety to the developing fetus. Exposure to SSRIs in pregnancy has been associated with miscarriage, premature delivery, neonatal complications, birth defects-specifically cardiac defects-and, more recently, neurodevelopmental disorders in childhood, specifically autism spectrum disorders...
June 2016: CNS Drugs
Bruce M Biccard, Christella S Alphonsus, David G Bishop, Larissa Cronje, Hyla-Louise Kluyts, Belinda Kusel, Salome Maswime, Ravi Oodit, Anthony R Reed, Alexandra M Torborg, Robert Wise
BACKGROUND: Perioperative research is currently unco-ordinated in South Africa (SA), with no clear research agenda. OBJECTIVE: To determine the top ten national research priorities for perioperative research in SA. METHODS: A Delphi technique was used to establish consensus on the top ten research priorities. RESULTS: The top ten research priorities were as follows: (i) establishment of a national database of (a) critical care outcomes, and (b) critical care resources; (ii) a randomised controlled trial of preoperative B-type natriuretic peptide-guided medical therapy to decrease major adverse cardiac events following non-cardiac surgery; (iii) a national prospective observational study of the outcomes associated with paediatric surgical cases; (iv) a national observational study of maternal and fetal outcomes following operative delivery in SA; (v) a stepped-wedge trial of an enhanced recovery after surgery programme for (a) surgery, (b) obstetrics, (c) emergency surgery, and (d) trauma surgery; (vi) a stepped-wedge trial of a surgical safety checklist on patient outcomes in SA; (vii) a prospective observational study of perioperative outcomes after surgery in district general hospitals in SA; (viii) short-course interventions to improve anaesthetic skills in rural doctors; (ix) studies of the efficacy of simulation training to improve (a) patient outcomes, (b) team dynamics, and (c) leadership; and (x) development and validation of a risk stratification tool for SA surgery based on the South African Surgical Outcomes Study (SASOS) data...
May 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Gregory S Matte, Kevin R Connor, Nathalia A Toutenel, Danielle Gottlieb, Francis Fynn-Thompson
A 34 year old mother with a history of polyhydraminos and premature rupture of membranes presented for an ex utero intrapartum treatment (EXIT) procedure to deliver her 34 week gestation fetus. The fetus had been diagnosed with a large cervical mass which significantly extended into the right chest. The mass compressed and deviated the airway and major neck vessels posteriorly. Imaging also revealed possible tumor involvement with the superior vena cava and right atrium. The plan was for potential extracorporeal membrane oxygenation (ECMO) during the EXIT procedure (EXIT-to-ECMO) and the potential for traditional cardiopulmonary bypass (CPB) for mediastinal tumor resection...
March 2016: Journal of Extra-corporeal Technology
Chun-Wei Lu, Mei-Hwan Wu, Jou-Kou Wang, Min-Tai Lin, Chun-An Chen, Shenn-Nan Chiu, Hsin-Hui Chiu
UNLABELLED: With advances that have been made over the recent decades in transcatheter and surgical interventions, most patients with congenital heart disease (CHD) can survive into adulthood. Overall, probably half of these surviving patients are female. When these female CHD patients reach childbearing age, however, pregnancy management will be a major issue. In order to meet the demands of fetal growth, the maternal cardiovascular system starts a series of adaptations beginning in early pregnancy...
November 2015: Acta Cardiol Sin
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