scholarly journals STUDIES OF CONGENITAL HEART DISEASE. II. THE PRESSURE AND OXYGEN CONTENT OF BLOOD IN THE RIGHT AURICLE, RIGHT VENTRICLE, AND PULMONARY ARTERY IN CONTROL PATIENTS, WITH OBSERVATIONS ON THE OXYGEN SATURATION AND SOURCE OF PULMONARY “CAPILLARY” BLOOD 1

1947 ◽  
Vol 26 (3) ◽  
pp. 554-560 ◽  
Author(s):  
L. Dexter ◽  
F. W. Haynes ◽  
C. S. Burwell ◽  
E. C. Eppinger ◽  
R. P. Sagerson ◽  
...  
Author(s):  
Iuliu Scurtu ◽  
Cosmin Pestean ◽  
Radu Lacatus ◽  
Meda Lascu ◽  
Mircea Mircean ◽  
...  

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.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Abdullah Mohammed Mustafa Hegab ◽  
Amr Mansour Mohammed ◽  
Yasmine Abd Elrazek Ismail ◽  
Alaa Mahmoud Roshdy

Abstract Background Surgery for congenital heart disease has progressed by leaps and bounds in the last few decades, but the right ventricular outflow tract continues to pose a challenge to the congenital heart surgeon. Objective To describe short and intermediate term outcome in congenital heart disease patients undergoing surgical repair using right ventricle to pulmonary artery conduits. Patients and Methods Our study included 33 patients that were operated upon by putting a conduit between the right ventricle and the pulmonary artery in a single center (Al Agouza police hospital) between 2015 and 2019. Results This study was done in order to follow up patients who underwent surgery for conduit placement between the right ventricle (RV) and the pulmonary artery (PA), to observe the reintervention rates and to determine the most important determinants of re-operation. 33 patients were included in this study, with age range 1.5-17 years and mean age of 8.29 +/- 4.7 years. The mean age at placement of the first conduit was 3.57 +/- 3.18 years. The youngest patient at time of conduit placement for the first time was 0.2 years old and the oldest had 12.5 years. Conclusion The use of conduits to treat the RV to PA discontinuity is a cornerstone in the treatment of some congenital heart diseases requiring construction of the right ventricle outflow tract (RVOT). Nevertheless, conduit failure and replacement is inevitable, and depends on many factors: as age at first operation, type of conduit, mean and peak pressure gradient across the conduit. The higher the age at first conduit, the bigger the event / re-intervention free survival period.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nadya Al-Wakeel-Marquard ◽  
Tiago Ferreira da Silva ◽  
Sarah Jeuthe ◽  
Sanaz Rastin ◽  
Frédéric Muench ◽  
...  

AbstractThe right ventricle´s (RV) characteristics—thin walls and trabeculation—make it challenging to evaluate extracellular volume (ECV). We aimed to assess the feasibility of RV ECV measurements in congenital heart disease (CHD), and to introduce a novel ECV analysis tool. Patients (n = 39) and healthy controls (n = 17) underwent cardiovascular magnetic resonance T1 mapping in midventricular short axis (SAX) and transverse orientation (TRANS). Regions of interest (ROIs) were evaluated with regard to image quality and maximum RV wall thickness per ROI in pixels. ECV from plane ROIs was compared with values obtained with a custom-made tool that derives the mean T1 values from a “line of interest” (LOI) centered in the RV wall. In CHD, average image quality was good (no artifacts in the RV, good contrast between blood/myocardium), and RV wall thickness was 1–2 pixels. RV ECV was not quantifiable in 4/39 patients due to insufficient contrast or wall thickness < 1 pixel. RV myocardium tended to be more clearly delineated in SAX than TRANS. ECV from ROIs and corresponding LOIs correlated strongly in both directions (SAX/TRANS: r = 0.97/0.87, p < 0.001, respectively). In conclusion, RV ECV can be assessed if image quality allows sufficient distinction between myocardium and blood, and RV wall thickness per ROI is ≥ 1 pixel. T1 maps in SAX are recommended for RV ECV analysis. LOI application simplifies RV ECV measurements.


Author(s):  
Fatchul Wahab ◽  
Mahrus Abdul Rahman ◽  
Teddy Ontoseno ◽  
Risa Etika ◽  
Alit Utamayasa ◽  
...  

ABSTRACT Delay diagnosis of Critical Congenital Heart Disease (CHD) can be associated with sudden clinical deterioration and dangerous cardiovascular conditions. The oxygen saturation screening among newborns in the first 10 hours of life is essential for early detection of critical CHD. This study aims to prove that measuring oxygen saturation among newborns in the first 10 hours of life can detect critical CHD. This study is a diagnostic experimental with consecutive sampling subjects in the infant care unit of Dr. Soetomo Hospital, including all newborns with birth weight ≥ 1500 grams and oxygen saturation at ≥ 1 hour of age below 90%. The measurement of oxygen saturation uses fingertip pulse oximetry in the right hand and foot at the age of 10 hours. A "positive oxygen saturation" is defined as oxygen saturation ≤ 85% or different oxygen saturation ≥ 3%, while a "negative oxygen saturation" is when the oxygen saturation is 85% to 90% or different oxygen saturation is 3%. Echocardiography is performed for the gold standard. From November 2019 to January 2020, 11 newborns underwent an oxygen saturation examination. Five subjects (45.46%) in the category of positive oxygen saturation, echocardiographic showed all Critical CHD (100%). Six subjects (54.54%) with negative oxygen saturation category, echocardiographic results showed two critical CHD (33.34%) and four non-critical CHD (66.66%). Fisher's exact test p < 0.005 (α). The diagnostic oxygen saturation test among newborns at 10 hours of life shows ≤85%, all subject’s echocardiography (100%) shows detection of critical CHD, while saturation 85% to 90% has of 33.3% for detection of critical CHD. The sensitivity and specificity of oxygen saturation for early diagnosis of critical CHD are 100% and 67%, respectively. Keywords: critical congenital heart disease, oxygen saturation, fingertip pulse oximetry, diagnostic tests*Corresponding Author: [email protected]


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