Atrial septal defect (ASD) accounts for 5-10% of congenital heart malformations. An uncorrected ASD may lead to congestive heart failure, severe pulmonary hypertension, or paradoxical arterial embolism with stroke. Transthoracic echocardiography is often diagnostic in the pediatric population, but transesophageal echocardiography may be required in adults. Closure of an ASD ...

The condition of pulmonary atresia (PA), ventricular septal defect (VSD), and major aortopulmonary collaterals (MAPCAs) can have an extremely variable pulmonary blood supply and there are essentially three main anatomical subtypes, one with confluent native pulmonary arteries, one with intrapulmonary but nonconfluent pulmonary arteries, and one with MAPCAs and no ...

Patients with unrepaired pulmonary atresia and ventricular septal defect may develop stenosis of collaterals or shunts to the pulmonary arteries leading to hypoperfusion of lungs and systemic hypoxemia. A 25-year-old female with pulmonary atresia and ventricular septal defect presented with progressively increasing cyanosis and exercise intolerance. A restrictive right-sided patent ...

The selection of patients for transcatheter or surgical closure of a secundum atrial septal defect requires accurate information regarding the anatomy of the defect such as its maximal diameter and the amount of circumferential tissue rim. Two-dimensional echocardiography is wanting as a means to define selection criteria for atrial septal ...

Percutaneous closure of a patent foramen ovale or atrial septal defect using various closure systems is now considered an alternative to surgical therapy in selected patients with cryptogenic strokes. We report the case of a late protrusion of the umbrella of a CardioSEAL Occluder into the left atrium associated with ...

The effects of exposure to the environment around the World Trade Center after the attack of September 11, 2001, are not fully described. We evaluated 240 police first-responders; respiratory symptoms occurred in 77.5% but resolved or improved in around three fourths of subjects by the time of their evaluation (mean ...

Pediatric interventional catheterization is an expanding specialty with a range of mature, emerging, and investigative procedures and technologies. Many dysfunctional obstructions and/or shunts caused by congenital heart defects may be treated or significantly palliated in the catheterization laboratory. These include valvar pulmonary or aortic stenosis, the patent ductus arteriosus, coarctation ...

BACKGROUND: The ultimate goal of surgical therapy for pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries is to create unobstructed and separate in series pulmonary and systemic circuits. Our preference has been a 1-stage complete unifocalization technique, avoiding collateral anastomosis with either the native pulmonary arteries or ...

Pulmonary atresia with ventricular septal defect and major aorta pulmonary collaterals arteries is a rare and complex congenital cardiac defect. There is considerable variability in the anatomy, morphology, and geometry of the native pulmonary arteries and the collateral vessels. While the ultimate goal of therapy is a biventricular correction with ...

Using transesophageal echocardiography, we sought to determine the anatomic characteristics of the secundum atrial septal defects (ASDs) that extend into the inferior sinus venosus and have no posteroinferior (PI) rim, to determine the factors related to potential closure with an Amplatzer occluder. We also sought to understand why large secundum ...

Neonatal hemangiomatosis is a well-recognized cause of left ventricular failure. We describe an infant with neonatal hemangiomatosis and an ostium secundum atrial septal defect who developed severe right heart failure. This was due to the combination of increased flow through the right heart as a result of the atrial septal ...

We aimed to characterize changes in interventricular septum (IVS) motion and any relationship between them and the pulmonary-to-systemic flow ratio (Qp/Qs) in adult patients with atrial septal defect (ASD). Patients and controls were studied using colour tissue Doppler imaging (TDI). The septum length (SL) and distance from the colour change ...

We modified the technique of patch repair for postinfarction ventricular septal rupture by beginning with a larger-than-needed circular patch and later trimming it into a 3-dimensional patch to match the size of the exclusion area. This technique makes it easier to determine the optimal size for the patch, and the ...

Atrial septal defect closure is now routinely performed using a percutaneous approach under echocardiographic guidance. Centrally located, secundum defects are ideal for device closure but there is considerable morphological variation in size and location of the defects. A small proportion of atrial septal defects may have multiple fenestrations and these ...

In 10 fetuses with tetralogy of Fallot, 9 lacked high velocity across the obstructed right ventricular outflow tract, which we conclude was due to the parallel flow circulations created by the combination of ventricular septal defect and arterial duct. The normally high resistance in the fetal pulmonary vascular system substantially ...

Heterotaxy syndromes, right or left atrial isomerism, result from disruption of left-right axis determination and their manifestations include complicated heart defects. Recent studies in model organisms have revealed complex genetic pathways and several genes involved in this process. In affected humans, however, molecular studies have identified mutations in a small ...

OBJECTIVE: To study the feasibility of continuous intravenous SonoVue contrast echocardiography for qualitative assessment of reversible myocardial perfusion in dipyridamole stress tests. METHODS: Eleven patients (10 male and 1 female, mean age 66 years) with a history of chest pain and a clinical indication for stress sestamibi single photon emission ...

OBJECTIVE: After positive experimental results were obtained with the FloWatch-R-PAB (EndoArt S.A., Lausanne, Switzerland), an implantable device for pulmonary artery banding with telemetric control, it was tested in a prospective, multicenter clinical trial. METHODS: From June to September 2002, 6 patients with a mean age of 10.6 months (1-31 months) ...

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by the presence of a dynamic left ventricular outflow tract gradient. We studied septal longitudinal motion by color coded tissue Doppler echocardiography in a 69-year old HOCM patient during and after catheter based treatment by trans coronary alcohol ablation of septal hypertrophy. The presence ...

OBJECTIVES: We assessed the use of intracardiac echocardiography (ICE) as the primary means for both selection of the Amplatzer Septal Occluder (ASO) and the guidance of transcatheter closure of secundum atrial septal defects (ASDs). BACKGROUND: The standard method for transcatheter closure of ASDs requires balloon-sizing maneuver and transesophageal echocardiographic (TEE) ...

Duodenal atresia with midgut deletion without abdominal wall defects is extremely rare. The authors report a newborn boy with this disease associated with left pulmonary, kidney, and upper limb absences and a contralateral upper limb malformation. At autopsy, agenesis of the arteries to such organs was confirmed. A fetal vascular ...

The authors report the case of an adult male patient with a congenital ventricular septal defect who underwent an invasive assessment of his heart disease. Here, the septal defect was identified in the perimembranous area and a pulmonary-to-systemic flow ratio of 1.4:1 was calculated. At coronary angiography, a single coronary ...

BACKGROUND: Tetralogy of Fallot with subarterial ventricular septal defect is frequently seen among Asians. Compared with infracristal ventricular septal defect, postoperative right ventricular outflow obstruction is more likely because of subpulmonary extension of the defect. Moreover the incidence of aortic regurgitation is a concern because of the absence of a ...

PURPOSE: To determine if CT variables predict in-hospital morbidity and mortality in patients with pulmonary embolism (PE). MATERIALS AND METHODS: CT scans and charts of 173 patients with CT scans positive for PE were reviewed. CT scans were reviewed for leftward ventricular septal bowing, increased right ventricle (RV) to left ...

A 51-year-old woman, presenting with increasing dyspnoea on exertion was admitted for surgery of a right sided partial anomalous pulmonary venous return. Contrast enhanced electron-beam tomography (EBT) presented a hypoplastic right lower lobe and confirmed the diagnosis of a so-called scimitar syndrome. Surgery consisted of creation of an atrial septal ...

A male infant presenting with severe heart failure and respiratory distress was diagnosed with a hypoplastic right lung, scimitar syndrome with pulmonary sequestration and multiple anomalous systemic arteries, left bronchomalacia, a large atrial septal defect and coarctation of the aorta. The infant underwent a successful combined treatment of surgical and ...

OBJECTIVE: To assess the results of a staged surgical approach for tetralogy of Fallot with pulmonary atresia, hypoplastic or absent pulmonary arteries, and major aortopulmonary collateral arteries. METHODS: We retrospectively reviewed a consecutive series of these patients from a single institution. RESULTS: From July 1993 to April 2001, 46 consecutive ...

A unique case of superoinferior ventricles, left atrial isomerism, concordant atrioventricular connection, and discordant ventriculoarterial connection is described. The associated anomalies were azygous vein continuation, large subpulmonary and apical ventricular septal defects, and left ventricular outflow tract obstruction (pulmonary stenosis). The diagnosis was mostly made by fetal echocardiography and the ...

The secundum type of atrial septal defect is one of the most common conditions associated with pulmonary arterial hypertension. In a series of 274 consecutive patients who have undergone percutaneous atrial septal defect device closure at our institution we observed an increase in pulmonary artery pressure with age, but only ...

There has been a marked increase in device closure of secundum atrial septal defects (ASDs) in the last decade. No clinical reports of late results have been forthcoming until now. The purpose of this report was to provide very long-term follow-up of nonoperative closure of secundum ADSs using the King-Mills ...

Between June 1999 and September 2002, 45 patients (age, 34 +/- 13 years; mean shunt ratio, 2.6 +/- 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.4 +/- 3 mm). Patients were selected by transesophageal echocardiography. The mean ASD ...

OBJECTIVE: To close perimembranous ventricular septal defects (PMVSDs) in children with the new Amplatzer asymmetric ventricular septal defect occluder (AAVSDO). PATIENTS AND DESIGN: 10 children, aged 1.5-12 years, with PMVSDs underwent transcatheter closure with the AAVSDO. The device consists of two low profile disks made of Nitinol wire mesh with ...

BACKGROUND: The aim of this study was to determine the relative role of pulmonary insufficiency and right ventricular outflow tract damage in the genesis of late symptoms related to right ventricular dilatation. METHODS: In a retrospective study we compared the late outcomes of patients who had undergone operations known to ...

A 53-year-old man with a history of repair of atrial septal defect 3-months ago by primary suture was admitted to an emergency department with sudden onset chest pain and dyspnea. Transthoracic echocardiography revealed a large and mobile thrombus attached to the right side of the interatrial septum. The chest X ...

OBJECTIVES: In patients with apical hypertrophic cardiomyopathy (ApHCM), we estimated the severity of cavity obliteration (CO) in the apical potion of the left ventricle and correlated it with various clinical findings including apical aneurysm. BACKGROUND: Apical hypertrophic cardiomyopathy sometimes develops apical aneurysm. The apical CO is often exhibited in ApHCM ...

Long-term survival of patients with partial atrioventricular septal defect (PAVSD) without operative therapy is very rare. The case is reported of a 75-year-old man who presented with dyspnea and decline of general condition. A heart defect was known but not investigated as the patient refused to undergo invasive cardiologic diagnosis. ...

This report describes the occurrence of a thrombus in an aneurysm of the membranous interventricular septum with cerebral embolism in a young patient. We would recommend periodic echocardiography checkups in patients with aneurysm of the membranous interventricular septum with or without a small ventricular septal defect. The findings of a ...

Catecholamine treatment for hypotension is common practice in neonatal intensive care units. In the presence of left ventricular hypertrophy, the positive inotropic action of catecholamines with mainly beta-receptor specificity can lead to excessive hypercontractility and paradoxical hypotension. This reports presents two cases of hypercontractile heart failure during beta-agonist treatment in ...

Spontaneous closure of a postinfarction ventricular septal rupture is extremely rare. We present such a case in which the postinfarction ventricular septal rupture closed spontaneously during follow-up. We postulate that the spontaneous closure of the ventricular septal rupture was probably due to thrombosis in the apical and septal aneurysm.

The use of transesophageal echocardiography (TEE) for guidance of transcatheter closure of secundum-type atrial septal defect (ASD) is increasingly becoming a routine procedure. ASD with attenuated anterior superior (SA) rim is a variant of secundum-type ASD and is suitable for transcatheter closure. The success rate of TEE guidance for device ...

Although the surgical technique of the Ross operation has been improved over the years, there are still some technical difficulties: (1) The possibility of damage to first septal artery during harvesting and reconstruction of right ventricular outflow tract (RVOT). (2) Weak posterior anastomotic area during RVOT reconstruction. (3) Persistent bleeding ...

The Helex Septal Occluder is a new device used to close atrial septal defects via interventional catheterization. In order to study the role of echocardiography during its use, and to describe the morphologic variants of defects suitable for closure with this occluder, we evaluated all patients undergoing intended closure of ...

Atrial septal defects, atrio-ventricular septal defects, ventricular septal defects and the persistent arterial duct are the most common congenital heart defects which may cause, in the presence of a significant left-to-right shunt, chronic volume overload of the heart and lead to the development of pulmonary arterial hypertension. Repair is indicated ...

We report successful transcatheter closure of a post-MI ventricular septal rupture acutely following unsuccessful surgical repair. Catheter closure was accomplished by the use of a 26-mm Amplatzer atrial septal occluder. Initial attempts to close the defect with the use of 28-mm and 33-mm CARDIOSEAL were unsuccessful. Closure technique, immediate and ...

We report a 12-year-old girl who had multiple congenital cardiac lesions, specifically an arterial duct, left pulmonary arterial stenosis, an atrial septal defect in the oval fossa, and mild Ebstein's malformation of the tricuspid valve. Therapeutic transcatheter intervention was performed to stent the left pulmonary artery, occlude the arterial duct ...

OBJECTIVES: False aneurysm of the right ventricular outflow tract (RVOT) is one of complications after surgery of congenital heart disease. It is controversial about materials for reconstruction of RVOT in this setting, when associated with pulmonary hypertension or bacterial infection. Pulmonary homograft seems to be the first choice, but its ...

A link between migraine with aura and cardiac right-to-left shunting has been previously reported. Abortion or decreased frequency of migraine with aura attacks after atrial septal defect closure has been reported in the literature. We report the first case of transformation of migraine with aura into a daily pattern after ...

OBJECTIVES: To validate the preliminary surgical results of 'integrated approach' to pulmonary atresia, ventricular septal defect (VSD), and multiple aortopulmonary collateral arteries by retrospective analysis of our center experience. METHODS: Between 01/94 and 03/02, 37 patients aged 22 days to 13 years underwent surgery for pulmonary atresia, VSD, and multiple ...

We report a 3-year-old girl who presented with Scimitar syndrome and underwent hypothermic circulatory arrest for correction of anomalous pulmonary veins and an atrial septal defect. In this case the Bispectral Index (BIS) correlated significantly with the gradual onset of hypothermia and circulatory arrest. However, BIS remained low during the ...

A 26-year-old man had been diagnosed with a cardiac murmur from birth. In 1998, he was admitted to hospital because of slight fatigue. A grade 5/6 continuous murmur was audible near the right sternal border at the second intercostal space. Doppler echocardiography detected an abnormal flow that suggested that an ...