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Aorta pulmonary window

John Baer, Matthew M Wyatt, Kenneth R Kreisler
OBJECTIVE: Pulmonary artery catheters (PACs) have routinely been positioned by wedging into the pulmonary artery before pulling back 1-2 centimeters or advancing the PAC several centimeters after achieving a pulmonary artery waveform. A rare, major complication is pulmonary artery rupture. This study presents transesophageal echocardiography (TEE) for PAC placement by leaving the catheter tip at the one o'clock position, upper window short-axis view of the ascending aorta at the bifurcation of the pulmonary artery (TEE distance)...
January 22, 2018: Echocardiography
André Y Denault, Stéphane Langevin, Martin R Lessard, Jean Francois Courval, Georges Desjardins
PURPOSE: Transthoracic examination of the heart and great vessels is an essential skill that allows the anesthesiologist to evaluate cardiac function. In this article, we describe a pragmatic technique to obtain the essential views to evaluate normal or abnormal cardiac function and to appreciate great vessel anatomy and physiology. PRINCIPAL FINDINGS: The cardiac anatomy and function can be described using standard parasternal, apical, and subcostal views. These windows can also be used to assess the aorta, pulmonary artery, and vena cavae; however, other transthoracic and abdominal windows can be used to complete the evaluation of the great vessels...
January 19, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Parvathi U Iyer, Guillermo E Moreno, Luiz Fernando Caneo, Tahira Faiz, Lara S Shekerdemian, Krishna S Iyer
In many parts of the world, mostly low- and middle-income countries, timely diagnosis and repair of congenital heart diseases (CHDs) is not feasible for a variety of reasons. In these regions, economic growth has enabled the development of cardiac units that manage patients with CHD presenting later than would be ideal, often after the window for early stabilisation - transposition of the great arteries, coarctation of the aorta - or for lower-risk surgery in infancy - left-to-right shunts or cyanotic conditions...
December 2017: Cardiology in the Young
Marcin Zieliński, Mariusz Rybak, Katarzyna Solarczyk-Bombik, Michal Wilkojc, Wojciech Czajkowski, Sylweriusz Kosinski, Edward Fryzlewicz, Tomasz Nabialek, Malgorzata Szolkowska, Juliusz Pankowski
BACKGROUND: To present the technique of minimally invasive extended thymectomy performed through the subxiphoid-bilateral subcostal video-assisted thoracoscopic surgery (VATS) approach, with double elevation of the sternum for nonthymomatous myasthenia gravis (MG). METHODS: The whole dissection was performed through the 4-7 cm transverse subxiphoid incision with single 10 mm extra-long bariatric laparoscopy ports inserted subcostally to the right and left chest cavities for videothoracoscope and subsequently for chest tubes...
2017: Journal of Visualized Surgery
S T Ren, Y Wang, J H Zhou, J Long, C H Wang, D B Li, Y Z Huang
OBJECTIVE: To investigate the clinical usefulness of echocardiography in the diagnosis of infracardiac total anomalous pulmonary venous connection (ITAPVC) in neonates and infants. METHODS: Retrospective analysis on 8 patients with ITAPVC was performed using echocardiography between April 2006 and December 2016. There were 4 boys and 4 girls with a mean age of 79.8 days (ranging from 15 to 195 days). A combined scanning via parasternal, subcostal and apical acoustic windows had been employed to diagnose ITAPVC and to trace the course and site of the anomalous pulmonary venous drainage, and to confirm the direction of the inter-atrial shunt and enlargement of right atrium and right ventricle...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Hai-Xia Xu, Dong-Dong Zheng, Min Pan, Xiao-Fei Li
Aortopulmonary window (APW), the presence of a communication between aorta and pulmonary artery, is a rare congenital heart disease, and surgical intervention is the standard for closure. Recently, several cases have been treated with transcatheter device occluders. Here, we report an APW patient treated successfully using a transcatheter closure with a symmetrical membranous ventricular septal occluder. We are the first to report on a case treated with this type of occluder for APW.
2017: Cardiology
Subramanian Chellappan, Ashish Katewa, Yogesh C Sathe
Aortopulmonary window (APW) is a relatively rare cardiac lesion representing approximately 0.2%-0.4% of all cardiac malformation. It is a cardiac abnormality that results from abnormal communication between the proximal aorta and the main pulmonary artery in the presence of two normally separated aortic and pulmonary valves. In the past, the diagnostic and surgical approach to APW was almost always preceded by cardiac catheterization. With recent advances in noninvasive approach and techniques of two-dimensional echocardiography diagnosis of the defect and associated anomalies are facilitated without a cath study...
October 2016: Journal of Cardiovascular Echography
Fuanglada Tongprasert, Rekwan Sittiwangkul, Phudit Jatavan, Theera Tongsong
Aortopulmonary window (APW) is a rare congenital heart defect, characterized by a connection between the ascending aorta and the pulmonary trunk before bifurcation. Prenatal diagnosis of APW is essential, as a surgical correction early after birth is required in most cases to prevent congestive heart failure secondary to high pulmonary blood flow. We report a series of three cases of APW that were detected by prenatal echocardiography. The key feature of diagnosis is demonstration of connection between the pulmonary artery and the aorta above the level of the two semilunar valves...
April 10, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Adetola F Louis-Jacques, Sarah G Običan, Thieu Nguyen, Anthony Odibo
Aortopulmonary window is a rare cardiac developmental anomaly characterised by a communication between the ascending aorta and the pulmonary artery. Aortopulmonary window may be isolated or associated with cardiac defects such as ventricular septal defect, atrial septal defect, interrupted aortic arch, and tetralogy of Fallot. We report a case of aortopulmonary window associated with aberrant subclavian artery based on fetal two-dimensional echocardiogram. The mother was referred for fetal echocardiography because of multiple fetal anomalies...
September 2017: Cardiology in the Young
Sachin Talwar, Palkesh Agarwal, Shiv Kumar Choudhary, Shyam Sunder Kothari, Rajnish Juneja, Anita Saxena, Balram Airan
OBJECTIVE: Aortopulmonary window (APW) is a rare congenital heart defect. We reviewed our experience with this condition over the last two decades. METHODS: Between September 1993 and December 2013, 62 patients underwent surgery for APW. Depending on the associated lesions, they were divided into two groups: Simple (Group 1) or complex (Group 2). In the complex group, six patients had a ventricular septal defect, five patients had interrupted aortic arch, three patients had tetralogy of Fallot, two patients had double outlet right ventricle, and one patient had the right pulmonary artery arising from the ascending aorta...
February 2017: Journal of Cardiac Surgery
Cecilia García, Teresa Álvarez, Coral Bravo, Ramón Pérez-Caballero, María Teresa Viadero, Francisco Gámez, Ricardo Pérez, Juan De León-Luis
A prenatal aortopulmonary window with an interrupted aortic arch was detected in a 22-week-old fetus. The 3-vessel and trachea view showed a communication between the ascending aorta and the pulmonary artery. Early postnatal surgery was successful. A PubMed-based search identified all cases of prenatal aortopulmonary windows between 2002 and 2015. Nine articles were identified. The average gestational age at diagnosis was 28 weeks (range, 22-33 weeks). The most frequent aortopulmonary window was type I (40%)...
October 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Ender Odemis, Osman Guvenc, Murat Saygi, Ibrahim Halil Demir
Aortopulmonary window (APW) is a rare abnormality in which a pulmonary defect exists between the ascending aorta and the main pulmonary artery. Given that it may result in cardiac failure and pulmonary vascular disease in the early period, treatment needs to be performed without delay. In addition to surgical treatment, transcatheter closure may also be performed for selected patients. This study describes the case of an infant diagnosed with APW and who underwent successful transcatheter closure using a Nit-Occlud® PDA-R device...
August 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
İsa Öner Yüksel, Erkan Köklü, Şakir Arslan, Çağın Mustafa Üreyen, Selçuk Küçükseymen
Aortopulmonary window is a rare anomaly, a communication between the ascending aorta and the main pulmonary artery. Prognosis in the absence of correction is poor, with mortality of around 40% in the first year of life. A case of aortopulmonary window without pulmonary vascular disease in adulthood is described in the present report.
June 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Ing-Sh Chiu, Meng-Luen Lee, Shu-Chien Huang, Chung-I Chang, Yih-Sharng Chen, Mei-Hwan Wu, Robert H Anderson
When the arterial switch operation includes the Lecompte maneuver, the arterial trunks are reconnected in parallel, rather than the spiral fashion observed in the normal heart. Thus, although the ventriculo-arterial connections are hemodynamically corrected, the anatomic arrangement cannot be considered normal. We hypothesized that, if feasible, it would be advantageous to restore a spiral configuration for the arterial trunks. In 58 patients, we reconstructed the arterial trunks such that, postoperatively, the pulmonary channel spirals round the aorta, passing to either the right or the left, and branches posteriorly...
August 2016: Pediatric Cardiology
A Fotaki, J Novaes, H Jicinska, J S Carvalho
Aortopulmonary window is a rare congenital cardiac anomaly characterized by communication between the aorta and the pulmonary artery above the semilunar valves. Prenatal diagnosis is rare. We report four fetuses with aortopulmonary window and review the relevant literature. Approximately half of the reported cases had additional cardiac defects. None had chromosomal abnormalities. In cases with normal cardiac connections, the diagnosis can be made prenatally on the standard three-vessel view, as seen in two of our cases...
April 2017: Ultrasound in Obstetrics & Gynecology
S U Weber, A Breuer, S-C Kim
BACKGROUND: The ultrasound-guided venipuncture of the internal jugular vein for placement of a central venous catheter is well established. For verification of the catheter tip position mostly intracardiac ECG or chest radiography are used. Previously, we established the right supraclavicular fossa view for ultrasound based verification of the catheter placement in the superior vena cava utilizing a microconvex probe. The microconvex probe has a small footprint. However, not all ultrasound systems used in the operating theater are equipped with a microconvex transducer...
March 2016: Der Anaesthesist
José Miguel Torres-Martel, Lydia Rodríguez-Hernández, Joaquín Rodolfo Zepeda-Sanabria
Anomalous origin of one pulmonary artery from the aorta is rare. We report a case of a three-month-old infant with aortopulmonary window and anomalous origin of the right pulmonary artery from the ascending aorta. He underwent surgery with anastomosis of the right pulmonary artery, ligation of the aortopulmonary window and the patent duct. He was released under medical treatment and had no signs of pulmonary hypertension or heart failure.
January 2016: Gaceta Médica de México
Shanthi Chidambarathanu, Ravi Agarwal, Zahra M Hussain, Nigel A Brown, Robert H Anderson
We describe, in this report, an unusually shaped aortopulmonary communication observed in a six-month-old infant who presented with an associated ventricular septal defect. The defect was tubular, measuring 7 mm in length, and located intrapericardially between the proximal ascending aorta and the pulmonary trunk. It was well defined by transthoracic echocardiogram and was suitable for surgical ligation. We share our dilemma in naming this defect appropriately. We base our explanation on our understanding of normal development of the intrapericardial arterial trunks...
May 2016: World Journal for Pediatric & Congenital Heart Surgery
Rachid El Haouati, Yassine Boukaidi, Zahira Zouizra, Drissi Boumzebra
Aortopulmonary window (APW) is a rare congenital malformation. It results from an incomplete division between the ascending aorta and the pulmonary artery. We describe a 26-year-old male, who presented with a grade II exertional dyspnea and palpitations. Echocardiography revealed an APW with an ascending aorta aneurysm. He underwent surgery under cardiopulmonary bypass without aortic cross-clamping. The APW was closed via the pulmonary artery flap technique using an autologous pericardial patch, and the aneurysm was repaired through the reduction aortoplasty technique...
July 3, 2015: Journal of Tehran Heart Center
Jamie Penk, David Wax, Christian Gilbert, C E Duffy
We report a case of a 15-month-old female presenting with a large aortopulmonary window during a medical mission. The optimal surgical correction for this patient would be based on an estimation of her pulmonary vascular reactivity. This report details the use of antegrade/retrograde flow ratios using Doppler measurements in the proximal descending aorta at baseline and while receiving 100% oxygen. A large increase in the proportion of retrograde flow under the 100% oxygen condition suggested a reactive pulmonary vascular bed...
March 2016: World Journal for Pediatric & Congenital Heart Surgery
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