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Fetal cardiac intervention

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https://www.readbyqxmd.com/read/28100569/multiple-pregnancy-in-a-primigravida-with-uncorrected-pentalogy-of-fallot
#1
Pamela Partana, Jarrod Kah Hwee Tan, Ju Le Tan, Lay Kok Tan
Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28063262/quantification-of-mechanical-dyssynchrony-in-growth-restricted-fetuses-and-normal-controls-using-speckle-tracking-echocardiography-ste
#2
Kristina Krause, Mareike Möllers, Kerstin Hammer, Maria Karina Falkenberg, Ute Möllmann, Dennis Görlich, Walter Klockenbusch, Ralf Schmitz
PURPOSE: To evaluate longitudinal mechanical dyssynchrony in normally grown fetuses by speckle tracking echocardiography (STE) and to compare longitudinal mechanical dyssynchrony in fetal growth restriction (FGR) with normal controls. MATERIALS AND METHODS: A prospective study was performed on 30 FGR and 62 normally grown fetuses, including 30 controls matched by gestational age, using STE and a transversal four-chamber view. Data analysis was carried out with a high frame rate of about 175 frames/s...
January 7, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28043830/fetal-primary-cardiac-tumors-during-perinatal-period
#3
REVIEW
Shi-Min Yuan
Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas...
October 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#4
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27995289/the-fetus-with-ectopia-cordis-experience-and-expectations-from-two-centers
#5
Maria C Escobar-Diaz, Sherzana Sunderji, Wayne Tworetzky, Anita J Moon-Grady
Ectopia cordis (EC) is a rare congenital anomaly often associated with congenital heart disease (CHD). There is a lack of contemporary information on EC diagnosed prenatally. We sought to combine the experiences of two regional referral centers in order to evaluate current outcomes for EC. Clinical, echocardiographic features and perinatal outcomes of fetuses with EC managed at two large cardiac centers from 1995 to 2014 were retrospectively reviewed. Seventeen fetuses with EC were diagnosed at a median gestational age of 23 weeks (range 17-36)...
December 19, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27864598/impact-of-fetal-counseling-on-outcome-of-antenatal-congenital-surgical-anomalies
#6
Shilpa Sharma, Ranjana Bhanot, Dipika Deka, Minu Bajpai, Devendra K Gupta
AIM: To analyze the impact of counseling on antenatal congenital surgical anomalies (ACSA). METHODS: Cases presenting with ACSA for fetal counseling and those presenting in post-natal period following diagnosis of ACSA (PACSA) for surgical opinion were analyzed for spectrum, presentation and outcome. RESULTS: 117 cases including ACSA(68);PACSA(49) were analyzed. Gestational age at diagnosis of ACSA;PACSA was 17-37;17-39 weeks (median 24;32 weeks)...
November 18, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27821206/the-neurodevelopmental-implications-of-hypoplastic-left-heart-syndrome-in-the-fetus
#7
David F A Lloyd, Mary A Rutherford, John M Simpson, Reza Razavi
As survival after cardiac surgery continues to improve, an increasing number of patients with hypoplastic left heart syndrome are reaching school age and beyond, with growing recognition of the wide range of neurodevelopmental challenges many survivors face. Improvements in fetal detection rates, coupled with advances in fetal ultrasound and MRI imaging, are contributing to a growing body of evidence that abnormal brain architecture is in fact present before birth in hypoplastic left heart syndrome patients, rather than being solely attributable to postnatal factors...
November 8, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27680809/f3-cardiac-output-and-total-peripheral-resistance-in-pregnancies-with-fetal-growth-restriction
#8
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
https://www.readbyqxmd.com/read/27591530/sudden-infant-deaths-from-undiagnosed-ventricular-septal-defect-report-of-two-autopsy-cases
#9
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
https://www.readbyqxmd.com/read/27582596/cesarean-scar-pregnancy-managed-with-conservative-treatment
#10
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
https://www.readbyqxmd.com/read/27556316/mitral-valve-prolapse-in-pregnancy
#11
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
https://www.readbyqxmd.com/read/27551581/acute-myocardial-infarction-in-the-first-trimester-of-pregnancy-in-a-great-grand-multiparous-woman-with-poorly-controlled-chronic-hypertension
#12
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
https://www.readbyqxmd.com/read/27530489/fetal-intrapericardial-teratoma-natural-history-and-management-including-successful-in-utero-surgery
#13
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 that, if relieved, could be life-saving. Optimal timing of intervention and methods for effective fetal treatment are unknown. OBJECTIVE: We describe our single-center experience with fetal intrapericardial teratoma including the first report of successful in utero surgical resection with survival to term. STUDY DESIGN: We reviewed our database for suspected fetal intrapericardial teratoma...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27521972/case-8-2016-percutaneous-fetal-cardiac-intervention-for-severe-aortic-stenosis-and-evolving-hypoplastic-left-heart-syndrome
#14
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
https://www.readbyqxmd.com/read/27455050/rate-and-outcomes-of-pulmonary-stenosis-and-functional-pulmonary-atresia-in-recipient-twins-with-twin-twin-transfusion-syndrome
#15
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
https://www.readbyqxmd.com/read/27439413/current-management-of-ebstein-s-anomaly-in-the-adult
#16
REVIEW
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
https://www.readbyqxmd.com/read/27423668/evaluation-and-management-of-fetal-cardiac-function-and-heart-failure
#17
REVIEW
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
https://www.readbyqxmd.com/read/27384077/human-fetal-growth-restriction-a-cardiovascular-journey-through-to-adolescence
#18
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
https://www.readbyqxmd.com/read/27359082/prenatal-detection-of-major-congenital-heart-disease-optimising-resources-to-improve-outcomes
#19
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
https://www.readbyqxmd.com/read/27279868/fetal-cardiac-interventions-clinical-and-experimental-research
#20
REVIEW
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
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