scholarly journals Repair of Aorto-Right Ventricular Tunnel: A Case Report

1970 ◽  
Vol 3 (1) ◽  
pp. 98-100 ◽  
Author(s):  
Naveen Sheikh
Keyword(s):  
Right Ventricular ◽  
Myocardial Protection ◽  
Congenital Heart ◽  
Septal Defect ◽  
Ascending Aorta ◽  
Mattress Suture ◽  
Cold Blood ◽  
The Right ◽  
Cold Blood Cardioplegia

Aorto-ventricular tunnel is a congenital, extracardiac channel which connects the ascending aorta above the sinutubular junction to the cavity of the left, or less commonly, to the right ventricle. Here, I report a successful surgical correction of aorto-right ventricular tunnel with anomalous right coronary artery (RCA) arising from the tunnel in a 42 years old woman diagnosed preoperatively with echocardiography and cardiac catheterization. The operation was performed with cardiopulmonary bypass and hypothermia. Myocardial protection was achieved by antegrade cold blood cardioplegia. The tunnel below the origin of RCA was closed with pericardial patch. Tunnel was closed with mattress suture and running stitches to reduce the diameter and making channel for RCA blood flow. Atrial septal defect was closed by patch. The postoperative course was uneventful except pericardial effusion which was managed conservatively. A follow-up transthoracic echocardiogram demonstrated a securely closed communication without any aortic valve incompetence. Keywords: Congenital heart disease; Aorto- RV Tunnel (ARVT). DOI: 10.3329/cardio.v3i1.6435Cardiovasc. j. 2010; 3(1): 98-100

A Woman with Double Chamber Right Ventricle

2021 ◽  
Vol 7 (1) ◽  
pp. 63-67
Author(s):  
Furqon Satria Adi Pradana ◽  
Lucia Kris Dinarti ◽  
Putrika Prastuti Ratna Gharini
Keyword(s):  
Right Ventricle ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Transoesophageal Echocardiography ◽  
Surgical Closure ◽  
Muscle Band ◽  
The Right ◽  
Double Chamber

Introduction: An additional membrane or muscle band inside right ventricle divides it into two chambers, the proximal and distal one. It is a rare congenital malformation which makes up approximately 0.5-1 per cent of all congenital heart defects. The double chambers right ventricle most often present in children but rarely in adults. Transoesophageal Echocardiography is the most effective tool in diagnosing a DCRV.Case presentation: A 36 years old woman, diagnosed with large ventricular septal defect by transthoracic echocardiography, underwent a TOE to complement the preparation of surgical closure. The TOE finding instead revealed a septum or membrane that divide the right ventricle into two separate chambers, later confirmed by a cardiac computer tomographic scan and cardiac cathetherization. The patient underwent surgery with VSD closure and resection of the septum without complications. Echocardiography paramater became normal albeit still had some septal tissue left in order to limit sudden surge of blood flow into pulmonary artery. Follow up indicate patient has no symptom associated with the surgeryConclusion: The patient was diagnosed with double chamber right ventricle during preparation for surgery by TOE examination. We present this case in order to emphasize the rarity of this congenital heart disease

Congenital right atrial diverticulum, atrial septal defect within the oval fossa, and complex pulmonary valvar obstruction in an infant with chromosome 8(p23.1) deletion

2005 ◽  
Vol 15 (3) ◽  
pp. 306-308 ◽  
Author(s):  
Aungkana Gengsakul ◽  
Suvro S. Sett ◽  
Martin C. K. Hosking
Keyword(s):  
Right Ventricular ◽  
Septal Defect ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Chromosome 8 ◽  
Right Atrial ◽  
Ventricular Compliance ◽  
The Right ◽  
Right Atrial Aneurysm

We describe an unusual right atrial aneurysm, occurring with progressive obstruction of the right ventricular outflow tract and increasing cyanosis, in a nine-month-old boy with chromosome 8(p23.1) deletion. Surgical resection of the diverticulum, and relief of the right ventricular obstruction, was successful, although impairment of right ventricular compliance persists after 19 months follow-up.

scholarly journals P718 Unexpected finding during follow up for a suspected arrythmogenic right ventricular cardiomyopathy (ARVC)

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Castellanos Alcalde ◽  
N Garcia Ibarrondo ◽  
G Ramirez-Escudero ◽  
R Candina Urizar ◽  
A Lanbarri Izaguirre ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Vena Cava ◽  
Interatrial Communication ◽  
The Right

Abstract Interatrial communication is the most common congenital defect found in adulthood, being the most common ostium secundum variety (70-80%). Superior and inferior sinus venosus defects are less usual, found in the 5-10% of cases of interatrial communication and frequently associated with anomalous pulmonary venous return (APVR). These defects are located near the junction of the superior (5%) or inferior (<1%) vena cava with the right atrium, which makes them difficult to diagnose by transthoracic ecocardiography (TTE). Case description: A 44-year-old man who is being followed up in our electrophysiology consulting with suspicion of ARVC (suggestive CMR with no gene found) after an episode of ventricular tachycardia (VT) 11 years ago. Asymptomatic since then under treatment with atenolol, except for an episode of chest pain that required a coronary computed tomography which described an image compatible with a patent foramen ovale and normal coronary arteries. During the follow-up a cardio magnetic resonance (CMR) is performed which showed a severely dilated right ventricle with diskinetic areas, no volume changes since last CMR (5 years ago) and preserved ejection fraction. A small interatrial communication located infero-posteriorly in the septum drawed our attention. Estimated QP/QS was 1.4. After this finding, we reviewed the CT made 4 years ago, where a flow from the left atrium to the right atrium could be seen. We decided to ask for both a transthoracic echocardiography (TTE) and a transesophageal echocardiography (TEE). TTE showed normal left ventricle, a dilated right ventricle with preserved function, no valvulopathies and normal pulmonary pressure. Shunt test with agitated saline was slightly positive after Valsalva maneuver, and QP/QS was again 1.4. TTE showed a small interatrial communication measuring 1.9x0.8cm, next to inferior vena cava`s drainage. Since right ventricle dilation could be due both to the atrial septal defect (ASD) and to the dysplasia, the case was discussed in the heart team, and as the defect was small, QP/QS was 1.4 and pulmonary pressure was normal we adopted a conservative approach. Inferior sinus venosus defects are one of the least common atrial septal defects. They are located in the atrial septum immediately above the orifice of the inferior vena cava and are often associated with partial anomalous connection of the right pulmonary veins. This location makes it difficult to see by means of a common TTE or TEE, and usually as in our case multimodal approach can be very helpful. Usually patients with this kind of atrial septal defect (ASD), signs of significant shunt (right ventricular volume overload, QP/QS≥1.5) and systolic PA pressure less than 50% of systemic pressure (with pulmonary vascular resistance less than one third of the systemic vascular resistance) are suggested for surgery. In this case the possibility of two pathologies overlapping makes it challenging for diagnosis and treatment. Abstract P718 Figure. Multimodal imaging for diagnosis.

Obstruction of the right ventricular outflow tract caused by a tuberculoma in a patient with ventricular septal defect and aneurysm of the membranous septum

1999 ◽  
Vol 9 (5) ◽  
pp. 509-511 ◽  
Author(s):  
Cleusa Lapa Santos ◽  
Fernando Moraes ◽  
Carlos R. Moraes
Keyword(s):  
Congenital Heart Disease ◽  
Ventricular Septal Defect ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Septal Defect ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
The Right ◽  
Membranous Septum

AbstractReported here is an obstruction of the right ventricular outflow tract caused by a tuberculoma in a 15-year-old boy who presented with a ventricular septal defect. The obstruction was discovered at surgery and the tuberculous aetiology was only demonstrated histologically. To the authors' knowledge, this is the first report of a tuberculoma of the heart associated with congenital heart disease.

scholarly journals preoperative right ventricular overwork is a major determinant of residual pulmonary arterial hypertension in patients with repaired arterial septal defect

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Suzuki ◽  
Y Tanaka ◽  
K Yamashita ◽  
A Shono ◽  
K Sumimoto ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Septal Defect ◽  
Hazard Ratio ◽  
Coupling Index ◽  
Pulmonary Arterial ◽  
Asd Closure ◽  
The Right ◽  
Postoperative Residual

Abstract Funding Acknowledgements Type of funding sources: None. Background The haemodynamic effect of atrial septal defect (ASD) is a chronic volume overload of the right heart and pulmonary vasculature. Pulmonary overcirculation is generally compensated for by the right ventricular (RV) and pulmonary arterial (PA) reserve. However, in a subset of patients, prolonged pulmonary overcirculation insidiously induces obstructive pulmonary vasculopathy, which results in postoperative residual pulmonary arterial hypertension (PAH) after ASD closure. Postoperative PAH is a major concern because it is closely associated with poor outcomes and impaired quality of life. However, to date, no clinically robust predictors of postoperative residual PAH have been clearly identified. Purpose This study sought to assess the haemodynamic characteristics of ASD patients in terms of mechano-energetic parameters and to identify the predictors of postoperative residual PAH in these patients. Methods A total of 120 ASD patients (age: 58 ± 17 years) and 46 normal controls were recruited. As previously reported, the simplified RV contraction pressure index (sRVCPI) was calculated as an index of RV external work by multiplying the tricuspid annular plane systolic excursion (TAPSE) by the pressure gradient between the RV and right atrium. RV- PA coupling was evaluated using TAPSE divided by PA systolic pressure as an index of the RV length-force relationship. These parameters were measured both at baseline and 6 months after ASD closure. Results As expected, baseline sRVCPI was significantly greater in patients with ASD than in controls (775 ± 298 vs. 335 ± 180 mm Hg • mm, P < 0.01), which indicated significant "RV overwork". As a result, RV-PA coupling in ASD patients was significantly impaired compared to that in controls (0.9 ± 0.8 vs. 3.5 ± 1.7 mm/mm Hg, P < 0.01). All 120 ASD patients underwent transcatheter or surgical shunt closure; 15 of them had residual PAH after closure. After 6 months, RV-PA coupling index significantly improved in patients without residual PAH, from 0.96 ± 0.81 to 1.27 ± 1.24 mm/mm Hg (P = 0.02). Furthermore, RV load was markedly reduced, with sRVCPI falling from 691 ± 258 to 434 ± 217 mm Hg • mm, P < 0.01). However, in patients with residual PAH, RV-PA coupling index deteriorated from 0.64 ± 0.23 to 0.53 ± 0.12 mm/mm Hg (P < 0.01). As a result, RV overload was not significantly relieved (sRVCPI; from 971 ± 382 to 783 ± 166 mm Hg • mm, P = 0.22). In a multivariate analysis, baseline pulmonary vascular resistance (hazard ratio 1.009; P < 0.01) and preoperative sRVPCI (hazard ratio 1.003; P < 0.01) revealed to be independent predictors of residual PAH. Conclusion In terms of mechano-energetic function, preoperative "RV overwork" can be used as a robust predictor of an impaired RV-PA relationship in ASD patients. Moreover, periodic assessment of sRVPCI may contribute to the better management for patients with unrepaired ASD. Abstract Figure.

scholarly journals Cor triatriatum dextrum: A rare congenital cardiac abnormality

2016 ◽  
Vol 31 (1) ◽  
pp. 37-40
Author(s):  
MS Haque ◽  
MA Saleh ◽  
SR Kabir ◽  
A Muhammad ◽  
ANMM Islam ◽  
...  
Keyword(s):  
Rare Case ◽  
Congenital Heart ◽  
Septal Defect ◽  
Incidental Finding ◽  
Right Heart Failure ◽  
Accurate Diagnosis ◽  
Cor Triatriatum ◽  
Right Heart ◽  
2D Echocardiography ◽  
The Right

Cor triatriatum dextrum is an exceptionally rare congenital heart disease, in which the right atrium is partitioned into two chambers by a membrane to form a triatrial heart. It is caused by persistence of the right valve of sinus venosus. The aim of presenting this case is to develop awareness regarding cor triatriatum dextrum , though a rare case, can be present and may contribute to right heart failure and 2D-echocardiography is an important tool in making early and accurate diagnosis. We are reporting a case of an elderly Bangladeshi male presented with the features of mitral stenosis with pulmonary hypertension with CCF with respiratory tract infection, where cor triatriatum dextrum with an atrial septal defect was an incidental finding on routine echocardiographic assessment.Bangladesh Heart Journal 2016; 31(1) : 37-40

scholarly journals THE CLINICAL CASE OF HEMIFACIAL MICROSOMIA IN THE NEWBORN BOY FROM MOTHER WITH Z-21

2021 ◽  
Vol 11 (2(40)) ◽  
pp. 64-67
Author(s):  
I.V. Lastivka ◽  
A.G. Babintseva ◽  
V.V. Antsupova ◽  
А.І. Peryzhniak ◽  
І.V. Koshurba ◽  
...  
Keyword(s):  
Clinical Case ◽  
Septal Defect ◽  
Neonatal Period ◽  
Hemifacial Microsomia ◽  
Internal Factors ◽  
Vascular Abnormalities ◽  
Branchial Arches ◽  
The Face ◽  
The Right

Hemifacial Microsomia (HFM) is a term used to identify facial deformities associated with the development ofthe first and second pairs of branchial arches, characterized by underdevelopment of one half of the face. One typeof hemifacial microsomia is oculo-auriculo-vertebral dysplasia or Goldenhar syndrome.The incidence of HFM is 1:3500-1:7000 of live births and occurs in 1 case per 1000 children with congenitaldeafness. The ratio of boys to girls is 3:2. The etiology and type of inheritance is studied insufficiently. There are threepossible pathogenetic models: vascular abnormalities and hemorrhages in the craniofacial region, damage of Meckel'scartilage, and abnormal cell development of the cranial nerve crest. Environmental factors, maternal internal factors,and genetic factors (OTX2, PLCD3, and MYT1 mutations) may also cause the development of hemifacial microsomia.The article demonstrates a clinical case of hemifacial microsomia in a newborn boy from a mother with Z-21 inthe form of deformation of the left auricle with atresia of the auditory canal and "false" ears on the right, combinedwith congenital anomaly of heart (atrial septal defect) and brain (hypoplasia of the corpus callosum).Emphasis is placed on the need of involving a multidisciplinary team of specialists in the management of thispatient both in the neonatal period and in the system of subsequent follow-up.

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