Congenital isolated absence of a single cusp of pulmonary valve

A 25-year-old, previously asymptomatic female, presented to the outpatient clinic with episodic palpitations for past 6 months. She was acyanotic and showed no peripheral stigmata of infective endocarditis. Transthoracic echocardiography revealed dilated right ventricle with severe low-pressure pulmonary regurgitation. A cardiac computed tomography angiography performed for evaluation of pulmonary arterial circulation and intracardiac anatomy revealed isolated absence of posterior pulmonary cusp. The two other (right anterior and left anterior) cusps were normal and covered only part of the valve orifice, resulting in pulmonary insufficiency. The main pulmonary artery showed asymmetric dilatation. No other structural heart defects were noted.

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Cardiac Computed Tomography Angiography for Imaging Coronary Arteriovenous Malformation: a Case Report

Acta Medica Marisiensis ◽

10.2478/amma-2014-0006 ◽

2014 ◽

Vol 60 (1) ◽

pp. 22-24

Author(s):

Suciu Zsuzsanna ◽

Jakó Beáta ◽

Benedek Theodora ◽

Benedek I

Keyword(s):

Computed Tomography ◽

Case Report ◽

Coronary Artery ◽

Pulmonary Artery ◽

Arteriovenous Malformation ◽

Computed Tomography Angiography ◽

Cardiac Computed Tomography ◽

Main Pulmonary Artery ◽

Cardiac Computed Tomography Angiography ◽

Ionic Contrast

Abstract Background: Coronary arteriovenous malformation is a rare congenital disease consisting mainly in a direct communication between a coronary artery and any one of the four cardiac chambers, coronary sinus, pulmonary arteries or veins. This disease can lead to various cardiovascular events, their severity depending on the degree of the malformation. Case report: We present the case of a 56-year-old male patient, who was admitted to our institution with dyspnea, palpitation and chest pain, having a history of hypertension and hyperlipidemia, and an abnormal electrocardiogram. Physical examination did not reveal any alterations and the cardiac enzymes were in normal ranges. Cardiac computed tomography was performed before any other invasive studies, with a 64-row scanner (Somatom Sensation multislice 64 equipment, Siemens) after intravenous administration of non-ionic contrast material. CT scan revealed a large (2-2.5 mm) coronary fistula originating from the LAD to the main pulmonary artery, and multiple significant atherosclerotic coronary lesions. Coronary angiography confirmed the arteriovenous malformation between LAD and pulmonary artery, associated with three vascular coronary artery disease. Conclusions: Cardiac computed tomography angiography can help for a non-invasive diagnosis of the coronary artery malformations, in the same time revealing anatomic details which can be particulary useful for choosing the appropriate management strategy (surgical planning, interventional treatment or optimum medical treatment)

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Damus–Kaye–Stansel procedure 5 years after Fontan operation with ligated main pulmonary artery

Cardiology in the Young ◽

10.1017/s1047951112001436 ◽

2012 ◽

Vol 23 (4) ◽

pp. 613-616

Author(s):

Mohsen Karimi ◽

Carol A. Rosenberg ◽

William Lutin

Keyword(s):

Computed Tomography ◽

Pulmonary Artery ◽

Surgical Planning ◽

Pulmonary Valve ◽

Cardiac Computed Tomography ◽

Fontan Operation ◽

Main Pulmonary Artery ◽

Three Dimensional ◽

Subaortic Stenosis ◽

Extracardiac Fontan

AbstractWe report a case of tricuspid atresia with transposed great arteries and rudimentary right ventricle owing to which the patient developed severe subaortic stenosis and restrictive bulboventricular foramen 5 years after her extracardiac Fontan operation. She underwent a successful modified Damus–Kaye–Stansel operation using her native pulmonary valve. Spiral cardiac computed tomography with three-dimensional reconstructions was instrumental in pre-operative surgical planning.

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Appropriate utilization of cardiac computed tomography for the assessment of stable coronary artery disease

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01957-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Hammer ◽

Muhtashim Mian ◽

Levi Elhadad ◽

Mary Li ◽

Idan Roifman

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiac Imaging ◽

Cardiac Computed Tomography ◽

The United States ◽

Appropriate Use ◽

Potential Cost ◽

Cardiac Computed Tomography Angiography ◽

Artery Disease

Abstract Background Appropriate use criteria (AUC) have been developed in response to growth in cardiac imaging utilization and concern regarding associated costs. Cardiac computed tomography angiography (CCTA) has emerged as an important modality in the evaluation of coronary artery disease, however its appropriate utilization in actual practice is uncertain. Our objective was to determine the appropriate utilization of CCTA in a large quaternary care institution and to compare appropriate utilization pre and post publication of the 2013 AUC guidelines. We hypothesized that the proportion of appropriate CCTA utilization will be similar to those of other comparable cardiac imaging modalities and that there would be a significant increase in appropriate use post AUC publication. Methods We employed a retrospective cohort study design of 2577 consecutive patients undergoing CCTA between January 1, 2012 and December 30, 2016. An appropriateness category was assigned for each CCTA. Appropriateness classifications were compared pre- and post- AUC publication via the chi-square test. Results Overall, 83.5% of CCTAs were deemed to be appropriate based on the AUC. Before the AUC publication, 75.0% of CCTAs were classified as appropriate whereas after the AUC publication, 88.0% were classified as appropriate (p < 0.001). The increase in appropriate utilization, when extrapolated to the Medicare population of the United States, was associated with potential cost savings of approximately $57 million per year. Conclusions We report a high rate of appropriate use of CCTA and a significant increase in the proportion of CCTAs classified as appropriate after the AUC publication.

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Coronary Centerline Extraction from CCTA Using 3D-UNet

Future Internet ◽

10.3390/fi13040101 ◽

2021 ◽

Vol 13 (4) ◽

pp. 101

Author(s):

Alexandru Dorobanțiu ◽

Valentin Ogrean ◽

Remus Brad

Keyword(s):

Computed Tomography ◽

Cardiac Computed Tomography ◽

Three Dimensional ◽

Class Imbalance ◽

Training Data ◽

Cardiac Computed Tomography Angiography ◽

Centerline Extraction ◽

Network Training ◽

Dimensional Reconstruction ◽

Coronary Centerline

The mesh-type coronary model, obtained from three-dimensional reconstruction using the sequence of images produced by computed tomography (CT), can be used to obtain useful diagnostic information, such as extracting the projection of the lumen (planar development along an artery). In this paper, we have focused on automated coronary centerline extraction from cardiac computed tomography angiography (CCTA) proposing a 3D version of U-Net architecture, trained with a novel loss function and with augmented patches. We have obtained promising results for accuracy (between 90–95%) and overlap (between 90–94%) with various network training configurations on the data from the Rotterdam Coronary Artery Centerline Extraction benchmark. We have also demonstrated the ability of the proposed network to learn despite the huge class imbalance and sparse annotation present in the training data.

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Abstract 2611: Transcatheter Valve Insertion A Model Of Enlarged Right Ventricular Outflow Tracts

Circulation ◽

10.1161/circ.118.suppl_18.s_753 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Adeline Basquin ◽

Younes Boudjemline

Keyword(s):

Right Ventricular ◽

Pulmonary Valve ◽

Main Pulmonary Artery ◽

Pulmonary Regurgitation ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

The Difference ◽

Group 2 ◽

Transcatheter Valve ◽

Group B

Background: Transcatheter pulmonary valve insertion has recently emerged as an alternative to surgery. To extend the indications to patients with large right ventricular outflow tract (RVOT), we previously developed an intravascular device that reduces the diameter of the main pulmonary artery (MPA) allowing the insertion of available valved stents. We report its use in a model of animals with enlarged RVOT and pulmonary valve incompetence (PVI). Methods and Results: 33 sheep were included. They first underwent surgical MPA enlargement. We then intended to implant percutaneously a reducer followed by the insertion of a valve. Three animals died during interstage. The remaining were sacrificed acutely (group 1, n=6), after a mean follow-up of 1 (group 2, n=12) and 2 months (group 3, n=12). Animals from chronic groups were equally divided into 2 subgroups according to the difference between diameters of the device inserted and MPA (A: < 5-mm, B: ≥ 5-mm). Reducers were inserted successfully (n=30). One embolized after its insertion (Group 3A). A valved stent could be implanted in all animals but one which experienced a balloon ruptured during its inflation leading to incomplete expansion and death of the animal. Six animals had pulmonary regurgitation after valve insertion. Five of them (Group A, n=5; Group B, n=1) had downsizing of the reducer. Conclusion: Pulmonary valve insertion is possible through a transcatheter technique using a PA reducer. Oversizing of this device reduces the risk of embolisation and paraprosthetic leak.

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