Objective: This study intends to summarize 5 years of intraoperative hybrid procedure (IHP) experience with neonates and young children having congenital heart disease (CHD). Methods: From March 2003 to March 2009, a total of 152 consecutive patients younger than 2 years old who had undergone IHP were enrolled. In the ...

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital cardiac malformation that accounts for 0.25-0.50% of children with congenital cardiac disease and can cause myocardial dysfunction in young infants. In any infant presenting with ventricular dysfunction, the diagnosis of anomalous origin of the left ...

A total of 25 (13 male, 12 female) adult, healthy Swiss albino mice were used to investigate the origin, course and anastomoses of coronary arteries. Coloured latex was injected into the aortic arch to enable these arteries to be clearly discerned. A. coronaria sinistra was larger than A. coronaria dextra. ...

In the past, coronary arterial anomalies have been difficult to diagnose by non-invasive methods. Identification of coronary arterial origins is now a routine part of the standard paediatric echocardiogram. Anomalous origin of a coronary artery from the pulmonary trunk is an extremely important diagnosis to make. Many echocardiographic features are ...

Tetralogy of Fallot with pulmonary atresia and diminutive or absent intrapericardial pulmonary arteries is a rare congenital abnormality, with high morbidity and mortality. Despite great advances in surgical- and catheter-based therapies, management remains challenging and controversial. We describe the surgical methods and the results from our institution. We performed a ...

Monitoring during thoracoabdominal aortic aneurysm repair has included the use of cerebrospinal fluid drainage and motor and somatosensory evoked potentials. We report our experience with neuromonitoring-guided thoracoabdominal aortic aneurysm repair. Between November 2008 and January 2010, 105 thoracic aorta repairs were performed; 89% of patients (93/105) underwent repair using cerebrospinal ...

There is increasing attention to prophylactic replacement of the moderately dilated ascending aorta at aortic valve surgery. Moderate ascending aortic dilatation is common in adult patients with conotruncal anomalies. There are no data outlining actual risk of progressive ascending aortic dilatation or dissection to provide management guidelines. From December 1973 ...

A 67 year-old man presented with stable angina pectoris. He underwent primary angioplasty with stenting of the left anterior descending artery ostial lesion five months previously. A small eccentric aneurysm was shown within the left main coronary artery. A second angiography, performed a month later, showed slight enlargement of the ...

Persistent left superior vena cava (PLSVC) is a congenital variant of the thoracic venous system, which is associated with other congenital abnormalities. Asymptomatic cases are often diagnosed incidentally during invasive cardiovascular procedures such as the deployment of central venous access devices. It is important to be aware of the existence ...

The anomalous aortic origin of a coronary artery from the wrong sinus of Valsalva with interarterial, intramural, and/or intraconal course is a rare congenital anomaly that is associated with a high risk of sudden death in children. The Congenital Heart Surgeons' Society established the Registry of Anomalous Aortic Origin of ...

Congenital anomalies of the coronary arteries are an uncommon, but important, cause of pain in the chest, myocardial ischaemia and even sudden cardiac death, especially in young individuals. This paper focuses on the surgical treatment of congenital anomalies of the coronary arteries in adults; indications for surgery and the different ...

A young man with an unremarkable medical history was diagnosed with meningococcal endocarditis and was treated with penicillin and gentamycin. Further history was complicated by a fistulisation between the left ventricle and right atrium and aortic and tricuspid valve insufficiency. Aortic valve replacement, correction of the fistulisation and annuloplasty of ...

Congenital coronary arterial abnormalities as isolated lesions are exceedingly rare. The electrocardiogram, while a reasonable adjunct in the diagnosis of coronary arterial abnormalities, should not supplant a good history and physical examination. Careful attention must be devoted to any signs or symptoms of ischaemic pain in the chest or syncope, ...

The most commonly reported coronary arterial malformation, in accounts of sudden deaths, is anomalous aortic origin of a coronary artery. Anomalous coronary arteries may arise from the left, right, or non-coronary sinuses of Valsalva. Importantly, although the left coronary artery from the right sinus has the worst prognosis, sudden death ...

Cerebral mycotic aneurysms are uncommon but severe complications of infective endocarditis. Management of these patients remains controversial. We present a case of a 23-year-old man who had infective endocarditis complicated by an intracranial mycotic aneurysm. Because antimicrobial therapy was not effective in reducing the size of the mycotic aneurysm, a ...

BACKGROUND/PURPOSES: There are various types of coronary artery fistula (CAF) with complex shapes; therefore, it is important to obtain a correct diagnosis and to understand its relations to the adjacent structures before surgery. This study evaluated echocardiography and 64-multislice computed tomography (64-MSCT) angiography in diagnosing CAF. Sixteen patients with CAF, ...

ObjectiveTo investigate the value of dual-source computed tomography (DSCT) angiography in the examination of congenital coronary artery anomalies. MethodsWe retrospectively examined 2530 patients by DSCT angiography between January 2008 and September 2010. Congenital coronary artery anomalites were shown by maximum intensity projection, curved planar reconstruction, and volume rendering. ResultsA total ...

D-Transposition of great arteries with an aortopulmonary window is a rare congenital anomaly. We describe a case of D-Transposition of great arteries with an aortopulmonary window and multiple ventricular septal defects in a 5-month boy who underwent successful surgical repair.

Where pulmonary veins drain and their relationship with an atrial septal defect (ASD) are important. A sinus venosus (high venosum) type of defect is the most common pathology accompanying partial anomalous pulmonary venous connection. Typically, the right superior pulmonary vein and occasionally the middle pulmonary vein drain into the junction ...

Neonates born with hypoplastic left heart syndrome now have a remarkably improved prognosis compared with the situation existing before the development of the Norwood sequence of operative procedures. Some of those born with hypoplastic right ventricles in the setting of pulmonary atresia with an intact ventricular septum, however, still have ...

Iatrogenic coronary artery stenosis (ICAS) after aortic valve replacement (AVR) is a rare but potentially fatal complication. Immediate traumatic lesions or late stenoses caused by insertion of an antegrade cardioplegia catheter during AVR mostly occur at the site of the left main trunk or right coronary ostium. Here, we report ...

Coronary artery anomalies are found in 0.2% to 1.3% of patients undergoing coronary angiography and 0.3% of an autopsy series. We aimed to estimate the frequency of coronary artery anomalies in our patient population. The data were collected retrospectively by analyzing the angiographic data of 12 457 consecutive adult patients ...

Abstract Purpose: To report a case of retrograde acute Stanford type A aortic dissection treated without hypothermic circulatory arrest. Case Report: A 55-year-old man presented with a retrograde acute type A aortic dissection with an entry tear 30 mm below the left subclavian artery. A concurrent emergent endovascular and surgical treatment ...

Cardiac surgical procedure and catheter intervention of the aorta or its major branches have a potential risk for iatrogenic aortic dissection. This case demonstrates an iatrogenic type A aortic dissection after the elective balloon angioplasty for severe stenosis of the left subclavian artery orifice. The dissection retrospectively extended to the ...

We report a case of iatrogenic claudication as a result of a misplaced percutaneous arterial closure device (PACD) used to obtain hemostasis after cardiac catheterization. The patient presented one week after his procedure with complaints suggestive of right lower extremity claudication. Computed tomographic angiography demonstrated a near total occlusion of ...

We describe here successful palliative repair of tricuspid atresia, hypoplastic right ventricle, transposition of the great arteries, and hypoplastic aortic arch in a neonate. The repair consisted of the Norwood procedure with a rudimentary right ventricle to pulmonary artery shunt, which was located on the right side of a neo-aorta. ...

The LiDCO plus monitor (LiDCO Ltd, Cambridge, UK) uses pulse contour analysis of the arterial pressure waveform to indicate changes in stroke volume and cardiac output. Calibration against a lithium indicator dilution method is required to permit display of absolute values in addition to trends. The effect of haemodynamic changes ...

Accessory mitral papillary muscle originating from the interventricular septum is a rare congenital anomaly. A 20-year-old male patient presented with a complaint of exertional dyspnea. On cardiac examination, a grade 3/4 diastolic murmur was heard over the right upper parasternal area, and the apical pulsations were easily palpable over the ...

Abnormalities of the coronary arterial circulation represent a broad spectrum of anomalies. Some of these coronary arterial anomalies are of little clinical significance and are generally discovered either as incidental findings at autopsy or at the time of diagnostic coronary angiography in patients with atherosclerotic ischaemic cardiac disease. Some of ...

We report a 24-year-old man who developed postoperative pulmonary edema and desaturation, after open reduction with internal fixation for left femoral shaft fracture sustained in a motorcycle accident. Cardiac catheterization revealed a left anterior descending coronary artery dissection. Review of his present history, showed that he neither had chest discomfort ...

Patients with congenital heart disease who undergo surgical implantation of a conduit between the right ventricle and the pulmonary artery (RV-PA conduit) may develop stenosis and/or insufficiency over time. These cases, which are associated with arrhythmias, RV dysfunction and sudden death, remain a challenge for surgical re-intervention, due to its ...

We describe a 72-year-old man who presented with left hemiparesis due to acute cerebral infarction in the right fronto-temporal lobe. Three months prior to admission, he was hospitalized for right hemiparesis due to the acute cerebral infarction in the left anterior cerebral artery territory. To investigate the cause of his ...

Pulmonary arterial hypertension (PAH) is a life threatening disease characterized by progressive pulmonary arterial occlusion which may ultimately result in death. Currently, the available treatments are diverse, but no therapy alone can reverse the disease process although they may have some clinical benefits. This study was designed to investigate single ...

A clinically apparent thromboembolism associated with arthroscopic shoulder surgery is extremely rare. We report a case of a fatal pulmonary embolism developed after an arthroscopic rotator cuff repair in a 45-year-old woman. On the first day after surgery, she experienced syncope that was complicated by cardiac arrest. No hemostasis impairment ...

Pulmonary thromboembolism is one of the most important causes of morbidity and mortality in patients undergoing lower extremity orthopedic surgery. Early diagnosis and appropriate management are important clinical challenges. In this case, massive pulmonary embolism causing sudden cardiac arrest was attributed to use of tourniquet inflation during lower extremity orthopedic ...

Pulmonary hypertension (PH) is defined as an increased mean pulmonary artery pressure (P(pa)) >25 mmHg at rest as assessed by right heart catheterisation (RHC). However, this technique is invasive and noninvasive alternatives are desirable for early diagnosis of PH. Although estimation of systolic pulmonary arterial pressure is easily obtained using ...

Pulmonary arterial hypertension (PAH) is a serious complication of congenital heart disease (CHD). Without early surgical repair, around one-third of paediatric CHD patients develop significant PAH. Recent data from the Netherlands suggest that >4% of adult CHD patients have PAH, with higher rates in those with septal defects. A spectrum ...

A 31-yr-old female patient previously diagnosed with idiopathic pulmonary arterial hypertension (PAH) was referred to our centre for further evaluation. Cardiac magnetic resonance imaging (MRI) and echocardiography revealed a superior sinus venosus atrial septal defect (ASD) with partial anomalous pulmonary venous drainage. Following re-diagnosis, surgical repair was considered. Despite a ...

Maldevelopment of outflow tract and aortic arch arteries is among the most common forms of human congenital heart diseases. Both Bmp4 and Tbx1 are known to play critical roles during cardiovascular development. Expression of these two genes partially overlaps in pharyngeal arch areas in mouse embryos. In this study, we ...

The collateral arterial circulation of the heart has been extensively studied. However, less attention has been paid to extracardiac anastomoses, which may also be of significant clinical importance. In this review, we will describe the most common types of these anastomoses, which include bronchial to coronary arteries and internal thoracic ...

The collateral arterial circulation of the heart has been extensively studied. However, less attention has been paid to extracardiac anastomoses, which may also be of significant clinical importance. In this review, we will describe the most common types of these anastomoses, which include bronchial to coronary arteries and internal thoracic ...

An unusual autopsy finding was seen in a young case of metastatic teratocarcinoma of the right testis. The patient presented with features of myocardial ischemia and died of sudden cardiac arrest. At autopsy, the lungs were studded with variably sized metastatic nodules composed of glistening hyaline cartilage. Examination of the ...

We report a patient who presented during fetal life with severe aortic stenosis, left-ventricular dysfunction, and endocardial fibroelastosis (evolving hypoplastic left heart syndrome). Management involved in utero and postnatal balloon aortic valvuloplasty for partial relief of obstruction and early postnatal hybrid stage I palliation until recovery of left-ventricular systolic function ...

AIM: To establish a mouse model for the study of congenital defects, using exposure of pregnant females to the teratogen BMS-189453, a multiple retinoic acid competitive antagonist.We found not less than 60% of fetuses had transposition of the great arteries and l5% had other congenital heart defects such as double ...

Aortic arch reconstruction plays an important role in the success of the Norwood procedure (NP) for hypoplastic left heart syndrome (HLHS). This study investigated the cardiac specimens to determine the etiology of distal aortic arch obstruction after the NP for HLHS and to locate coarctation of the aorta in HLHS ...

Congenital arteriovenous malformations between the subclavian artery and the superior vena cava (SVC) is a very rare anomaly scantily described in the literature. We describe this anomaly in a 4-month-old infant who presented with congestive heart failure. He was diagnosed to have a right subclavian artery to SVC fistula associated ...

Motor-evoked potential monitoring is used to prevent paraplegia during thoracic aortic surgery. Multidetector computed tomography has been used preoperatively to detect the Adamkiewicz artery, but the hemodynamic significance of the Adamkiewicz artery is controversial. This study aims to evaluate whether the multidetector computed tomography-defined Adamkiewicz artery is hemodynamically essential and ...

OBJECTIVE: Aortic homografts were compared with pulmonary homografts in the setting of right ventricular outflow tract reconstruction in adolescent sheep. Furthermore, clinically available stentless porcine and bovine xenografts were studied as an alternative to homografts. METHODS: In 51 adolescent sheep cryopreserved aortic and pulmonary (ovine) homografts, as well as 6 ...

A concomitant one-stage unifocalization and bidirectional Glenn procedure was performed in a patient with a functionally single ventricle, pulmonary atresia, and major aortopulmonary collateral arteries (MAPCAs). Reconstruction of the absent central pulmonary artery was achieved using the MAPCAs as well as the autologous pericardium. After 1 year, cineangiography and cardiac catheterization ...

Supravalvular aortic stenosis is associated with the Williams-Beuren syndrome, but it also occurs in a non-syndromatic congenital form. An elastin gene mutation of chromosome 7q11.23 is responsible in both cases. The vascular features are identical. These patients have a higher risk of sudden death, particularly when undergoing diagnostic or surgical ...