scholarly journals The Clinical Manifestation of Straight Back Syndrome in Echocardiogram Performance

2021 ◽  
Author(s):  
Wanqian Yu ◽  
Hongzhou Zhang ◽  
Pingping Yang ◽  
Lujin Gan ◽  
Chenxi Wang ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Supine Position ◽  
Left Ventricular Outflow Tract ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Standing Position ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Experimental Group

Abstract Background: There were no studies on the mechanism of clinical manifestations of straight back syndrome. Our aim was to explore the mechanism of clinical symptoms of straight back syndrome.Methods: From February 2018 to February 2021, we included 4 patients (3 males and 1 female) with straight back syndrome as the experimental group, and 4 normal people matched with sex and BMI as the normal control group. Basic information of patients, laboratory examination, echocardiography in supine and standing position, chest film in positive and lateral position, basic information of control group and echocardiography in supine and standing position were collected. The differences of clinical data between the two groups were compared and analyzed. Results: There were significant differences in left ventricular outflow tract diameter, right ventricular outflow tract diameter and right ventricular outflow tract velocity in the experimental group (their P values were 0.035, 0.011 and 0.015, respectively), but there was no significant difference in left ventricular outflow tract velocity in the standing and supine position (P=0.638). The left ventricular outflow tract diameter, the right ventricular outflow tract diameter and the right ventricular outflow tract velocity in the experimental group were significantly different (P<0.05). The internal diameters of left ventricular outflow tract in upright position, supine position, right ventricular outflow tract, supine position, right ventricular outflow tract were20.50±1.91mm, 18.75±0.96mm;10.00±6.68mm, 15.45±6.06mm;124.25±40.29cm/s and 91.00±28.93cm/s, respectively, in standing position, recumbent position, right ventricular outflow tract, right ventricular outflow tract, supine position, right ventricular outflow tract, supine position, supine position. The velocity of left ventricular outflow tract in upright position was 82.50±2.01 cm/s, and that in supine position was 83.25±2.06 cm/s. There was no significant difference in left ventricular outflow tract velocity in standing and supine position, which may be related to the compression of right ventricular outflow tract.Conclusions: In this study, we got the clinical manifestations of direct-back syndrome patients through comparison of straight back syndrome.

Surgical Treatment of a 4-Year-Old Child with Hypertrophic Obstructive Cardiomyopathy: Case Report

2016 ◽  
Vol 19 (1) ◽  
pp. 043
Author(s):  
Jin Chen ◽  
Qingyu Wu ◽  
Zhonghua Xu ◽  
Xiangchen Kong
Keyword(s):  
Surgical Treatment ◽  
Right Ventricular ◽  
Left Ventricular Outflow Tract ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Left And Right

The incidence of pediatric hypertrophic obstructive cardiomyopathy is low. The lesions usually involve the left ventricle or ventricular septum, leading to either left or right ventricular outflow tract stenosis. However, combined left and right ventricular outflow tract stenosis is rare, and the surgical treatment is limited, especially in children. Surgery to release the obstruction was performed successfully in a 4-year-old child with right and left ventricular outflow tract obstruction together with a hypertrophic cardiomyopathy. The result was excellent.

scholarly journals Relationship of left ventricular outflow tract velocity time integral to treatment strategy in submassive and massive pulmonary embolism

2020 ◽  
Vol 10 (3) ◽  
pp. 204589402095372
Author(s):  
David Antoine ◽  
Taylor Chuich ◽  
Ruben Mylvaganam ◽  
Chris Malaisrie ◽  
Benjamin Freed ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Velocity Time Integral ◽  
Systemic Thrombolysis ◽  
Percent Change ◽  
Time Integral ◽  
Left Ventricular Outflow

Pulmonary embolism is associated with high rates of mortality and morbidity. It is important to understand direct comparisons of current interventions to differentiate favorable outcomes and complications. The objective of this study was to compare ultrasound-accelerated thrombolysis versus systemic thrombolysis versus anticoagulation alone and their effect on left ventricular outflow tract velocity time integral. This was a retrospective cohort study of subjects ≥18 years of age with a diagnosis of submassive or massive pulmonary embolism. The primary outcome was the percent change in left ventricular outflow tract velocity time integral between pre- and post-treatment echocardiograms. Ultrasound-accelerated thrombolysis compared to anticoagulation had a greater improvement in left ventricular outflow tract velocity time integral, measured by percent change. No significant change was noted between the ultrasound-accelerated thrombolysis and systemic thrombolysis nor systemic thrombolysis and anticoagulation groups. Pulmonary artery systolic pressure only showed a significant reduction in the ultrasound-accelerated thrombolysis versus anticoagulation group. The percent change of right ventricular to left ventricular ratios was improved when systemic thrombolysis was compared to both ultrasound-accelerated thrombolysis and anticoagulation. In this retrospective study of submassive or massive pulmonary embolisms, left ventricular outflow tract velocity time integral demonstrated greater improvement in patients treated with ultrasound-accelerated thrombolysis as compared to anticoagulation alone, a finding not seen with systemic thrombolysis. While this improvement in left ventricular outflow tract velocity time integral parallels the trend seen in mortality outcomes across the three groups, it only correlates with changes seen in pulmonary artery systolic pressure, not in other markers of echocardiographic right ventricular dysfunction (tricuspid annular plane systolic excursion and right ventricular to left ventricular ratios). Changes in left ventricular outflow tract velocity time integral, rather than echocardiographic markers of right ventricular dysfunction, may be considered a more useful prognostic marker of both dysfunction and improvement after reperfusion therapy.

Aortic valve replacement using Konno procedure for prior Yasui procedure

2021 ◽  
pp. 021849232110523
Author(s):  
Yuki Nakayama ◽  
Yusuke Iwata ◽  
Takashi Kuwahara ◽  
Naoki Kuwabara ◽  
Kentaro Omoya ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Interrupted Aortic Arch ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Septal Defect Closure ◽  
Left Ventricular Outflow

A 2-year-old girl underwent conversion to the Konno procedure by removing the Damus–Kaye–Stansel anastomosis after the neonatal Yasui procedure for an interrupted aortic arch with left ventricular outflow tract stenosis. Her postoperative course was uneventful. However, left ventricular outflow tract restenosis occurred due to narrowed ventricular septal defect and moderate neoaortic regurgitation from the old pulmonary valve. The Konno procedure was performed by removing the Damus–Kaye–Stansel anastomosis for left ventricular outflow tract restenosis and neoaortic regurgitation and performing right ventricular outflow tract reconstruction and ventricular septal defect closure. Left ventricular outflow tract restenosis was not observed.

scholarly journals Acute pharmacodynamic effects of pimobendan in client-owned cats with subclinical hypertrophic cardiomyopathy

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Maureen S. Oldach ◽  
Yu Ueda ◽  
Eric S. Ontiveros ◽  
Samantha L. Fousse ◽  
Lance C. Visser ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Left Ventricular Outflow Tract ◽  
Maximum Velocity ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Fractional Shortening

Abstract Background Prior studies have suggested that pimobendan is associated with several positive effects in cats, including improved survival in cats with congestive heart failure and improved left atrial function in research colony cats with hypertrophic cardiomyopathy (HCM) and normal cats. However, there is still a paucity of pharmacodynamic data refuting or supporting the use of pimobendan in a clinical cat population. This clinical trial aimed to evaluate the pharmacodynamic effects and tolerability of a single dose of pimobendan in cats with HCM. Echocardiograms and Doppler-derived systolic blood pressures were performed in 21 client-owned cats with subclinical HCM at baseline and 90-min after oral administration of 1.25 mg of pimobendan (Vetmedin). Seven additional cats were evaluated post-placebo administration to account for intra-day variability. Results Heart rate, systolic blood pressure, and murmur grade were not significantly different between baseline and post-pimobendan evaluations. Left auricular blood flow velocity, left atrial size, and left ventricular fractional shortening were not significantly different between baseline and post-pimobendan evaluations. Mean (± standard deviation) tissue Doppler peak systolic velocity of the mitral annulus was significantly higher following pimobendan (7.4 cm/s ± 1.5 vs 8.5 ± 1.6; p = 0.02). Median (min, max) left-ventricular outflow tract maximum velocity was significantly higher following pimobendan [1.9 m/sec (1.5, 3.4) vs 2.6 m/sec (2.0, 4.0); p = 0.01]. Mean right-ventricular outflow tract maximum velocity was also significantly higher following pimobendan (1.5 m/s ± 0.51 vs 2.0 ± 0.53; p = 0.004). Mean left atrial fractional shortening was significantly higher following pimobendan (28% ± 6 vs 32% ± 7; p = 0.02). No adverse events were observed following pimobendan administration. Right ventricular outflow tract velocity was significantly higher following placebo in control cats (1.02 ± 0.21 versus 1.31 ± 0.31; p = 0.01). No other significant differences were detected. Conclusions In client-owned cats with HCM, pimobendan acutely increased left atrial function and mildly increased left ventricular systolic function. Left ventricular outflow tract velocity was increased after pimobendan. Pimobendan was well tolerated in the acute setting in cats with HCM. The findings of this prospective, acute-dosing study confirm previous findings in research animals and retrospective analyses and suggest that chronic dosing studies are safe and warranted.

scholarly journals Effect of 3D-Printed Hearts Used in Left Ventricular Outflow Tract Obstruction: A Multicenter Study

2022 ◽  
Author(s):  
Xianzhi Wang ◽  
Jixiang Liang ◽  
Cunfu Mu ◽  
Wenlin Zhang ◽  
Chunzhu Xue ◽  
...  
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Operation Time ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Left Ventricular Outflow ◽  
3D Printed ◽  
Experimental Group

Abstract Objective:The purpose of this research was to explore the application value of a three-dimensional (3D)-printed heart in the operation for left ventricular outflow tract (LVOT) obstruction. Methods: From August 2019 to October 2021, 46 patients with LVOT obstruction underwent surgical treatment at Peking University International Hospital, Southwest Medical University Affiliated Hospital of Traditional Chinese Medicine and Guangyuan First People's Hospital. According to the treatment method, 22 cases were allocated to the experimental group and 24 cases to the control group . The operation time, cardiopulmonary bypass time, intraoperative blood loss, hospitalization time, postoperative ejection fraction (EF), left ventricular flow velocity (LVFV), LVOT pressure difference (LVP), postoperative interventricular septal thickness (IST), inner diameter of the left ventricular outflow tract (IDLV), systolic anterior motion (SAM), atrioventricular block rate, aortic regurgitation (AR) rate and surgical complication rate of the two groups were compared. Results: The operation time, cardiopulmonary bypass time, intraoperative blood loss, hospitalization time, LVP, postoperative IST, AR, SAM, and postoperative LVFV of the experimental group were significantly lower than those of the control group (P < 0.05). The IDLV was larger than that of the control group (P < 0.05). There was no significant difference in the postoperative EF, atrioventricular block rate or complication rate between the two groups (P > 0.05). Conclusion: A 3D-printed heart model for in vitro simulation surgery is conducive to formulating a more reasonable surgical plan and reducing surgical trauma and operation time, thereby promoting the recovery and maintenance of the heart.

scholarly journals Outcome of modified réparation à l’ètage ventriculaire (REV) based on anatomical characteristics for the anomalous ventriculoarterial connection with ventricular septal defect and left ventricular outflow tract obstruction

2020 ◽  
Vol 31 (5) ◽  
pp. 674-679
Author(s):  
Kang An ◽  
Shengshou Hu ◽  
Shoujun Li ◽  
Jun Yan ◽  
Xu Wang ◽  
...  
Keyword(s):  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Peak Gradient

Abstract OBJECTIVES The present study evaluated the results of the modified réparation à l’étage ventriculaire (REV) based on the individual anatomical and pathological findings of the patients with an anomalous ventriculo-arterial connection with ventricular septal defect (VSD) and left ventricular outflow tract obstruction. METHODS We reviewed a series of 24 patients who underwent modified REV between 2005 and 2019. Surgical indications included ventricles and atrioventricular valves suitable for biventricular repair, severe left ventricular outflow tract obstruction (peak gradient &gt;30 mmHg), unrestrictive subaortic VSD and coronary arteries not suitable for reimplantation. RESULTS The mean follow-up time was 7.0 ± 4.2 years (range 0.5–14.1 years). Kaplan–Meier analyses showed that overall survival was 100% and freedom from any reoperation was 93.3% ± 6.4%. Longitudinal analyses of the available postoperative echocardiographic data showed that the left ventricular outflow tract peak gradient was less than 10 mmHg in all patients (15/15) and the left ventricular ejection fraction was more than 50% in 93.3% of patients (14/15). The right ventricular outflow tract peak gradient was less than 40 mmHg in 73.3% of patients (11/15). CONCLUSIONS The REV remains an option for selected patients despite the increasing use in recent years of the Nikaidoh procedure and its modifications. The surgical strategy needs to be determined by the specific anatomical and pathological findings of the patient. The modified REV had excellent long-term survival and freedom from reoperation for the treatment of anomalous ventriculo-arterial connection with VSD and left ventricular outflow tract obstruction. The long-term performance of the reconstructed left ventricular outflow tract and right ventricular outflow tract is satisfactory.

A Simplified Two-Stepwise Electrocardiographic Algorithm to Distinguish Left from Right Ventricular Outflow Tract Tachycardia Origin

Cardiology ◽  
2020 ◽  
Vol 145 (11) ◽  
pp. 710-719
Author(s):  
Miao Yu ◽  
Xiaofeng Li ◽  
Hao Zhang ◽  
Yu Xia ◽  
Jun Liu ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Transitional Zone ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Receiver Operating Characteristic Curves ◽  
Ventricular Outflow Tract Tachycardia ◽  
Left Ventricular Outflow ◽  
Sensitivity Specificity

<b><i>Background:</i></b> There are several electrocardiographic algorithms to predict the origin of idiopathic outflow tract ventricular arrhythmias (OT-VAs). This study aimed to develop a more accurate and efficient stepwise electrocardiographic algorithm to discriminate left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin. <b><i>Methods and Results:</i></b> We analyzed 12-lead electrocardiographic characteristics of 173 consecutive OT-VAs patients who underwent successful radiofrequency catheter ablation in the RVOT (<i>n</i> = 124) or LVOT (<i>n</i> = 49). Based on the areas under the receiver operating characteristic curves, the combination of transitional zone (TZ) index &#x3c;0 and V2S/V3R index ≤1.5 exhibited 93.5% sensitivity, 85.9% specificity, and 87.3% accuracy. A further analysis was performed in the 71 OT-VAs with a V3-lead precordial transition. The sensitivity, specificity, and accuracy of the integration of V2S/V3R index ≤1.5 and R-wave deflection interval in lead V3 &#x3e;80 ms were 91.7, 83.1, and 85.9%, respectively. In the prospective evaluation, the combination of TZ index and V2S/V3R index could identify the correct origin sites with 91.2% accuracy in the overall analysis, and the integration of V2S/V3R index ≤1.5 and R-wave deflection interval in lead V3 &#x3e;80 ms exhibited 94% accuracy in V3-lead precordial transition. <b><i>Conclusions:</i></b> The combination of TZ index &#x3c;0 and V2S/V3R index ≤1.5 is a simple and efficient stepwise electrocardiographic algorithm for predicting LVOT origin. For the OT-VAs with a V3-lead precordial transition, the integration of V2S/V3R index ≤1.5 and R-wave deflection interval in lead V3 &#x3e;80 ms would be a better choice.

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