scholarly journals Case Report of a Gore-Tex TCPC conduit dissection causing severe stenosis

2021 ◽  
Author(s):  
Oliver Bates ◽  
Thomas Semple ◽  
Sylvia Krupickova ◽  
Carles Bautista-Rodriguez
Keyword(s):  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Cross Sectional ◽  
Perimembranous Ventricular Septal Defect ◽  
Complex Anatomy ◽  
Cross Sectional Imaging ◽  
Accessory Hepatic Vein ◽  
Work Up ◽  
Atrioventricular Discordance ◽  
Fontan Patients

Abstract Background The patient is a 15-year-old male with situs inversus, dextrocardia, bilateral superior caval veins, atrioventricular discordance with a single outlet, large perimembranous ventricular septal defect, aortic override, pulmonary atresia and right aortic arch. The complex anatomy with a VSD distant from the aorta (unsuitable for baffling to the aorta) meant he was unsuitable for biventricular repair and proceeded down a univentricular palliation pathway. Case Summary Post TCPC his clinical course was uneventful until the age of five when he developed fatigability with desaturation. An accessory hepatic vein was surgically banded with improved saturations and exercise tolerance. At the age of fifteen CMR was performed to investigate borderline saturations and as work up for transition to adult services. CMR and cardiac CT imaging demonstrated an eccentric thrombus causing stenosis of the extra cardiac conduit and a thrombus outside of the lumen contained by the thin outer membrane of the Gore-Tex conduit. Collateralisation suggested this was longstanding. Cardiac catheterisation demonstrated a 4x6mm stenosis at the junction of the conduit with the pulmonary arteries. The region was successfully balloon dilated and stented with a 34 mm-long Cheatham Platinum (CP) stent, with no complications. Discussion To date this is the first documented case of a dissecting thrombus of a Gore-Tex graft in the literature. This case emphasises the need for anticoagulation and serial cross-sectional imaging (CT or CMR) in Fontan patients with prosthetic grafts throughout a patients’ lifetime.

State-of-the-art pulmonary arterial imaging – Part 2

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 361-375 ◽  
Author(s):  
Harold Goerne ◽  
Abhishek Chaturvedi ◽  
Sasan Partovi ◽  
Prabhakar Rajiah
Keyword(s):  
Pulmonary Artery ◽  
State Of The Art ◽  
Therapy Monitoring ◽  
Pulmonary Arteries ◽  
Imaging Modalities ◽  
Cross Sectional ◽  
Multiple Imaging ◽  
Cross Sectional Imaging ◽  
Pulmonary Arterial ◽  
Arterial Imaging

Abstract. Although pulmonary embolism is the most common abnormality of the pulmonary artery, there is a broad spectrum of other congenital and acquired pulmonary arterial abnormalities. Multiple imaging modalities are now available to evaluate these abnormalities of the pulmonary arteries. CT and MRI are the most commonly used cross-sectional imaging modalities that provide comprehensive information on several aspects of these abnormalities, including morphology, function, risk-stratification and therapy-monitoring. In this article, we review the role of state-of-the-art pulmonary arterial imaging in the evaluation of non-thromboembolic disorders of pulmonary artery.

scholarly journals A Pattern-based Imaging Approach to Pediatric Jaw Lesions

2021 ◽  
Author(s):  
Biswanath Sahu ◽  
Rama Anand ◽  
Sandeep Kumar ◽  
Ravi Shankar Solanki ◽  
Pravesh Mehra ◽  
...  
Keyword(s):  
Systematic Approach ◽  
Developmental Process ◽  
Pediatric Population ◽  
Careful Attention ◽  
Cross Sectional ◽  
Complex Anatomy ◽  
Infancy And Childhood ◽  
Imaging Approach ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

AbstractJaw lesions in the pediatric population, although infrequently encountered in clinical practice, can cause functional impairment and cosmetic disfiguring. It is further complicated by the difficulty in diagnosis due to complex anatomy and facial developmental process during infancy and childhood. Intraosseous pediatric jaw lesions may vary from odontogenic to nonodontogenic types with nonspecific clinical features in most cases. They deserve careful attention by a systematic approach to provide a relevant diagnosis or differential diagnosis for timely management. Imaging plays a major role in diagnosis with orthopantomograph being the foremost investigation, followed by cross-sectional imaging, essentially computed tomography as a problem-solving tool. This article highlights the imaging spectrum of various jaw lesions in the pediatric population with a pattern-based approach for radiological diagnosis.

Imaging of Pediatric Chronic Neck Infections

2017 ◽  
Vol 15 (05) ◽  
pp. 294-304
Author(s):  
Santhosh Gaddikeri ◽  
Murali Nagarajan ◽  
Surjith Vattoth ◽  
Ahmed El Beltagi
Keyword(s):  
Imaging Modality ◽  
Pediatric Population ◽  
Cross Sectional ◽  
Complex Anatomy ◽  
Cross Sectional Imaging ◽  
Ear Infections ◽  
Sectional Imaging ◽  
Primary Modality

AbstractChronic neck infections in the pediatric population can have an indolent presentation that can mimic more serious conditions including neoplasia. Ultrasound remains a reliable primary modality for imaging of sialadenitis and infected congenital cystic neck lesions in children, whereas cross sectional imaging is needed if intervention is contemplated, to better evaluate multispatial involvement, lymph nodal morphology and distribution, and as the primary imaging modality to study more complex anatomy in case of ear infections.

scholarly journals Sinonasal Chondrosarcoma, an Unusual Location

2020 ◽  
Author(s):  
Oumniya Abouhanine ◽  
Aicha Merzem ◽  
Vianney Ndayishimiye ◽  
Omar Amriss ◽  
Hasnaa Belgadir ◽  
...  
Keyword(s):  
Hard Palate ◽  
Locally Advanced ◽  
Long Bones ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Extension Work ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Left Maxillary Sinus ◽  
Work Up

Introduction: Chondrosarcoma is a tumour with a cartilaginous matrix frequently encountered in long bones and the pelvis with rare sinonasal location. Patient and methods: We report the case of a 25-year-old patient who was referred to us for an extension work-up for sinonasal chondrosarcoma confirmed by anatomopathological examination. Results: Facial magnetic resonance imaging (MRI) confirmed by a CT scan showed an osteolytic tumour process of the hard palate and walls of the left maxillary sinus that was locally advanced. Conclusion: The sinonasal location of a chondrosarcoma is rare. Characterized by cross-sectional imaging, confirmation was provided by histological assessment.

Persistent fifth aortic arch: the “great pretender” in clinical practice

2017 ◽  
Vol 28 (2) ◽  
pp. 175-181 ◽  
Author(s):  
David F. A. Lloyd ◽  
S. Y. Ho ◽  
Kuberan Pushparajah ◽  
Subhasis Chakraborty ◽  
Mohamed Nasser ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Imaging Techniques ◽  
Case Reports ◽  
Pulmonary Arteries ◽  
Postnatal Life ◽  
Diagnostic Features ◽  
Cross Sectional ◽  
Persistent Fifth Aortic Arch ◽  
Cross Sectional Imaging ◽  
Definition Of

AbstractPersistence of the embryonic “fifth aortic arch” in postnatal life is a rare, enigmatic – and at times controversial – condition, with variable anatomical forms and physiological consequences. First described in humans over 40 years ago by Van Praagh, the condition was labelled the “great pretender” by Gerlis 25 years later, because of its apparent propensity to mimic anatomically similar structures. Despite many subsequent case reports citing the condition, the true developmental origin of these structures remains unresolved, and has been the subject of debate among embryologists for more than a century. A persistent fifth aortic arch has been defined as an extrapericardial structure, arising from the ascending aorta opposite or proximal to the brachiocephalic artery, and terminating in the dorsal aorta or pulmonary arteries via a persistently patent arterial duct. This description may therefore encompass various anatomical forms, such as a unilateral double-lumen aortic arch, an unrestrictive aortopulmonary shunt, or a critical vascular channel for either the systemic or pulmonary circulation. The physiological properties of these vessels, such as their response to prostaglandins, may also be unpredictable. In this article, we demonstrate a number of cases that fulfil the contemporary definition of “persistent fifth aortic arch” while acknowledging the embryological controversies associated with this term. We also outline the key diagnostic features, particularly with respect to the use of new cross-sectional imaging techniques.

Pulmonary artery wall thickness in children with Fontan physiology: an optical coherence tomography case control study

2019 ◽  
Vol 29 (4) ◽  
pp. 524-527
Author(s):  
Eimear McGovern ◽  
Christine Voss ◽  
Nathan W. Brunner ◽  
Stephanie Duncombe ◽  
Kevin C. Harris ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Pulmonary Artery ◽  
Wall Thickness ◽  
Structural Changes ◽  
Pulmonary Arteries ◽  
Causative Factor ◽  
Optical Coherence ◽  
Artery Wall ◽  
Cross Sectional ◽  
Fontan Patients

AbstractIntroduction:Failure of the Fontan circulation is not a well-understood clinical phenomena.For some patients, a gradual increase in pulmonary vascular resistance (PVR) and structural changes in the pulmonary artery may be an important causative factor. To further investigate this issue, we employed optical coherence tomography (OCT) to evaluate structural changes within the pulmonary arteries of Fontan patients and compared to those with a normal pulmonary circulation.Materials and Methods:Pulmonary artery OCT was performed, without complications, in 12 Fontan and 11 control patients. Wall thickness and wall:vessel cross-sectional area (CSA) ratio were calculated after image acquisition, using digital planimetry.Results:There was no difference in wall thickness between both groups. Median wall thickness for Fontan patients was 0.12 mm (IQR, 0.10–0.14) and for controls was 0.11 mm (IQR, 0.10–0.12; p = 0.62). Wall:vessel CSA ratio for Fontan patients was 0.13 (IQR, 0.12–0.16) and for controls was 0.13 (IQR, 0.11–0.15) (p = 0.73). There was no association between wall thickness and ventricle morphology, age at catheterisation, age at Fontan, years since Fontan completion, pulmonary artery pressure, and PVR. The vessel media was more readily visualised in control patients.Discussion:OCT of the pulmonary arteries in Fontan patients is safe and feasible. Our OCT findings suggest that during childhood, pulmonary artery wall dimensions are normal in Fontan children with reassuring hemodynamics. Further evaluation of Fontan patients with abnormal hemodynamics and serial evaluation into adulthood are required to conclude on the utility of OCT for identifying early pulmonary artery structural changes.

Echocardiographic evaluation, management and outcomes of bilateral arterial ducts and complex congenital heart disease: 16 years' experience

2002 ◽  
Vol 12 (3) ◽  
pp. 272-277 ◽  
Author(s):  
Alejandro Peirone ◽  
Mustafa M. Abdullah ◽  
Frank Dicke ◽  
Robert M. Freedom ◽  
Jeffrey Smallhorn
Keyword(s):  
Blood Supply ◽  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Left Pulmonary Artery ◽  
Complex Congenital Heart Disease ◽  
Cross Sectional ◽  
Color Flow ◽  
Poor Outcomes ◽  
Collateral Vessels ◽  
The Right

Bilateral arterial ducts represent an uncommon form of pulmonary or systemic blood supply associated with complex congenital cardiac disease. We sought to determine the role of high-resolution cross-sectional echocardiography and color flow Doppler ultrasonography in assessing this condition, as well as to describe the management and outcome in a group of patients. A retrospective review was conducted of 11 newborns identified over a 16-year period as having bilateral arterial ducts. Pulmonary atresia associated with non-confluent pulmonary arteries was the dominant lesion, with the heterotaxy syndrome also frequently being recognized. Echocardiography best identified the source of blood supply to either the pulmonary or systemic circulations, allowing differentiation from collateral vessels. Stenosis of the right or left pulmonary artery at the initial site of ductal insertion needs careful evaluation on follow-up. Management of patients with this condition remains a challenge, as indicated by the poor outcomes observed in our series.

Abstract 15665: Can Pulmonary Vasodilators Grow Pulmonary Vasculature in Cases With Bidirectional Glenn for Fontan Candidates?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kousuke Yonehara
Keyword(s):  
Fontan Procedure ◽  
Pde5 Inhibitor ◽  
Pulmonary Arteries ◽  
Operative Management ◽  
Pulmonary Vasculature ◽  
Endothelin Receptor ◽  
Cross Sectional ◽  
Pulmonary Vasodilators ◽  
Pulmonary Flow ◽  
Fontan Patients

Background: The condition of pulmonary vasculature is a key to determine the outcome of Fontan candidates. The previous reports described no significant growth of pulmonary arteries (PA) after having bi-directional Glenn shunt (BDG), which may influence peri- and post-operative management of Fontan procedure. Aim: We hypothesized the pulmonary vasodilators (PVDs) facilitate to grow small PA even after BDG in Fontan Candidates. Method: The twenty-one cases after BDG, whose PA index (Nakata index) were less than 140 mm 2 /m 2 , were enrolled. The enrolled cases were divided into two group: 15 with PVDs treatment ( PV+) and 6 without (PV-). PVDs used in this study were PDE5 inhibitor, Endothelin-receptor-blocker, oral prostacyclines , and their combination. In addition to measure the hemodynamic parameters ( mean PA pressure(mPAp), indexed pulmonary vascular resistance (Rp), Pulmonary flow (Qp) ), PA index and PA branch index ( a sum of cross-sectional area of first PA branches at both side indexed by body surface area) were measured and compared at the timing of after BDG and at after Fontan completion, respectively. Result: PA index and PA branch index after BDG of (PV+) and (PV-)were 104±33 vs 104±17 mm 2 /m 2 : 151±33 vs 194±45 mm 2 /m 2 . PA index in both groups after Fontan procedure was increased up to 153±42 vs 152±56 mm 2 /m 2 in same fashion, while PA branch index of (PV+) was significantly increased up to 199±60 than that of (PV-) 226±65 mm 2 /m 2 (% increase was 131% vs 116%). Rp and mPAp in both groups were not changed , while Qp in (PV+) was significantly more increased (140%) than that in (PV-)(107%). In conclusion, PVDs facilitates the growth of PA branches by increasing Qp, which brings a favor outcome of Fontan patients.

Solitary arterial trunk

1994 ◽  
Vol 4 (1) ◽  
pp. 71-74
Author(s):  
Daniel J. Penny ◽  
Rakesh Dua ◽  
James L. Wilkinson
Keyword(s):  
Ventricular Septal Defect ◽  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Pulmonary Trunk ◽  
Descending Aorta ◽  
Perimembranous Ventricular Septal Defect ◽  
Arterial Trunk ◽  
Pulmonary Arterial

AbstractA heart is described in which there was a solitary arterial trunk that exited from the heart astride a large perimembranous ventricular septal defect, with the pulmonary arterial supply originating entirely from collaterals from the descending aorta. There was no evidence of either hilar pulmonary arteries or an atretic pulmonary trunk. The morphology of the ventricular outlet component, with absence of the outlet septum supports the description of this heart as solitary arterial trunk, rather than tetralogy of Fallot with pulmonary atresia.

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