scholarly journals Application of Homograft Valved Conduit in Cardiac Surgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Yige Huyan ◽  
Yuan Chang ◽  
Jiangping Song
Keyword(s):  
Tissue Engineering ◽  
Immune Response ◽  
Congenital Heart Disease ◽  
Congenital Heart ◽  
Improved Method ◽  
Potential Growth ◽  
Valved Conduit ◽  
The 1960S ◽  
The Right ◽  
Growth Ability

Valved conduits often correct the blood flow of congenital heart disease by connecting the right ventricle to the pulmonary artery (RV-PA). The homograft valved conduit was invented in the 1960s, but its wide application is limited due to the lack of effective sterilization and preservation methods. Modern cryopreservation prolongs the preservation time of homograft valved conduit, which makes it become the most important treatment at present, and is widely used in Ross and other operations. However, homograft valved conduit has limited biocompatibility and durability and lacks any additional growth capacity. Therefore, decellularized valved conduit has been proposed as an effective improved method, which can reduce immune response and calcification, and has potential growth ability. In addition, as a possible substitute, commercial xenograft valved conduit has certain advantages in clinical application, and tissue engineering artificial valved conduit needs to be further studied.

"Micro-Bentall" procedure

2020 ◽  
Keyword(s):  
Congenital Heart Disease ◽  
Aortic Root ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Congenital Heart Diseases ◽  
Salvage Procedure ◽  
Experienced Surgeon ◽  
Bentall Procedure ◽  
Valved Conduit ◽  
The Right

Truncus arteriosus, an anomaly of the conotruncus, is an extremely rare congenital heart disease that affects 1.19% of all patients with congenital heart diseases. We present a surgical technique using an 8-mm cryopreserved aortic root homograft in the aortic position and a 12-mm pulmonary valved conduit in the right position that allowed us to correct this rare congenital malformation. The cryopreserved aortic root homograft was considered a priority option for surgical correction. The neonatal Bentall (micro-Bentall) procedure is a surgically demanding procedure but can be performed successfully by an experienced surgeon. If we were performing a non-salvage procedure, we would have chosen a decellularized allograft.

scholarly journals Measuring myocardial extracellular volume of the right ventricle in patients with congenital heart disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nadya Al-Wakeel-Marquard ◽  
Tiago Ferreira da Silva ◽  
Sarah Jeuthe ◽  
Sanaz Rastin ◽  
Frédéric Muench ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Image Quality ◽  
Right Ventricle ◽  
Wall Thickness ◽  
Congenital Heart ◽  
Extracellular Volume ◽  
Analysis Tool ◽  
Custom Made ◽  
The Right

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.

Abstract 11740: Fetal and Neonatal Markers of Neurodevelopmental Outcome in Congenital Heart Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ismee A Williams ◽  
Howard Andrews ◽  
Michael M Myers ◽  
William Fifer
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Infant Development ◽  
Umbilical Artery ◽  
Neurodevelopmental Outcome ◽  
Abdominal Circumference ◽  
Temporal Region ◽  
Z Score ◽  
The Right

Objectives: Children with congenital heart disease (CHD) are at risk for abnormal neurodevelopment (ND). We evaluated associations between fetal Doppler and biometry measures, neonatal electroencephalogram (EEG) and 18-month ND. Methods: Fetuses with hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF) had middle cerebral (MCA) and umbilical artery (UA) Doppler velocities, as well as biometry such as head (HC) and abdominal circumference (AC), prospectively recorded at 20-25 (F1), 26-32 (F2), and 33-39 (F3) wks gestational age (GA). Pulsatility indices (PI) with GA-derived z-scores and cerebral-to-placental resistance (CPR) ratios were calculated. Neonatal high-density EEG was preformed preoperatively and the Bayley Scales of Infant Development-III were assessed at 18-months. Factor analysis was used to reduce the number of EEG predictors used in regression analysis. Results: Among 56 CHD fetuses (N=19 HLHS, N=16 TGA, N=21 TOF) who underwent preoperative EEG, ND scores are available for 33 to date. Cardiac subtype was highly associated with EEG and was considered in all models. Cognition scores were predicted by CPR< 1 ever (B=-15.7, P=0.002) and HC/AC at F2 (B=-130, P=0.013, R 2 =0.42). Language scores were predicted by UA PI z-score at F1 (B=-9.6, P=0.005, R 2 =0.27). Motor scores were predicted by UA PI z-score at F1 (B=-3.9, P=0.085), HLHS (B=-15, P<0.001), EFW%ile (B=0.374, P=0.007), and delta band right parietal and right temporal log power in active sleep (B=3.9, P=0.045, R 2 =0.61). Conclusion: Lower umbilical artery pulsatility at 20-25 wks GA was associated with higher 18-month Language and Motor scores. A diagnosis of HLHS predicted poorer Motor scores. Increased EEG power in the parietal and temporal region of the right brain predicted higher Motor scores. A larger abdomen relative to head at 26-32 wks was associated with improved cognition while diminished cerebrovascular compared with placental resistance predicted poorer cognition, similar to what has been observed in the growth restricted fetus. Further investigation is needed to confirm these hypothesis-generating findings.

Asymmetric Crying Facies: Which Is the `Right-Wrong' Side?

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 144-145
Author(s):  
KARL-GEORG EVERS ◽  
PETER GRONECK
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Soft Palate ◽  
Congenital Heart ◽  
Cleft Lip ◽  
Congenital Defects ◽  
Wrong Side ◽  
Organ Systems ◽  
Depressor Muscle ◽  
The Right

To the Editor.— Congenital asymmetric crying facies is generally considered to be due to unilateral agenesis or hypoplasia of the anguli oris depressor muscle (HAODM). Electromyographic (EMG) examinations of the affected sides have revealed absent spontaneous activity or diminished motor unit activity.1-3 Association of HAODM syndrome with congenital heart disease, the "cardiofacial syndrome," has been described.4 Major defects of other organ systems and minor congenital defects may be associated with asymmetric crying facies as well.5 Monreal6 reported five patients with asymmetric congenital crying facies syndroms who besides this anomaly displayed juxtaoral defects, egm atresia of one side of the jaw and soft palate, cleft lip, hypoplasis of mandible and ear.

Development of the ventricles and valves

ESC CardioMed ◽  
2018 ◽  
pp. 44-49
Author(s):  
José M. Pérez-Pomares ◽  
José L. de la Pompa
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cardiac Development ◽  
Experimental Studies ◽  
Heart Tube ◽  
Cellular Mechanisms ◽  
Valve Development ◽  
Tissue Interactions ◽  
The Right

The heart is the first functional organ of the vertebrate embryo, beginning to beat at around 4 weeks of gestation in humans. Tissue interactions orchestrate the complex patterning, proliferation, and differentiation processes that transform the embryonic cardiac primordium into the adult heart. During heart embryogenesis, cardiac mesoderm progenitor cells originate bilaterally during gastrulation and move rostrally to form the primitive heart tube, which will then loop towards the right and initiate septation to give rise to the mature four-chambered heart. Experimental studies in animal models have revealed the crucial role that a number of highly conserved signalling pathways, involving active molecular cross-talk between adjacent tissues, play in cardiac development, and how the alterations in these signalling mechanisms may cause congenital heart disease affecting the neonate or adult. Here, we describe briefly the knowledge gained on the molecular and cellular mechanisms underlying cardiac chamber and valve development and its implication in disease. This knowledge will ultimately facilitate the design of diagnostic and therapeutic strategies to treat congenital heart disease.

Adult congenital heart disease

2020 ◽  
pp. 225-254
Author(s):  
Andrew Hilton
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Anatomical Variation ◽  
Critically Ill Patient ◽  
Crista Terminalis ◽  
Echocardiographic Examination ◽  
Adult Congenital ◽  
The Right

The prevalence of congenital heart disease (CHD) in adults is increasing and many of these are likely to be admitted to the intensive care unit (ICU). Some of these patients may have undiagnosed CHD, usually relatively simple lesions such as atrial and ventricular septal defects. Occasionally, these may be more complex lesions (e.g. Ebstein’s anomaly) that even if unrecognized earlier in life can still allow survival into adulthood. Whether simple or complex, CHD can complicate the management of the critically ill patient, particularly if shunting or heart failure is present. The critical care echocardiographer is required to both recognize both normal anatomical variation and definite abnormal structural abnormalities in the adult patient. The aim of this chapter is to familiarize the echocardiographer with common anatomical variants, such as remnants of the right valve of the sinus venosus and crista terminalis, and present a careful and systematic approach to echocardiographic examination that may reliably identify relatively simple undiagnosed CHD in the adult.

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