scholarly journals Evaluation and Cardiac Rehabilitation on a patient with a congenital heart disease

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
A Felix
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Artery ◽  
Cardiac Rehabilitation ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Interindividual Variation ◽  
Initial Assessment ◽  
Control Group ◽  
Developmental Outcome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Severe congenital heart disease (CHD) requiring surgical intervention occurs in 6 of 1000 live-born infants. Substantial improvements in surgical treatment and perioperative care have led to excellent long-term cardiac outcomes for most of these patients and, consequentially, to a significant increase in survival rates. Formal evaluations of preschool, school-aged children and adolescents born with complex CHD demonstrate a pattern of neurodevelopmental sequelae, which may appear alone, or in combination. Purpose F. is a 21 years-old patient with repaired complex transposition of the great arteries with ventricular septal defect, who have already undergone three surgeries: a) an initial palliative surgery (pulmonary artery banding and ductus arteriosus ligation) at the neonatal period; b) a corrective surgery (arterial switch and VSD closure) at the end of the first year of life and c) Pulmonary artery plasty for residual pulmonary stenosis at the age of 16 years-old. Now, he was admitted to our department for urgent wide-complex tachycardia treatment.  His initial assessment documented a subjectively impaired motor development, and subsequently, a formal assessment was performed. Methods The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) is an individually administrated test that resorts to a series of engaging, goal-directed activities to measure a wide array of motor skills in individuals ages 4 through 21. The BOT-2 uses a subtest and composite structure that highlights motor performance in the broad functional areas of stability, mobility, strength, coordination, and object manipulation. Results Patient"s performance in the four main motor skill areas will be report, namely: Fine Manual Control, Manual Coordination, Body Coordination, and Strength and Agility. Because Fabio completed all four parts of the BOT-2, a comprehensive score from all four areas, the Total Motor Composite, will also be reported. Fabio"s scores were compared to the ones of a control group of age and gender-matched individuals. This Patient started sessions of Cardiac Rehabilitation. The rehabilitation sessions are conducting for 1 hour three times a week for 1 year. This program still in progress, but we speculate that the will improve his motor abilities and developmental skills. Conclusion The risk of a poor developmental outcome varies according to the specific cardiac effect. In addition, there is significant interindividual variation in developmental outcome even among children with the same cardiac defect. Other factors may contribute to neurologic dysfunctions. These factors can be divided into three main categories and time-frames: prenatal, perioperative and post-discharge.

scholarly journals REVERSE PDA – LESS COMMON TYPE OF PATENT DUCTUS ARTERIOSUS -CASE REPORT

2016 ◽  
Vol 73 (2) ◽  
pp. 351 ◽  
Author(s):  
Iuliu Scurtu ◽  
Cosmin Pestean ◽  
Radu Lacatus ◽  
Meda Lascu ◽  
Mircea Mircean ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Right Ventricle ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Positive Diagnosis ◽  
The Right ◽  
Patent Ductus

Introduction: PDA represents one of the most frequently diagnosed type of congenital heart disease. Ductus arteriosus is a normal structure in foetal life, which permits shunting of oxygenated blood from the pulmonary artery into the aorta. Failure of sealing after birth is an abnormal condition and is called patent ductus arteriosus. In normal PDA, due to fact that systemic pressure is fivefold higher than pulmonary circulation, blood is shunted from the aorta into the pulmonary artery. In reverse PDA, pulmonary artery pressure does not drop after birth, and blood will be shunted form right to left. Aims: We want to evaluate clinical, haematological, ECG and echocardiographic changes in case of reverse PDA. Materials and Methods: Two-year old female Bichon Frise was referred to our clinic with signs of effort intolerance and dyspnoea for more than a year. ECG was performed in the right lateral recumbency using a digital device and echocardiography was done with Esaote MyLab40 Vet with a phased array transducer matched with the size of the dog (7.5 MHz). Results: We identified a dog with a good body score, quite alert and without any sign of illness. Haematological investigation underlined polycythaemia and very high PCV. The ECG revealed a normal sinus rhythm with a deep S wave, changes consistent with right ventricle enlargement.  Right atrial dilation and right ventricle hypertrophy were found on cardiac ultrasonography. The right ventricle free wall was hypertrophied and interventricular septum was flattened, changes consistent with increased pressure on the right side of the heart. The left heart was small. Positive diagnosis was done, performing “bubble study” and identification of contrast bubble within the abdominal aorta.   Conclusion: Reverse PDA is a rarely diagnosed congenital heart disease. Polycythaemia in young dogs could raise the suspicion of reverse PDA.  For positive diagnosis, echocardiography and bubble study are required. ECG is not a sensitive tool for diagnosis.

scholarly journals Translational value of partial resection of the pulmonary artery wall for congenital heart disease-induced bronchial compression

2019 ◽  
Vol 47 (10) ◽  
pp. 4949-4957
Author(s):  
Xiangyang Wu ◽  
Jie Zhu ◽  
Hao Liu ◽  
Wensheng Chen ◽  
Yalin Wei ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Treatment Group ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Partial Resection ◽  
Control Group ◽  
Artery Wall ◽  
Severe Congenital Heart Disease ◽  
Bronchial Compression

Objective This study was performed to evaluate the clinical efficacy and safety of a novel surgical procedure in treating tracheal or bronchial compression related to severe congenital heart disease. Methods The clinical data of 28 patients with tracheal or bronchial compression related to severe congenital heart disease were retrospectively analyzed. In the control group, 12 patients underwent surgery for congenital cardiac malformations. In the treatment group, 16 patients underwent surgery for congenital cardiac malformations combined with partial resection of the pulmonary artery wall. The cardiothoracic ratio, pulmonary arterial pressure, left ventricular end-diastolic dimension, diameter of the pulmonary artery, and diameter of the trachea in the stenotic segment were quantitatively measured before and 9 days after the operation. Results The diameter of the pulmonary artery and diameter of the trachea in the stenotic segment were almost restored to the normal range in the treatment group. Patients in the treatment group recovered more rapidly and effectively than those in the control group. Conclusion Partial resection of the pulmonary artery wall is an efficacious and safe technique in the treatment of tracheal or bronchial compression related to severe congenital heart disease.

A retrospective analysis of a pediatric tele-echocardiography service to treat, triage, and reduce trans-Pacific transport

2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Medical Centers ◽  
Prompt Diagnosis ◽  
Patent Ductus

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.

scholarly journals Identification and characterization of a novel ELN mutation in congenital heart disease with pulmonary artery stenosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cuilan Hou ◽  
Junmin Zheng ◽  
Wei liu ◽  
Lijian Xie ◽  
Xiaomin Sun ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Artery ◽  
Molecular Mechanism ◽  
Protein Level ◽  
Congenital Heart ◽  
Artery Stenosis ◽  
Pulmonary Artery Stenosis ◽  
Functional Component ◽  
Functional Changes

AbstractCongenital heart defects, one of the most common birth defects, affect approximately 1% of live birth globally and remain the leading cause of infant mortality in developed countries. Utilizing the pathogenicity score and inheritance mode from whole exome sequencing results, a heterozygous mutation (NM_001278939.1: c.1939G>T, p.Gly647Ter) in elastin (ELN) was identified among 6,440 variants in a female proband born with an atrial septal defect accompanied by pulmonary artery stenosis. Results of RT-PCR showed that the mutation (NM_001278939.1: c.1939G>T, p.Gly647Ter) did not affect the expression levels of ELN mRNA but increased protein level. The content of ELN truncate (functional component) was significantly lower in both the intracellular and extracellular compartments after mutation. These results indicate that the ELN mutation (NM_001278939.1: c.1939G>T, p.Gly647Ter) affected the protein truncate, which may be a functional component of ELN and play crucial roles for this pedigree. Here we report of an ELN heterozygous variant associated with congenital heart disease accompanied with pulmonary artery stenosis, which is less common. Based on our results, we speculate that this may be the main molecular mechanism underlying the mutation-led functional changes, and propose that the decrease of ELN protein level may cause this pedigree vascular abnormality, especially pulmonary artery stenosis, and reinforce the view that ELN insufficiency is the primary cause of these vascular lesions. This may be the main molecular mechanism underlying the mutation-led functional changes. Thus, systematic analysis not only enables us to better understand the etiology of this disease but also contributes to clinical and prenatal diagnosis.

scholarly journals Anomalous Origin of the Left Anterior Descending Coronary Artery in an Adult

2021 ◽  
Vol 10 (01) ◽  
pp. e9-e10
Author(s):  
Keisuke Shibagaki ◽  
Chikara Shiiku ◽  
Hiroyuki Kamiya ◽  
Yoichi Kikuchi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Left Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Anomalous Origin ◽  
Bypass Grafting

AbstractAn anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Among the variants, an anomalous origin of the left anterior descending coronary artery from the pulmonary artery (ALADPA) is extremely rare. Here, we report a case of ALADPA in an adult that was treated with coronary artery bypass grafting using the left internal thoracic artery.

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