Valvar aortico-ventricular tunnel: an insight into the development of the great arteries

2016 ◽  
Vol 27 (4) ◽  
pp. 788-790
Author(s):  
Khadijah Maghrabi ◽  
Sanjiv Gandhi ◽  
Kevin C. Harris

AbstractAorto-left ventricular tunnel is a rare congenital heart lesion, with an incidence of <0.1% of all CHD. We present a unique case of a valvar aorto-left ventricular tunnel in a neonate, in belief that our findings may shed some light on the developmental origins of this lesion.

2017 ◽  
Vol 9 (3) ◽  
pp. 364-367
Author(s):  
Abid Iqbal ◽  
Sabarinath Menon ◽  
Baiju S. Dharan ◽  
Kapilamoorthy Tirur Raman ◽  
Jayakumar Karunakaran

Submitral aneurysms are rare clinical entities occurring predominantly in young adults of African descent. A host of etiologies have been proposed for this entity. We present a unique case of submitral aneurysm which developed after pulmonary artery banding in a three-year-old girl with complex congenital heart disease. The aneurysmal sac was burrowing into the interatrial septum.


2004 ◽  
Vol 32 (Supplement) ◽  
pp. A50
Author(s):  
Matthew Niedner ◽  
Jennifer Foley ◽  
Edmund Capparelli ◽  
Alex Rodarte ◽  
Riffenburgh Robert

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1215
Author(s):  
Stephan Ellmann ◽  
Julie-Marie Nickel ◽  
Rafael Heiss ◽  
Nouhayla El Amrani ◽  
Wolfgang Wüst ◽  
...  

For therapeutic decisions regarding uni- or biventricular surgical repair in congenital heart disease (CHD), left ventricular mass (LVM) is an important factor. The aim of this retrospective study was to determine the LVM of infants with CHD in thoracic computed tomography angiographies (CTAs) and to evaluate its usefulness as a prognostic parameter, with special attention paid to hypoplastic left heart (HLH) patients. Manual segmentation of the left ventricular endo- and epicardial volumes was performed in CTAs of 132 infants. LVMs were determined from these volumes and normalized to body surface area. LVMs of patients with different types of CHD were compared to each other using analyses of variances (ANOVA). An LVM cutoff for discrimination between uni- and biventricular repair was determined using receiver operating characteristics. Survival rates were calculated using Kaplan–Meier statistics. Patients with a clinical diagnosis of an HLH had significantly lower mean LVM (21.88 g/m2) compared to patients without applicable disease (50.22 g/m2; p < 0.0001) and compared to other CHDs, including persistent truncus arteriosus, left ventricular outflow tract obstruction, transposition of the great arteries, pulmonary artery stenosis or atresia, and double-outlet right ventricle (all, p < 0.05). The LVM cutoff for uni- vs. biventricular surgery was 33.9 g/m2 (sensitivity: 82.3%; specificity: 73.7%; PPV: 94.9%). In a subanalysis of HLH patients, a sensitivity of 50.0%, specificity of 100%, PPV of 100%, and NPV of 83.3% was determined. Patient survival was not significantly different between the surgical approaches or between patients with LVM above or below the cutoff. LVM can be measured in chest CTA of newborns with CHD and can be used as a prognostic factor.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Combs ◽  
Vanessa Fernandez ◽  
brent j barber ◽  
Wayne J Morgan ◽  
Chiu-Hsieh Hsu ◽  
...  

Introduction: Obstructive sleep apnea (OSA) is associated with cardiac dysfunction in children without congenital heart disease (CHD). Children with CHD are at increased risk for OSA and may be susceptible to further cardiovascular consequences due to OSA but the extent and nature of such cardiovascular effects of OSA are unknown. Methods: Children (6-17 years old) with corrected CHD without current cyanosis or Down syndrome were recruited from pediatric cardiology clinic. Home sleep tests were done to determine the presence and severity of OSA. OSA was defined as an obstructive apnea hypopnea index (oAHI) ≥1. Mild OSA was defined as an oAHI of ≥1 to <5 and moderate OSA was defined as an oAHI of ≥5 to <10. Standard clinically indicated echocardiograms were performed in clinic. Echocardiographic findings were compared between children with CHD with and without comorbid OSA using t-tests, Wilcoxon-sign rank tests as well as linear or logistic regression as appropriate. Results: Thirty-two children had sleep study and echocardiographic data available. OSA was present in 18 children (56%). OSA was mild in 89% and moderate in 11% of cases. There were no significant differences in age, body mass index, CHD severity, gender or ethnicity between children with and without OSA. Children with OSA had larger height-indexed right ventricular end-diastolic diameter (RVDi) compared to those without OSA (median 1.35, 95% CI 1.09, 1.56 vs. 1.21, 95% CI 1.01, 1.57; p=0.04). Children with moderate OSA had a reduced left ventricular shortening fraction compared to both those with mild OSA and no OSA (30.0 ± 6.1% vs. 38.7 ± 4.4%; p=0.009 and 39.2 ± 3.6%; p=0.007, respectively). Children with moderate OSA had increased left ventricular end-systolic diameter compared to those with mild OSA and no OSA (3.4 ± 0.4 cm vs. 2.5 ± 0.4; p=0.007 and 2.4 ± 0.5; p=0.001, respectively). Children with an RVDi above the median were seven times more likely to have OSA than those with an RVDi below the median (odds ratio 6.9.; 95% CI 1.3, 35; p=0.02). Conclusions: OSA is associated with changes in cardiac morphology and reduced contractility in children with CHD. Additionally, the presence of right ventricular dilation may suggest the need for OSA evaluation in children with CHD.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Srinivas Tapa ◽  
Lianguo Wang ◽  
Samantha D. Francis Stuart ◽  
Zhen Wang ◽  
Yanyan Jiang ◽  
...  

Abstract Myocardial infarction (MI) can result in sympathetic nerve loss in the infarct region. However, the contribution of hypo-innervation to electrophysiological remodeling, independent from MI-induced ischemia and fibrosis, has not been comprehensively investigated. We present a novel mouse model of regional cardiac sympathetic hypo-innervation utilizing a targeted-toxin (dopamine beta-hydroxylase antibody conjugated to saporin, DBH-Sap), and measure resulting electrophysiological and Ca2+ handling dynamics. Five days post-surgery, sympathetic nerve density was reduced in the anterior left ventricular epicardium of DBH-Sap hearts compared to control. In Langendorff-perfused hearts, there were no differences in mean action potential duration (APD80) between groups; however, isoproterenol (ISO) significantly shortened APD80 in DBH-Sap but not control hearts, resulting in a significant increase in APD80 dispersion in the DBH-Sap group. ISO also produced spontaneous diastolic Ca2+ elevation in DBH-Sap but not control hearts. In innervated hearts, sympathetic nerve stimulation (SNS) increased heart rate to a lesser degree in DBH-Sap hearts compared to control. Additionally, SNS produced APD80 prolongation in the apex of control but not DBH-Sap hearts. These results suggest that hypo-innervated hearts have regional super-sensitivity to circulating adrenergic stimulation (ISO), while having blunted responses to SNS, providing important insight into the mechanisms of arrhythmogenesis following sympathetic nerve loss.


Author(s):  
В.В. Шерстнёв ◽  
М.А. Грудень ◽  
О.В. Сенько ◽  
В.П. Карлина ◽  
А.В. Кузнецова ◽  
...  

В настоящее время доказано, что предгипертензия, характеризующая состояние лиц с артериальным давлением (АД) от 120/80 мм рт.ст. до 139/89 мм рт.ст., имеет высокую и постоянно возрастающую распространенность среди населения во всем мире и является независимым фактором риска формирования артериальной гипертонии, развития сердечно-сосудистой заболеваемости и смертности. Это делает актуальным изучение взаимосвязи развития предгипертензии с наличием других факторов риска сердечно-сосудистых заболеваний. Целью данного исследования явилось изучение гендерных особенностей взаимосвязи факторов риска сердечно-сосудистых заболеваний и развития предгипертензии. Методы исследования. Проведен сравнительный и корреляционный анализ показателей модифицируемых и немодифицируемых факторов риска сердечно-сосудистых заболеваний у 115 обследованных лиц мужского (n = 49) и женского пола (n = 66), средний возраст которых составил 47,6 ± 0,7 года с оптимальным АД (n = 63, АД < 120/80 мм рт.ст.) и предгипертензией (n = 52, АД 120-139/80-89 мм рт.ст.). Результаты исследования. Обнаружено, что мужчины и женщины с оптимальным АД и с предгипертензией различаются спектром факторов риска и структурой взаимосвязи исследованных показателей. У мужчин предгипертензия ассоциирована с повышенным содержанием креатинина в крови и табакокурением, тогда как у женщин - с гипертрофией левого желудочка сердца, стрессом и наследственной отягощенностью по гипертонической болезни. Развитие предгипертензии у женщин по сравнению с мужчинами характеризуется более выраженными количественными и качественными изменениями структуры взаимосвязей показателей исследованных факторов риска сердечно-сосудистых заболеваний. Заключение. Полученные результаты представляют интерес для понимания механизмов патогенеза предгипертензии и разработки стратегии её персонифицированной немедикаментозной и медикаментозной профилактики, основанной на устранении или ослаблении определенных факторов риска сердечно-сосудистых заболеваний. Currently it is proved that prehypertension characterizing the condition of individuals with blood pressure (BP) from 120/80 mm Hg to 139/89 mm Hg has a high, continuously increasing prevalence worldwide and is an independent risk factor for development of arterial hypertension and cardiovascular morbidity and mortality, which justifies studying the relationship between prehypertension and the presence of other risk factors for cardiovascular diseases. The aim of this study was to investigate gender features of the relationship between risk factors for cardiovascular disease and development of prehypertension. Methods. Comparative and correlation analyses of modifiable and non-modifiable cardiovascular risk factors were performed for 115 males (n = 49) and females (n = 66) aged 47.6 ± 0.7 with optimal BP (n = 63, BP < 120/80 mm Hg) or prehypertension (n = 52, AD = 120-139/80-89 mm Hg). Results. Men and women with optimal BP and prehypertension differed in the array of risk factors and the structure of relationship between the studied indices. In men, prehypertension was associated with an elevated blood creatinine and tobacco smoking whereas in women - with left ventricular hypertrophy, stress, and hereditary burden of hypertension. The development of prehypertension in women compared to men was characterized by more pronounced quantitative and qualitative changes in the structure of interrelationships between indices of the studied cardiovascular risk factors. Conclusion. The obtained results provide insight into pathogenetic mechanisms of prehypertension. They can be used for developing a strategy for individualized non-drug and drug prevention of hypertension based on elimination or reduction of certain cardiovascular risk factors.


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