OBJECTIVE: The goal of this study was to assess the utility and accuracy of solid anatomic models constructed with rapid prototyping technology for surgical planning in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. METHODS: In 6 patients with pulmonary atresia with ventricular septal defect ...

Atrial septal endocarditis can occur as an isolated event or in association with valvular endocarditis. It is also reported following percutaneous device closure of atrial septal defects. We present the echocardiography findings from a young man presenting with endocarditis of an abnormal mitral valve in whom endocarditis was demonstrated associated ...

During transcatheter closure of an atrial septal defect with insufficient aortic rim, a standard delivery sheath was modified by cutting a bevel at the distal tip to improve device orientation. The sheath split longitudinally when attempting to recapture the closure device. Troubleshooting allowed a device to be implanted successfully. Pitfalls ...

Transcatheter closure of the fossa ovalis atrial septal defect with adequate rims has become the procedure of choice in recent times. We report our experience with 439 patients who were selected for percutaneous device closure and 430 of whom underwent transcatheter closure of fossa ovalis atrial septal defects from May ...

AIM: To correlate anatomic and genetic features of paediatric patients with pulmonary atresia, ventricular septal defect (VSD) and multiple aortopulmonary collateral arteries with surgical outcome. METHODS: 44 consecutive patients aged 33 +/- 40 mo underwent either primary one-stage unifocalization (n = 32) or palliative right ventricular outflow tract reconstruction (n ...

BACKGROUND: Cor triatriatum is rarely found in adults and its diagnosis is mostly dependent on transesophageal echocardiogram. We present a case of an adult male with cor triatriatum and discuss our approach to diagnosis with a review of literature. CASE: A 49-year-old male presented with progressive exertional dyspnea for the ...

OBJECTIVES: To analyze fetal echocardiographic findings of absent pulmonary valve syndrome (APVS), its association with chromosomal and extracardiac anomalies including nuchal translucency (NT) and the outcome after diagnosis. METHODS: Data of 14 fetuses with confirmed APVS retrospectively collected in two tertiary referral centers between 1998 and 2004 were analyzed. The ...

OBJECTIVES: To assess the reliability of two-dimensional gray-scale (2D) and color Doppler echocardiography in the study of the size and anatomy of the central pulmonary arteries and of the sources of pulmonary blood flow in a case series of fetuses with pulmonary atresia and ventricular septal defect (PA-VSD), and to ...

We report a patient with abnormal systemic blood supply to the right lung and right-sided anomalous pulmonary venous drainage to the inferior vena cava (scimitar syndrome or pulmonary venolobar syndrome). In addition, she had an atrial septal defect, underdeveloped right pulmonary artery, an aberrant right bronchus, and tracheobronchomalacia. She improved ...

OBJECTIVES: Our purpose was to evaluate self-expanding nanoplatinum-coated nitinol devices for transcatheter closure of atrial septal defects and patent ductus arteriosus in a swine model. The devices were braided from platinum-activated nitinol wires and filled with polyester to enhance thrombogenicity. The platinum activation of the nitinol wires was carried out ...

Occlusion of secundum atrial septal defects (ASD) by means of percutaneous transcatheter systems is increasingly used in clinical practice. A variety of different types and models of septal occluder devices are available nowadays, amongst which the Amplatzer device (Amplatzer Medical, Golden Valley, MN, U.S.A.), is regarded as one of increasing ...

trophic cardiomyopathy remains controversial. The safest procedure and the simplest procedure is the mitral valve replacement. Septal myomectomy is difficult because of the poor surgical exposure and complications: incomplete resection, complete heart block, ventricular septal defect. Case presentation: A 56-years old man with hypertrophic cardiomyopathy, double coronary stenosis and grade ...

OBJECTIVES: To determine the characteristic morphological features of hearts with concordant ventriculoarterial connections and parallel arterial trunks, and to provide unequivocally a method to describe their anatomy. DESIGN, METHODS AND PATIENTS: The entire cardiac database and cardiac pathological archive at the Hospital for Sick Children, Toronto, Ontario, Canada, was interrogated ...

BACKGROUND: The pathological effects and the mechanisms of action of intracoronary administration of ethanol for alcohol septal ablation (ASA) for the management of hypertrophic obstructive cardiomyopathy (HOCM) are unknown. METHODS: We examined surgical specimens and, in one case, autopsy specimens from four patients who underwent surgical septal myectomy 2 days ...

AIMS: To clarify the mechanisms of electrocardiographic abnormalities in hypertrophic cardiomyopathy, 102 patients were examined with cardiac magnetic resonance. Distribution and magnitude of hypertrophy and late-enhancement were correlated with electrocardiographic abnormalities. METHODS AND RESULTS: Abnormal Q waves were associated with greater upper anterior septal thickness (22+/-7 mm vs. 18+/-5 mm, ...

A 33-year-old man presented with an acute myocardial infarction (MI) after a recent long-haul flight. Angiography revealed thrombus in the right and circumflex coronary artery but no underlying atherosclerosis. Echocardiography revealed the presence of an atrial septal defect (ASD). In view of the recent flight, the presence of an ASD ...

Left ventricular outflow tract (LVOT) obstruction has been classically observed in hypertrophic cardiomyopathy in which the LVOT obstruction is associated with asymmetric septal hypertrophy producing a systolic pressure gradient across the LVOT. Basal septal hypertrophy (BSH) with hypertension may result in dynamic LVOT obstruction as well. It was suggested that ...

Multidetector-row computed tomography (MDCT) studies were performed in three adult patients with pulmonary atresia with a ventricular septal defect. In all patients, the native pulmonary arteries were absent, and the pulmonary circulation was totally supplied by major aortopulmonary collateral arteries (MAPCAs). MDCT studies with 1-mm collimation provided detailed information on ...

We report a case of aortic perforation after transcatheter closure of an atrial septal defect by an Amplatzer septal occluder. During emergency surgery, perforations of the dome of the right atrium and the noncoronary sinus of Valsalva of the aorta were repaired. Atrial septal defect was primarily closed. A short ...

A 2.5-year-old patient with complex congenital heart disease involving dextrocardia, atrioventricular and ventriculoarterial discordance, pulmonary stenosis, ventricular septal defect (VSD), atrial septal defect (ASD), and paroxysmal supraventricular tachycardia (SVT) underwent electrophysiological study. The tachycardia mechanism was diagnosed with cryomapping. The ability of cryomapping to have transient and reversible effect on ...

We describe a case of a 50-year-old male with hypertrophic obstructive cardiomyopathy (HOCM) who presented with syncope, progressively limiting dyspnea and chest discomfort. Coronary angiography showed an unusually extreme angle (approximately 130 degrees) to the origin of the major septal artery. After conventional guidewire cannulation failed, use of magnetic navigation ...

We report the transesophageal echocardiogram of a patient who was admitted to the intensive care unit with a diagnosis of acute ischemic stroke, in whom a large atrial septal aneurysm (ASA) was seen bulging toward the right atrium with marked spontaneous echo contrast (SEC) inside but without thrombi, suggesting that ...

Atrial septal defect transcatheter occlusion techniques have become a reliable alternative to surgical procedures. Possible complications can derive from unfavorable anatomy of the defect and over-dimensioning of the device. We describe the first case ever reported of anterior mitral leaflet perforation caused by an atrial septal occluder. The diagnosis was ...

We describe our initial experience with a new technique, consisting in direct closure of the ventricular septal defect component of the AV canal, by directly attaching the common bridging leaflets to the crest of the ventricular septum with interrupted sutures. After closure of the cleft, the ostium primum defect was ...

BACKGROUND/AIMS: To evaluate computed tomography during arterial portography for preoperative evaluation in patients with intrahepatic cholangiocarcinoma. METHODOLOGY: Computed tomography during arterial portography was performed in 11 intrahepatic cholangiocarcinoma patients undergoing hepatectomy. Segmental perfusion defect, sensitivity of the main tumor, and sensitivity of intrahepatic metastasis on computed tomography during arterial portography ...

A 63-year-old-man with significant left hemiplegia was admitted to hospital. He had experienced a transient cerebral ischemic attack 10 years ago. Computed tomography revealed hypodensity along the right lateral ventricle, which corresponded to the left paralysis. Echocardiography and left ventricular angiography revealed an aneurysm of the membranous septum (AMS) without ...

The details of transhepatic closure of moderate - large size atrial septal defect as well as assisted closure of a modified Blalock Taussig shunt in a 2 1/2 year old patient with occluded femoral vessels are discussed. The technical variations as well as the potential advantages of this route are ...

The objective of this study was to evaluate the prevalence of atrial septal aneurysm (ASA) in newborns, to define the natural course of ASA, and to investigate its role on closure of associated interatrial septal opening (IASO). A total of 1072 consecutive neonates were examined with echocardiography in the early ...

Myocardial progenitor cells expressing Fgf10 give rise to the outflow tract and right ventricle of the mammalian heart. In order to define the role of fibroblast growth factor (FGF) signaling in this process we investigated whether Fgf10 or the major Fgf10 receptor Fgfr2-IIIb are required for normal heart development. The ...

In a newborn with anal atresia and urethral valves an incomplete VACTERL association, was diagnosed and a colon anus praeter was placed. Sweating and heart murmur led to cardiac diagnostics. By 2D colour Doppler echocardiography a huge atrial septal defect and pulmonary venous stenoses were diagnosed. Additionally, a pulmonary sling ...

A 35-year-old woman was found on echocardiography to have a pseudoaneurysm of the mitral-aortic intervalvular fibrosa, residual ventricular septal defect, and aortic regurgitation. She had undergone surgical closure of a ventricular septal defect at age 7 and was found to have residual shunt several years later. She had been followed ...

OBJECTIVES: We described morphologic characteristics, particularly pulmonary anatomy, and determined the prevalence of definitive end states and their determinants in children with pulmonary atresia associated with ventricular septal defect (PAVSD). BACKGROUND: Pulmonary atresia associated with ventricular septal defect represents a broad morphologic spectrum that greatly influences management and outcomes. METHODS: ...

To assess the accuracy of prenatal diagnosis, the association with genetic and extracardiac anomalies, and outcome in fetuses with isolated pulmonary atresia with ventricular septal defect (PA-VSD). Retrospective study in a tertiary centre for fetal cardiology. Echocardiographic video recordings of 27 consecutive fetuses with PA-VSD were reviewed for: (1) intracardiac ...

We report on a 40-year-old woman referred for evaluation of a cardiac murmur and dyspnea on exertion. The electrocardiogram (ECG) showed incomplete right bundle branch block, and echocardiography revealed a large atrial septal defect (ASD, ostium secundum type) with dilated right-sided heart chambers. At cardiac catheterization, a large left-to-right shunt ...

BACKGROUND: A global function index (GFI) derived from tissue Doppler imaging (TDI) has been proposed to improve the diagnosis of hypertrophic cardiomyopathy (HCM). We aimed to evaluate the usefulness of this index in a large selected HCM population. METHODS: GFI =[E/Ea]/Sa, was calculated at mitral annulus lateral and septal borders ...

Serious complications after percutaneous atrial septal abnormality closure are uncommon. We present a case of patent foramen ovale closure with early mobilization of the device and asymptomatic embolization into the descending aorta without sequels. Percutaneous retrieval of the device was successful down to the femoral artery from where it was ...

BACKGROUND: There are no large series describing the morphologic spectrum and the clinical outcomes of children with ductal origin of the distal pulmonary artery (PA). METHODS: Medical records were reviewed for all children presenting between 1970 and 2001. Angiograms were reviewed at presentation and at last available follow-up. RESULTS: Forty-five ...

Isolated infundibuloarterial inversion is a rare conotruncal cardiac anomaly characterized by a leftward and posterior aortic valve in the face of ventriculoarterial concordance. It has previously been described only in cases associated with severe additional defects of substantial hemodynamic significance. We present a case of isolated infundibuloarterial inversion with a ...

OBJECTIVE: To test the hypothesis that major aorto-pulmonary collaterals (MAPCAs) have the same anatomy as bronchial arteries. METHODS: Two hundred and thirty-eight angiographies performed on 61 patients with pulmonary atresia, ventricular septal defect (VSD), and MAPCAs constituted the basis for this study. This represented all available angiographies performed on this ...

Transcatheter closure of atrial septal defect (ASD) has become an accepted alternative to surgery. A number of complications associated with ASD device closure have been recognized but most are rare or minor in severity. We report a rare complication of atrial septal laceration during transcatheter closure of secundum ASD. We ...

BACKGROUND: The precise knowledge of regional anatomical details is of utmost importance specially in complex procedures such as the Ross operation. This anatomical study offers a critical approach regarding the advantages, limits, and precautions for this procedure. METHODS: Using dissection techniques, magnifications up to x6 and nontraditional approaches, 68 fixed ...

We describe the case of a patient who underwent elective mitral valve replacement and whose postoperative progress was complicated by a persistently high inspired oxygen requirement and consequent inability to wean from respiratory support. The reason for this was initially unclear, but transesophageal echocardiography identified the cause as a postoperative ...

Rupture of a sinus of Valsalva aneurysm (SVA) is a rare, but life-threatening, event and requires immediate recognition and intervention. We present two previously healthy and physically active patients who were 12 and 33 years of age when rupture of a right coronary SVA into the right ventricle occurred. A ...

Pulmonary hypertension due to left to right shunts is a challenging problem in decision making for corrective surgery. Pre-operative cardiac data evaluation with proper medication convey better outcomes in those patients. We describe a succesful combination therapy in a paient with severe pulmonary hypertension prior , during and following ventricular ...

Changes in regional myocardial perfusion throughout the entire coronary vascular tree, as opposed to changes in the worst regional perfusion defect, have not been described during long-term regression or progression of coronary artery disease (CAD) or related to clinical outcomes. METHODS: Four-hundred nine patients with CAD undergoing dipyridamole PET at ...

Scimitar syndrome (SS) is a rare congenital cardiac anomaly defined by an anomalous right pulmonary vein draining of the right lung into the inferior vena cava. We describe a direct reimplantation technique and atrial septal defect closure using cardiopulmonary bypass via a right minithoracotomy on a 24 year-old female SS ...

A 6-month-old child with worsening cyanosis from birth, hypercyanotic spells and failure to thrive, was admitted with severe desaturation. Systemic saturation was < 56%, and echocardiography revealed severe infundibular pulmonary stenosis with normal pulmonary valve and a restrictive ventricular septal defect. The child underwent percutaneous stenting of the right ventricular ...

We describe the echocardiographic findings in a 4-day-old thoroughbred foal with an aortico-pulmonary septal defect. The foal had labored breathing, cyanotic mucous membranes and a continuous grade 5/6 heart murmur with point of maximal intensity over the base of the heart on the right side. Echocardiographically, there was a large ...

Doubly committed subarterial ventricular septal defect complicated by severe aortic regurgitation caused by a prolapsed aortic cusp still represents a challenging surgical problem. We report on our "two-patch" technique, were the ventricular septal defect is closed through the aortic valve by a patch anchored to another patch through the prolapsed ...

BACKGROUND: Membranous interventricular septal aneurysm has been reported to accompany atrioventricular (AV) conduction defects. If it is accompanied by AV block, patients generally become symptomatic before the age of 40. CASE REPORT: A 65-year-old male presented with presyncope and extreme fatigue for one week. Resting ECG showed a 2: 1 ...