scholarly journals P1445 DORv and window: a case of an uncorrected double outlet right ventricle with d-transposition of great arteries with concomitant aortopulmonary window in a 31-year-old female

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Enero ◽  
S Obillos ◽  
P Yao ◽  
E Dizon ◽  
V Choa ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Main Pulmonary Artery ◽  
Double Outlet Right Ventricle ◽  
Left Ventricular ◽  
Aortopulmonary Window ◽  
Transposition Of Great Arteries ◽  
Severe Aortic Regurgitation ◽  
The Third ◽  
The Right

Abstract Funding Acknowledgements none Double outlet right ventricle (DORV) is a rare type of ventriculo-arterial connection occurring in about 1-3% of congenital heart defects. Moreover, transposition of the great arteries, wherein the aorta is anterior and to the right of the pulmonary artery (D-TGA), accounts for only 26% of cases of DORV. An aortopulmonary window, on the other hand, represents approximately only 0.2% of all congenital cardiac lesions. A case of DORV with D-TGA and pulmonary stenosis with a concomitant aortopulmonary window has never been reported, particularly in an adult in the third decade of life and without any history of surgical repair. We present the case of a 31-year-old female who had sought consult for left-sided weakness. On physical examination, a grade IV/VI systolic murmur was heard at the left anterior chest and cyanosis of the digits of the upper and lower extremities were noted. Transthoracic echocardiogram revealed a non-restrictive ventricular septal defect (VSD) and segmental approach showed atrial and visceral situs solitus, levocardia, and atrioventricular concordance. However, there was ventriculoarterial discordance with fusiform aneurysmal dilatation of the aorta, which was noted to be at the right of and anterior to the pulmonary artery. Both great vessels arose from the right ventricle. Other echocardiographic findings included dilated right atrium, dilated and hypertrophied right ventricle with volume and pressure overload, global left ventricular hypokinesia with mild systolic dysfunction, and moderate to severe aortic regurgitation. The above complex congenital anomalies were confirmed via transesophageal echocardiogram and cardiac magnetic resonance imaging (MRI). Furthermore, pulmonary valve stenosis and aortopulmonary window, that was 3.5 centimeters in length located at the level of the proximal ascending aorta and main pulmonary artery, were seen on the MRI. Various cardiac imaging modalities aided in cinching the diagnosis for this very rare complex congenital case in an adult reaching the third decade of life. Palliative care was deemed best for this patient due to the severity of her cardiac condition. Abstract P1445 Figure 1.

Absence of the coronary sinus with coronary venous drainage into the main pulmonary artery

2012 ◽  
Vol 23 (5) ◽  
pp. 759-762
Author(s):  
Kiyoshi Ogawa ◽  
Takashi Hishitani ◽  
Kenji Hoshino
Keyword(s):  
Coronary Angiography ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Contrast Medium ◽  
Coronary Arteries ◽  
Coronary Sinus ◽  
Main Pulmonary Artery ◽  
Venous Drainage ◽  
Anterior Wall ◽  
The Right

AbstractWe describe the case of a 9-year-old girl demonstrating isolated absence of the coronary sinus with abnormal coronary venous drainage into the main pulmonary artery. Coronary angiography showed normal coronary arterial trees and contrast medium from both coronary arteries drained into the main pulmonary artery via an abnormal cardiac vein on the anterior wall of the right ventricle.

scholarly journals Clostridium septicum-induced gangrene in the right lower extremity complicating pneumatosis in the right ventricle and the pulmonary artery and occlusion of right femoral artery: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui-Dan Jing ◽  
Lei Li ◽  
Jun-Ying Tian ◽  
Dong-Po Jiang
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Femoral Artery ◽  
Treatment Success ◽  
Main Pulmonary Artery ◽  
Arterial Occlusion ◽  
Air Embolism ◽  
Gas Gangrene ◽  
Clostridium Septicum ◽  
The Right

Abstract Background Gas gangrene is usually manifested as myonecrosis and subcutaneous gas accumulation, but rarely manifested as arterial occlusion or pneumatosis in the right ventricle and the pulmonary artery. Case presentation We report a case of gas gangrene caused by Clostridium septicum. The patient developed gas gangrene after being pecked by a chicken but turned for the better following antibiotic treatment and debriment. Imaging test revealed a rare occlusion of the right femoral artery and pneumatosis in the right ventricle and the main pulmonary artery. Conclusions In the presence of gas gangrene, special care must be taken to prevent against the formation of circulatory air embolism. The gas gangrene-induced gangrene in the limb of this patient might be attributed to the combined action of infection and arterial occlusion. MDT (Multidisciplinary team)-Green Channel mode is conductive to treatment success of gas gangrene.

scholarly journals Does Larger Fetal Ascending Aorta Than the Pulmonary Artery Indicate Major Cardiac Anomaly?

2020 ◽  
pp. 1
Author(s):  
Safak Yilmaz Baran ◽  
Alev Arslan ◽  
Gulsen Dogan Durdag ◽  
Hakan Kalayci ◽  
Seda Yuksel Simsek ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Valve ◽  
Main Pulmonary Artery ◽  
Double Outlet Right Ventricle ◽  
Ascending Aorta ◽  
Pulmonary Valve Stenosis ◽  
Chamber View ◽  
Aorta Diameter ◽  
Pulmonary Artery Diameter

<p><strong>OBJECTIVE:</strong> This study investigated the cases in which the fetal ascending aorta is larger than the main pulmonary artery on the three-vessel view and aimed to determine the relationship between the larger ascending aorta and major cardiac anomalies.</p><p><strong>STUDY DESIGN:</strong> Pregnancies between 18-24 gestational weeks who underwent detailed second-trimester screening during 2015-2019 were evaluated. Cases whose fetal ascending aorta diameter was larger than fetal main pulmonary artery diameter on the three-vessel view despite normal four-chamber view were analyzed. Prenatal and postnatal echocardiography studies were performed for each case.</p><p><strong>RESULTS:</strong> Fetal ascending aorta diameter larger than fetal main pulmonary artery diameter on the three-vessel view despite normal four-chamber view was detected in 21 fetuses in a total of 3810 pregnancies (0.55%), and 10 (47.6%) of them had major congenital heart disease. The diagnosis of Tetralogy of Fallot, double outlet right ventricle, ventricular septal defect, pulmonary valve stenosis, and moderate to severe tricuspid regurgitation were confirmed with prenatal/postnatal echocardiography studies. The highest ratio of ascending aorta/main pulmonary artery was 1.4 in a fetus with a double outlet right ventricle and pulmonary valve stenosis.</p><p><strong>CONCLUSION:</strong> The fetal ratio of ascending aorta/main pulmonary artery larger than 1 on the three-vessel view may be a sign of certain cardiac anomalies. Nevertheless, this rate is not an indicator of a serious cardiac defect in all cases. Fetal advanced echocardiography and early postnatal cardiac evaluation should be done to confirm the diagnosis.</p>

Anomalous origin of both pulmonary arteries from the ascending aorta with a nonbranching main pulmonary artery arising from the right ventricle

1990 ◽  
Vol 11 (3) ◽  
pp. 156-158 ◽  
Author(s):  
Hiroyuki Aotsuka ◽  
Yoko Nagai ◽  
Manabu Saito ◽  
Hiroo Matsumoto ◽  
Tsunetaro Nakamura
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Ascending Aorta ◽  
Anomalous Origin ◽  
The Right

Pulmonary hypertension induced with an intra-arterial balloon: an alternate mechanism

1986 ◽  
Vol 61 (2) ◽  
pp. 746-751 ◽  
Author(s):  
T. C. Lloyd ◽  
C. E. Juratsch
Keyword(s):  
Pulmonary Artery ◽  
Arterial Pressure ◽  
Main Pulmonary Artery ◽  
Balloon Catheter ◽  
Pulmonary Arteries ◽  
Pressure Rise ◽  
Left Ventricular ◽  
Balloon Inflation ◽  
Right Pulmonary Artery ◽  
The Right

The Laks catheter is a triple-lumen balloon catheter used to distend the canine main pulmonary artery while recording right ventricular pressure and the arterial pressure distal to the balloon. A rise in arterial pressure reported to occur during distension has been attributed to vasoconstriction rather than passive obstruction by the balloon. We tested this in six anesthetized dogs by inflating the Laks catheter-balloon while recording pressure distal to the balloon from the Laks catheter as well as from additional catheters in right and left pulmonary arteries placed retrogradely through lobar branches following thoracotomy. We found that balloon inflation increased pressures in the arterial port of the Laks catheter and in the left pulmonary artery catheter but reduced it in the right pulmonary artery. Tightening a snare around the right pulmonary artery had the same effects on pressures. Similar results were obtained while cardiac output was controlled by left ventricular bypass perfusion in four dogs. We conclude that the Laks catheter-balloon obstructs flow to the right lung and that the arterial pressure rise recorded in it during balloon inflation cannot be distinguished from that caused by occlusion of the right pulmonary artery.

P885 Pulmonary artery stent implantation in an adult with chronic thromboembolic pulmonary stenosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E A Khalifa ◽  
S Helmy ◽  
F Elallus ◽  
S F Mohamed ◽  
M Alkuwari
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Stent Implantation ◽  
Pulmonary Valve ◽  
Main Pulmonary Artery ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Pulmonary Artery Stenosis ◽  
The Right

Abstract Introduction Pulmonary artery stenosis presenting in adults is rare. Chronic thromboembolic pulmonary hypertension (CTEPH) is by far the most common cause of pulmonary artery stenosis. Stenosis in these patients are not caused by an abnormality of the arterial wall itself, but by intraluminal narrowing as a result of the only partially resolved and organized thromboembolism. In contrast to paediatric patients, in adults with pulmonary artery stenosis, pulmonary stenting is not routinely performed. Case report A 51-year male, smoker, diabetic, hypertensive, and with chronic kidney disease. He was diagnosed two years earlier with bilateral multiple pulmonary emboli and was maintained on oral anticoagulation therapy. Recently, he presented with gradually progressive shortness of breath and signs of right ventricular failure. Diagnostic imaging: 1-Transthoracic and transesophageal echocardiography showed normal global systolic left ventricular function with no regional wall motion abnormalities, dilated right ventricle (RV) with moderately impaired function, severe pulmonic valve incompetence, mild tricuspid incompetence and a severely elevated right ventricular systolic pressure (RVSP) of 82 mmHg. In addition, a small rounded mass (6 x 11 mm) was visualized attached to the posterior wall of the RV outflow tract (RVOT) about 15mm proximal to the pulmonary valve annulus, (figure A). 2- Computed tomography pulmonary angiography showed a right main pulmonary artery (RPA) with circumferential narrowing, which was highly suggestive of chronic thrombosis. There was an abrupt tapering noted in the segmental branches of the right lower lobar pulmonary artery, with non-opacification of the distal arteries. No contrast opacification was noted in the right upper lobe pulmonary arteries. The left main pulmonary artery showed thickening of its bifurcation, again suggestive of chronic thrombosis, with narrowing of its left upper lobar branch, (figures B&C). 3-Cardiac magnetic resonance (CMR) showed a non enhancing RVOT mass protruding through the incompetent pulmonary valve during systole with features suggestive of a thrombus. Management In view of the clinical history, CTEPH was considered to be the most likely aetiology of the pulmonary hypertension. The decision was to perform balloon angioplasty and stent implantation in the RPA. Immediately after the procedure, RVSP was reduced from 80 to 50 mmHg. The clinical course after this procedure was uncomplicated and the patient showed significant clinical improvement. Follow up CMR showed patent stent with improvement of RV function ( fig D) Abstract P885 Figure.

Repair of double outlet right ventricle with doubly-committed ventricular septal defect

2001 ◽  
Vol 11 (4) ◽  
pp. 415-419 ◽  
Author(s):  
Hideki Uemura ◽  
Toshikatsu Yagihara ◽  
Takayuki Kadohama ◽  
Youichi Kawahira ◽  
Yoshiro Yoshikawa
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Pulmonary Stenosis ◽  
Pulmonary Arteries ◽  
Ventricular Outflow Tract ◽  
Double Outlet Right Ventricle ◽  
Left Ventricular ◽  
Aortic Orifice ◽  
The Right

Objective: To investigate our surgical results of intraventricular rerouting in patients having double outlet right ventricle with doubly-committed ventricular septal defect. Methods: We undertook repair in 8 patients with this particular feature. Of these, 2 patients had pulmonary stenosis, and another had interruption of the aortic arch. The subarterial defect was unequivocally related to both the aortic and the pulmonary orifices in all, albeit slightly deviated towards the aortic orifice in one, and towards the pulmonary orifice in another. Intraventricular rerouting was carried out via incisions to the right atrium and the pulmonary trunk. To ensure reconstruction of an unobstructed pulmonary pathway, a limited right ventriculotomy was made in 5. Results: All patients survived the procedure, and are currently doing well, with follow-up of 25 to 194 months, with a mean of 117 ± 68 months. Catheterization carried out 16 ± 6 months after repair demonstrated excellent ventricular parameters. Mean pulmonary arterial pressure was 16 ± 7 mmHg, being higher than 20 mmHg in 2 patients. No significant obstruction was found between the right ventricle and the pulmonary arteries. A pressure gradient across the left ventricular outflow tract became significant in one patient in whom a small outlet septum was present, and a heart-shaped baffle had been used for intraventricular rerouting. Reoperation was eventually needed in this patient for treatment of the obstruction, which proved to be progressive. Conclusion: Precise recognition of the morphologic features is of paramount importance when choosing the optimal options for biventricular repair in patients with double outlet right ventricle and doubly-committed interventricular communication.

scholarly journals Remodeling Process in the Right and Left Atria and Ventricles Following Percutaneous Closure of the Atrial Septal Defect in Children and Adolescents: A Mid-term Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hamid Amoozgar ◽  
Saeed Safniyat ◽  
Mohammad Reza Edraki ◽  
Hamid Mohammadi ◽  
Nima Mehdizadegan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Main Pulmonary Artery ◽  
Left Ventricular ◽  
Defect Closure ◽  
Atrial Septal Defect Closure ◽  
Z Scores ◽  
The Right

Background: Atrial septal defect and its closure can lead to changes in the right and left cardiac cavities' function and size. In this study, Z-scores of the cardiac chambers and the heart function were assessed, and the important complications were mentioned. Methods: This interventional cross-sectional study was done on patients who had atrial septal defect closure aged younger than 18 years. All patients were recruited for transthoracic echocardiography. About half of the patients were randomly selected. The information of angiography and its side effects belong to all patients, but the echocardiographic parameters and Z-scores belong only to the selected group. Results: A total of 370 patients underwent the atrial septal defect closure, of whom 150 patients participated in the study. The patients' average age and weight were 9.25 ± 3.44 years and 15.12 ± 11.83 kg, respectively, and the mean follow-up time was 2.56 years. Z-scores of the interventricular septal dimension in diastole, the left ventricular posterior wall dimension in diastole, the left ventricular internal dimension in systole, and Z-scores of the size of the right atrium, right ventricle, pulmonary valve annulus, and the main pulmonary artery were more than Z-scores of the normal population. Furthermore, Z-scores of the E/A and the Eat/Aat of the tricuspid valve were less than their peers. Besides, the correlation between Z-scores and the atrial septal defect size and weight of the patients was assessed, which was statistically significant, and patients who underwent atrial special defect closure at the age of fewer than three years and less than 15 kg had more normal cardiac Z-scores. Conclusions: Z-scores of the cardiac chambers and pulmonary artery were more than normal after successful closure of the atrial septal defect in the mid-term follow-up.

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