Dilatation of the pulmonary trunk in stenosis of the pulmonary valve and of the pulmonary arteries in children

1964 ◽  
Vol 68 (5) ◽  
pp. 612-620 ◽  
Author(s):  
Ivan A. D'Cruz ◽  
Rene A. Arcilla ◽  
Magnus H. Agustsson
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Arteries ◽  
Pulmonary Trunk

Longitudinal extension of the pulmonary trunk during breathing in young rabbits: a possible factor in elastin fragmentation

1976 ◽  
Vol 54 (2) ◽  
pp. 113-117
Author(s):  
Paul H. Smith
Keyword(s):  
Pulmonary Arteries ◽  
Pulmonary Trunk ◽  
Corrosion Casts ◽  
Longitudinal Stress ◽  
Longitudinal Extension ◽  
Silicone Polymer

Corrosion casts of the pulmonary trunk and major branches of the pulmonary arteries of 39 rabbits were made from a silicone polymer. In half of the rabbits the casts were made with the lungs expanded and half with the lungs collapsed. The length of various segments of the casts were measured from magnified photographs. It was found that in rabbits less than 23 days old the pulmonary trunk is significantly longer when the lungs are expanded than when they are collapsed. This suggests that a repeated longitudinal extension of the vessel occurs during breathing. This effect disappears after 30 days of age, possibly because of elastin fragmentation. Between the ages of 23 and 30 days the growth in length and diameter of the pulmonary trunk undergoes a rapid acceleration. This may also be the result of elastin fragmentation. Whereas it may be that repeated longitudinal stress in the pulmonary trunk during breathing causes elastin in its media to fragment, one cannot exclude the possibility that other factors such as growth are responsible.

scholarly journals P180 Pulmonary valve stenosis and pulmonary trunk aneurysm in old female with syncope

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Fiore ◽  
A M F Ali ◽  
T Kemaloglu Oz ◽  
G Cagnazzo ◽  
M Melone ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Pulmonary Trunk ◽  
Aortic Aneurysms ◽  
Heart Team ◽  
The Right

Abstract A 77-year-old female, known hypertensive and dyslipidemic on treatment presented with three episodes of syncope in the last two months. On examination; there was grade 4/6 harsh systolic murmur on the lateral sternal border. Transthoracic echocardiography was difficult because of mesocardia and abnormal rotation of the heart due to enlarged right sided chambers. There is mild left ventricular hypertrophy with normal ejection fraction, no left sided valvular disease. The right ventricle was hypertrophied and dilated with normal RV function. The pulmonary valve was thickened with significant systolic flow aliasing through the valve with significant regurgitation and huge main pulmonary trunk aneurysm (59 mm at its wideset diameter) (Figure 1). Transthoracic approach did not allow a correct alignment of the Doppler CW and the correct estimate of pulmonary valvulopathy; TEE was performed with a correct visualization of the valve in deep transgastric projection at 90 degrees. The valve was thickened, fibrotic, degenerated with systolic doming of leaflets (Figure 2) and peak systolic gradient ∼ 70 mmHg (Figure 3). 3D reconstruction of the valve showed a tricuspid valve (Figure 4) with a valve area ∼ 0.9 cm2 using planimetry in MPR (Figure 5). CT scan was performed which confirmed the main pulmonary trunk aneurysm ∼ 60 mm (Figure 6). Therefore, in light of the clinical and instrumental picture, the patient was referred to heart team discussion for the plan of surgical intervention. Discussion According to the ESC guidelines for grown up congenital heart disease in 2010, this pulmonary valve should be intervened upon as it is severe symptomatic PS (1), but there are 2 problems with this case; the first is significant associated PR, so no place for balloon dilatation here, the second problem is the pulmonary artery aneurysm (PAA). The dilemma of management of pulmonary PAA is that all the available data are about aortic aneurysms. Indications for intervention for PAA include: Absolute PAA diameter ≥ 5.5 cm, Increase in the diameter of the aneurysm of ≥ 0.5 cm in 6 mo, Compression of adjacent structures, Thrombus formation in the aneurysm sack, Evidence of valvular pathologies or shunt flow Verification of PAH, Signs of rupture or dissection (2). Surgery could include: Aneurysmorrhaphy only decreases the diameter of the vessel (3). Aneurysmectomy and repair or replacement of the right ventricular outflow tract is commonly used technique recently and mostly suits connective tissue disorders (6). Also, Replacement of the PA and the pulmonary trunk with a conduit (Gore-Tex or Dacron tubes, homografts, or xenografts) starting in the right ventricular outflow tract with replacement of the pulmonary valve (4). Conclusion PAA management is currently challenging because there are no clear guidelines on its optimal treatment. The presence of significant pulmonary valve dysfunction could affect the decision making of the associated PAA management. Abstract P180 Figure.

scholarly journals P701 Usefulness of echocardiography in diagnosis and monitoring in patient with pulmonary embolism during pregnancy, a case report

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Starzyk ◽  
P Dybich ◽  
K Ciuraszkiewicz ◽  
W Rokita ◽  
B Wozakowska-Kaplon
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Troponin T ◽  
Pulmonary Arteries ◽  
Pulmonary Trunk ◽  
Clinical State ◽  
Main Trunk ◽  
Right Pulmonary Artery ◽  
Low Incidence ◽  
The Right

Abstract Pulmonary embolism is one of the leading causes of maternal mortality despite a low incidence of during pregnancy. We present 32-year-old woman, in the 35 week of first pregnancy, admitted to the Intensive Care Unit with dyspnea, tachycardia, cyanosis. Echocardiography confirmed the presence of embolic material in the main trunk of pulmonary artery, spreading to the right pulmonary artery. D-dimer and troponin T level were elevated, BNP remained within the normal range. The risk in PESI scale was assumed as intermediate high. LMWH therapy was initiated, the patient was constantly monitored. Venous thrombotic disease in lower extremities was excluded by ultrasonography. The treatment was carried out under obstetric supervision. The clinical state gradually improved, the patient was hemodynamically stable. Serial echocardiographic testing, revealed gradual regression of changes in the pulmonary trunk. Normalization of troponins and lowering of BNP levels were observed. The pregnancy was terminated in 39 week, by cesarean section (obstetric indications). The LMWH was continued few days after delivery, as the patient started lactation. She decided to terminate lactation in a first week after delivery so the therapy was switched into rivaroxaban for at least 3 months. Echocardiography after 3 month confirmed lack of changes in pulmonary trunk, the risk of pulmonary hypertension was low. Echocardiography can be a method of choice for confirming and monitoring pulmonary embolism during pregnancy, in a situation of high or intermediate clinical risk and good visualization of changes in pulmonary arteries Abstract P701 Figure. Embolism of pulmonary trunk and RPA

Echocardiographic features of the morphologically right ventriculo-arterial junction

2005 ◽  
Vol 15 (S1) ◽  
pp. 17-26 ◽  
Author(s):  
Richard M. Martinez ◽  
Robert H. Anderson
Keyword(s):  
Right Ventricle ◽  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Pulmonary Trunk ◽  
Free Standing ◽  
Ventricular Mass ◽  
Echocardiographic Evaluation ◽  
The Right ◽  
Relationship Of

In the normal heart, the morphologically right ventricle supports the pulmonary trunk. The key to echocardiographic evaluation of the junction between these structures is to understand not only the arrangement of the pulmonary valve, but also the complete muscular infundibulum that supports the valvar leaflets, lifting the valvar complex away from the base of the ventricular mass. As explained in the previous review,1 it is the presence of this free-standing muscular infundibular sleeve that makes it possible for the surgeon to remove the pulmonary valve for use as an allograft in the Ross procedure.2 In this review, we will address the echocardiographic features of the junction, considering primarily the situation in which the morphologically right ventricle supports the pulmonary trunk, but making comparisons with the abnormal arrangements in which either the aorta, or both arterial trunks, arise from the right ventricle. As we will see, the basic arrangement of the free-standing complete muscular infundibulum, or conus, is preserved with these abnormal arrangements, but there can be variation depending on the precise arrangement of the inner heart curvature, or ventriculo-infundibular fold, and the morphology can be further changed depending on the relationship of the arterial trunks themselves. The key to analysis, therefore, and also to accurate description, is to analyse separately the way in which the arterial trunks are joined to the ventricular mass, the relationships of the trunks one to the other, and the precise structure of the supporting right ventricular outflow tract, or outflow tracts in the setting of double outlet connection. If each of these features is then described in its own right, avoiding the temptation to make inferences regarding one feature from knowledge of another, then it is possible to avoid many of the persisting controversies relating to nomenclature.

Double outlet right atrium and complete atrioventricular septal defect with abnormal findings of the biopsied lung

1994 ◽  
Vol 4 (4) ◽  
pp. 402-404 ◽  
Author(s):  
Kiyoshi Suzuki ◽  
Toshio Kikuchi ◽  
Shigekazu Mimori
Keyword(s):  
Septal Defect ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Atrioventricular Septal Defect ◽  
Pulmonary Trunk ◽  
Atrial Septum ◽  
Corrective Surgery ◽  
Rare Type ◽  
Medial Hypertrophy ◽  
Complete Atrioventricular

SummaryWe describe a rare type of atrioventricular septal defect with common atrioventricular orifice and malaligned atrial septum, the latter feature resulting in severe obstruction of the left atrial egress. Excision of the atrial septum and banding of the pulmonary trunk was performed at the age of thirteen months. Lung biopsy demonstrated marked medial hypertrophy with severe intimal fibrosis in the small pulmonary arteries and mild thickening of the pulmonary veins, considered contraindications for corrective surgery.

scholarly journals Tetralogy of fallot with diminutive pulmonary arteries: Preoperative pulmonary valve dilation and transcatheter rehabilitation of pulmonary arteries

1996 ◽  
Vol 27 (7) ◽  
pp. 1741-1747 ◽  
Author(s):  
Jacqueline Kreutzer ◽  
Stanton B. Perry ◽  
Richard A. Jonas ◽  
John E. Mayer ◽  
Aldo R. Castañeda ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Pulmonary Valve ◽  
Pulmonary Arteries

Two-stage repair in a patient with “absent pulmonary valve syndrome”

1993 ◽  
Vol 3 (1) ◽  
pp. 67-69
Author(s):  
Hussam Tamimi ◽  
Omar Galal ◽  
Zohair Al Halees
Keyword(s):  
Respiratory Distress ◽  
Pulmonary Valve ◽  
Stable Condition ◽  
Postoperative Recovery ◽  
Pulmonary Trunk ◽  
Dramatic Improvement ◽  
Absent Pulmonary Valve ◽  
Two Stage ◽  
Severe Respiratory Distress ◽  
Absent Pulmonary Valve Syndrome

SummaryA seven-month-old boy with severe respiratory distress because of absence of the leaflets of the pulmonary valve underwent banding of the pulmonary trunk. Postoperative recovery was uneventful with dramatic improvement of his general and hemodynamic status. Repair was performed successfully almost two years later when the child had grown satisfactorily and was in stable condition.

Significance of lung anomalies in fetuses affected by tetralogy of Fallot with absent pulmonary valve syndrome

2017 ◽  
Vol 27 (9) ◽  
pp. 1740-1747 ◽  
Author(s):  
Estelle Tenisch ◽  
Marie-Josée Raboisson ◽  
Françoise Rypens ◽  
Julie Déry ◽  
Andrée Grignon ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Pulmonary Valve ◽  
Pulmonary Arteries ◽  
Fetal Lung ◽  
Bronchial Tree ◽  
Normal Lung ◽  
Absent Pulmonary Valve ◽  
Tree Compression ◽  
Significant Compression ◽  
Absent Pulmonary Valve Syndrome

AbstractObjectivesTetralogy of Fallot with absent pulmonary valve syndrome is a rare form of tetralogy of Fallot with dilatation of large pulmonary arteries. Prognosis is related to the severity of the cardiac malformation and to bronchial tree compression by dilated pulmonary arteries. This study analyses the prenatal echographic lung appearance in fetuses with tetralogy of Fallot with absent pulmonary valve and discusses its significance.MethodsWe carried out a retrospective review of fetal and postnatal files of nine fetuses diagnosed with tetralogy of Fallot with absent pulmonary valve syndrome in our institution. Correlations of prenatal ultrasound and cardiac imaging findings were obtained with outcome.ResultsAbnormal heterogeneous fetal lung echogenicity was detected in eight cases out of nine, always associated with significant lobar arterial dilatation. This aspect was well correlated with postnatal imaging and outcome in the four neonatal cases. The only fetus with normal lung echogenicity also had lower degree of pulmonary artery dilatation in the series.ConclusionsThis study demonstrates that a heterogeneous ultrasound appearance of the fetal lungs can be detected in utero in the most severe cases. This aspect suggests an already significant compression of the fetal bronchial tree by the dilated arteries that may have prognostic implications.

scholarly journals Streptococcus pyogenes Pericarditis with Resultant Pulmonary Trunk Compression Secondary to Mycotic Pseudoaneurysm

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
E. Fry ◽  
J. Urbanczyk ◽  
J. Price ◽  
R. Digiovanni ◽  
M. Jepson ◽  
...  
Keyword(s):  
Streptococcus Pyogenes ◽  
Mycotic Aneurysm ◽  
Pulmonary Arteries ◽  
Ascending Aorta ◽  
Pulmonary Trunk ◽  
Purulent Pericarditis ◽  
Mycotic Pseudoaneurysm ◽  
History Of ◽  
Group A ◽  
Mycotic Aneurysms

Purulent pericarditis is a rare disease in the era of antibiotics, with Streptococcus pyogenes being a possible, though uncommon etiology. Even more uncommon are mycotic aneurysms secondary to group A strep purulent pericarditis and bacteremia. We report a case of an 18-year-old female with a history of strep pharyngitis develop Streptococcus pyogenes purulent pericarditis with subsequent ventricular fibrillation (VF). Following initial stabilization, she ultimately developed a 4.8 cm mycotic aneurysm of the ascending aorta, with resultant compression of the pulmonary trunk and right pulmonary arteries.

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