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Evan M Zahn, Jennifer C Chang, Dustin Armer, Ruchira Garg
Current balloon expandable transcatheter valves have limited applicability to patients with "native" right ventricular outflow tracts (RVOT), meaning those who have had previous surgery and are left with large, compliant, irregular RVOT. The Alterra Adaptive PrestentTM is a self-expanding, partially covered stent that was designed to internally reconfigure these types of RVOT, making them suitable for implantation of a commercially available balloon expandable heart valve, the SAPIEN 3. Herein, we describe the first human implant of this device...
March 9, 2018: Catheterization and Cardiovascular Interventions
M Barczuk-Falęcka, Ł A Małek, D Roik, K Werys, B Werner, M Brzewski
AIM: To assess the accuracy of simple cardiovascular magnetic resonance imaging (CMR) parameters for first-line analysis of right ventricle (RV) dysfunction in children to identify those who require in-depth analysis and those in whom simple assessment is sufficient. MATERIALS AND METHODS: Sixty paediatric CMR studies were analysed. The following CMR parameters were measured: RV end-diastolic and end-systolic area (4CH EDA and 4CH ESA), fractional area change (FAC), RV diameter in end-diastole (RVD1), tricuspid annular plane systolic excursion (TAPSE), and RV outflow tract diameter in end-diastole (RVOT prox)...
March 6, 2018: Clinical Radiology
Takako Miyazaki, Masaaki Yamagishi, Yoshinobu Maeda, Satoshi Taniguchi, Shuhei Fujita, Hisayuki Hongu, Hitoshi Yaku
OBJECTIVE: Various types of conduits are available for right ventricular outflow tract (RVOT) reconstruction. We have developed an expanded polytetrafluoroethylene (ePTFE) conduit with bulging sinuses and a fan-shaped ePTFE valve. This study summarized the results of a multicenter study evaluating the valved ePTFE conduit. METHODS: The valve functions of 902 patients (median age, 3.9 years; median weight, 12.6 kg) who underwent RVOT reconstruction using valved ePTFE conduits (9 different sizes, 8-24 mm in diameter) at 65 hospitals between 2001 and 2015 were retrospectively investigated...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Martin Koestenberger, Alexander Avian, Hannes Sallmon, Andreas Gamillscheg, Gernot Grangl, Stefan Kurath-Koller, Sabrina Schweintzger, Ante Burmas, Georg Hansmann
OBJECTIVE: The right ventricular outflow tract (RVOT) is pivotal for adequate RV function and known to be adversely affected by elevated pulmonary arterial pressure (PAP) in adults with pulmonary hypertension (PH). Aim of this study was to determine the effects of increased RV pressure afterload in children with PH on RVOT size, function, and flow parameters. METHODS: We conducted a transthoracic echocardiographic study in 51 children with PH (median age: 5.3 years; range 1...
March 5, 2018: Echocardiography
Joanna Ghobrial, Daniel S Levi, Jamil Aboulhosn
No abstract text is available yet for this article.
February 22, 2018: JACC. Cardiovascular Interventions
Nicholas Isom, Aniket S Rali, Ivan Damjanov, Kevin Hubbard, Joel Grigsby, Kamal Gupta
BACKGROUND Cardiac involvement by a malignant tumor is rare. However, this is a case of right heart failure due to cardiac metastasis from a yolk sac tumor. Although a few case reports of cardiac metastasis from yolk sac tumors have been published, to our knowledge this is the first instance of multiple metastases to the right ventricular of yolk sac tumor in an adult male. CASE REPORT The patient is a 46-year-old male with a history of testicular cancer that presented with dyspnea on exertion. He was found to have two large right sided intracardiac masses on echocardiography...
March 2, 2018: American Journal of Case Reports
Adam Lee, Russell Denman, Haris M Haqqani
BACKGROUND: Ectopy-mediated cardiomyopathy (EMC) is a potentially reversible form of left ventricular systolic dysfunction. Various risk factors for the development of EMC have been proposed in the literature. We aim to assess medium term outcomes of focal ventricular arrhythmia (VA) ablation in the setting of cardiomyopathy (CMP) and to validate published risk factors for EMC. METHODS: Medium term recovery of left ventricular (LV) function and freedom from VA recurrence was assessed and compared between patients undergoing focal VA ablation in the setting of CMP and a control group with normal LV function...
February 12, 2018: Heart, Lung & Circulation
J Fedida, T Strisciuglio, M Sohal, M Wolf, K Van Beeumen, A Neyrinck, P Taghji, C Lepiece, A Almorad, Y Vandekerckhove, R Tavernier, M Duytschaever, S Knecht
PURPOSE: Catheter ablation is an effective treatment for premature ventricular complexes (PVCs). Activation mapping is accurate but requires PVCs at the time of the ablation. Pace-mapping correlation (PMC) is a supplemental tool recently developed as an integrated module for an electro-anatomical mapping platform. Our study sought to investigate whether pace-mapping technology provides similar ablation results in patients with low versus high idiopathic PVC burden at the time of ablation and the relationship between sites with the highest PMC and the earliest local activation time (LAT)...
February 24, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Miyuki Shibata, Keiichi Itatani, Taiyu Hayashi, Takashi Honda, Atsushi Kitagawa, Kagami Miyaji, Minoru Ono
The optimal timing for pulmonary valve replacement after Tetralogy of Fallot (TOF) repair remains controversial. In this study, we estimated the feasibility of using flow energy loss (FEL) to predict right ventricular (RV) deterioration due to pulmonary regurgitation after TOF repair. We examined RV outflow tract (RVOT) flow in nine patients who underwent TOF or double-outlet right ventricle repair in the intervention group (Group I) and compared them with three healthy children in the control group (Group C)...
February 16, 2018: Pediatric Cardiology
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Arun Gopalakrishnan, Ajitkumar Valaparambil
Premature Ventricular Contraction (PVC)/ventricular tachycardia (VT) with left bundle branch block (LBBB) morphology and inferior axis has been described classically to originate from the right ventricular outflow tract (RVOT). Some uncommon sites of idiopathic ventricular arrhythmia (VA) origins have been revealed including tricuspid annulus (TA) and right ventricular (RV) inflow free wall region. We present a series of two cases who have undergone electrophysiological study and successful radiofrequency ablation of frequent monomorphic PVCs with LBBB pattern originating from relatively uncommon sites of RV - TA and RV inflow free wall region...
February 13, 2018: Indian Pacing and Electrophysiology Journal
Ahmed Kheiwa, Punag Divanji, Vaikom S Mahadevan
Right ventricular outflow tract (RVOT) dysfunction is a common hemodynamic challenge for adults with congenital heart disease (ACHD), including patients with repaired tetralogy of Fallot (TOF), truncus arteriosus (TA), and those who have undergone the Ross procedure for congenital aortic stenosis and the Rastelli repair for transposition of great vessels. Pulmonary valve replacement (PVR) has become one of the most common procedures performed for ACHD patients. Areas covered: Given the advances in transcatheter technology, we conducted a detailed review of the available studies addressing the indications for PVR, historical background, evolving technology, procedural aspects, and the future direction, with an emphasis on ACHD patients...
March 2018: Expert Review of Cardiovascular Therapy
Clauden Louis, Michael F Swartz, Bartholomew V Simon, Jill M Cholette, Nader Atallah-Yunes, Hongyue Wang, Francisco Gensini, George M Alfieris
OBJECTIVE: Repair of truncus arteriosus often requires early right ventricular outflow tract (RVOT) re-operation. Using a modified repair the branch pulmonary arteries are left in-situ, which may avoid earlier RVOT reoperation. We hypothesized that our modified repair for Type I and II truncus arteriosus would extend the time to RVOT re-operation. METHODS: Infants with truncus arteriosus were divided into two groups: A) Traditional technique where the branch pulmonary arteries are excised from the truncal root, or B) Modified repair where the branch pulmonary arteries are left in-situ and septated from the truncal root...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
Mohammad Qasem, Keith George, John Somauroo, Lynsey Forsythe, Benjamin Brown, David Oxborough
Our objective was to assess the influence of different levels of exposure to dynamic training on right ventricular (RV) structure, function and mechanics in elite male athletes. We recruited 492 male elite athletes aged between 18 and 30 years old. Athletes were grouped according to their sporting discipline using the Mitchell Classification as Low Dynamic (LD), Moderate Dynamic (MD) or High Dynamic (HD). All participants underwent 2D, Doppler, tissue Doppler and strain (ε) echocardiography with a focused and comprehensive assessment of the right heart...
February 7, 2018: International Journal of Cardiovascular Imaging
Yuichi Matsuzaki, Takeshi Hiramatsu, Takahiko Sakamoto, Mitsugi Nagashima, Hiroshi Niinami, Kenji Yamazaki
BACKGROUND: There has been no report observing the LV function of Konno incision. We examined the outcomes of the Konno operations over 20 years. METHODS: We investigated 63 Konno operations with mechanical valves performed from 1984. This study aimed to evaluate the effects of Konno incision including LV function changes and the long-term outcomes of patient survival and reoperation rate (RVOT and LVOT complications). RESULTS: The postoperative follow-up period was 20...
February 2, 2018: General Thoracic and Cardiovascular Surgery
Allison K Cabalka, Jeremy D Asnes, David T Balzer, John P Cheatham, Matthew J Gillespie, Thomas K Jones, Henri Justino, Dennis W Kim, Te-Hsin Lung, Daniel R Turner, Doff B McElhinney
BACKGROUND: Stented bioprosthetic valves (BPVs) are commonly used for surgical pulmonary valve (PV) replacement in postoperative congenital heart disease, but develop structural failure in a time-related fashion. The Melody transcatheter PV (TPV) (Medtronic, Minneapolis, Minn) has been used to treat BPV dysfunction, but there have been few studies in this population. METHODS: We performed a retrospective, multicenter study to evaluate Melody valve function in patients who underwent TPV replacement (TPVR) into a dysfunctional pulmonary BPV...
December 6, 2017: Journal of Thoracic and Cardiovascular Surgery
Amr A Arafat, Elatafy E Elatafy, Sahar Elshedoudy, Mahmoud Zalat, Neamet Abdallah, Ahmed Elmahrouk
BACKGROUND: Right ventricular (RV) volume overload increases morbidity and mortality after tetralogy of Fallot (TOF) repair. Surgical strategies like pulmonary leaflets sparing and tricuspid valve repair at time of primary repair may decrease RV overload. Our objective is to evaluate early and midterm results of pulmonary leaflets sparing with infundibular preservation and tricuspid valve repair in selected TOF patients with moderate pulmonary annular hypoplasia. METHODS: From 2011 to 2016; 46 patients with TOF and moderate pulmonary annular hypoplasia had surgical repair with sparing of the pulmonary valve leaflets...
January 22, 2018: Journal of Cardiothoracic Surgery
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
Roya Sherkat, Mohammad Reza Sabri, Bahar Dehghan, Hamid Bigdelian, Nahid Reisi, Nooshin Afsharmoghadam, Hamid Rahimi, Narges Rahmanian, Cristoph Klein
RATIONALE: Primary cardiac lymphoma (PLC) is an extremely uncommon malignancy. PCL is more common in secondary immunodeficient patients. In this report, we describe a unique case of PLC who had been diagnosed as a STK4 deficient patient. This case is the first Primary immunodeficiency (PID) patient developing PCL in the world. PATIENT CONCERNS: An eleven-year-old girl, a known case of PID, was referred to the pediatric cardiology department because of chest pain and dyspnea...
December 2017: Medicine (Baltimore)
Gijsbert F L Kapel, Sergio Laranjo, Nico A Blom, Mark G Hazekamp, Martin J Schalij, Margot M Bartelings, Monique R M Jongbloed, Katja Zeppenfeld
OBJECTIVE: In tetralogy of Fallot (TOF), the dominant ventricular tachycardia substrates are slow-conducting anatomical isthmuses. Surgical correction has evolved, which might have influenced isthmus presence and dimensions. METHODS: One hundred and forty-two postmortem TOF specimens (84/58 corrected/uncorrected) were studied for isthmus presence. Isthmus 1 is located between the tricuspid annulus and right ventricular (RV) outflow tract (RVOT) patch/RV incision, isthmus 2 between RVOT patch/RV incision and pulmonary valve, isthmus 3 between pulmonary valve and ventricular septal defect (patch), isthmus 4 between ventricular septal defect (patch) and tricuspid annulus...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
John P Carney, Lindsey M Zhang, Jeffrey J Larson, Matthew T Lahti, Nicholas A Robinson, Agustin P Dalmasso, Richard W Bianco
BACKGROUND: Xenograft conduits have been used successfully to repair congenital heart defects, but are prone to failure over time. Hence, in order to improve patient outcomes, better xenografts are being developed. When evaluating a conduit's performance and safety it must first be compared against a clinically available control in a large animal model. The study aim was to evaluate a clinically available xenograft conduit used in right ventricular outflow tract (RVOT) reconstruction in a sheep model...
July 2017: Journal of Heart Valve Disease
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