scholarly journals A Rare Case of Shone Complex, Where Coarctation was Treated Successfully with Covered Cheatham Platinum Stent

2019 ◽  
pp. 1-5
Author(s):  
R. Singla ◽  
A. Kaushikh ◽  
H. Khemani ◽  
G. Singh ◽  
N. O. Bansal
Keyword(s):  
Balloon Dilatation ◽  
Coarctation Of The Aorta ◽  
Subaortic Stenosis ◽  
Left Heart ◽  
Specific Patient ◽  
Parachute Mitral Valve ◽  
Multiple Levels ◽  
The Right ◽  
Severe Congenital Heart Disease

Shone complex is an extremely rare and severe congenital heart disease characterized by left -heart obstruction at multiple levels namely supravalvular mitral ring, parachute mitral valve, subaortic stenosis and coarctation of the aorta. We in the present case describe a patient of shone complex who underwent successful coarctoplasty with the help of BIB (balloon in balloon) dilatation catheter and covered CP (cheatham platinum) stent. The role of interventional cardiologist is to diagnose and choose the right approach for the specific patient, whether surgery, balloon or stent.

The risk of having additional obstructive lesions in neonatal coarctation of the aorta

2001 ◽  
Vol 11 (1) ◽  
pp. 44-53 ◽  
Author(s):  
Jami C. Levine ◽  
Stephen P. Sanders ◽  
Steven D. Colan ◽  
Richard A. Jonas ◽  
Philip J. Spevak
Keyword(s):  
Aortic Stenosis ◽  
Mitral Stenosis ◽  
Coarctation Of The Aorta ◽  
Subaortic Stenosis ◽  
Left Heart ◽  
Cross Sectional ◽  
Increased Risk ◽  
Doppler Data ◽  
The Right ◽  
Stenotic Lesions

AbstractInfants with coarctation of the aorta may have obstructions at other sites within the left heart which are not always apparent on the initial echocardiogram. The magnitude of the risk of having the additional obstructions is not well described, with few reliable quantitative criterions for identifying patients at the highest risk. We determined the frequency of additional, late appearing, stenotic lesions within the left heart, and the predictive morphologic features on the initial cross-sectional echocardiogram.We identified all patients with coarctation of the aorta diagnosed by 3 months of age, excluding those with complex cardiac disease or definite additional stenotic lesions at presentation, leaving 101 patients for study. At follow-up, 31 stenotic lesions were diagnosed in 23 patients, 15 of whom had at least 1 intervention. Mitral stenosis was diagnosed in 11 patients, aortic stenosis in 10, subaortic stenosis in 8, and supravalvar aortic stenosis in 2. The probability for freedom from obstructive lesions was 81% at 1 year, 74% at 3 years, and 70% at 5 years. Echocardiographic predictors of mitral stenosis included smaller mitral valvar annuluses, presence of a mean transmitral gradient between 2.5 and 5.0 mmHg, and elongation of the area of intervalvar fibrous continuity. Predictors of aortic stenosis were smaller mitral valvar annuluses, an initial aortic valvar gradient between 15 and 20 mmHg, and obliteration of the commissure between the right and non-coronary leaflets of the aortic valve. Predictors of subaortic stenosis were smaller mitral valvar annuluses and elongation of the area of intervalvar fibrous continuity. Patients with Z-scores for the diameter of the mitral valve of less than −1 were at the highest risk for manifesting obstructive lesions at any level.Associated stenoses in the left heart are common in the setting of aortic coarctation. When Doppler data is equivocal, features of the cross-sectional echocardiogram can identify the sub-group of infants at increased risk.

Persistence of the left superior caval vein: can it potentiate obstructive lesions of the left ventricle?

1999 ◽  
Vol 9 (3) ◽  
pp. 285-290 ◽  
Author(s):  
Gabriella Agnoletti ◽  
Francesco Annecchino ◽  
Laura Preda ◽  
Adele Borghi
Keyword(s):  
Left Ventricle ◽  
Left Ventricular ◽  
Subaortic Stenosis ◽  
Left Heart ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
High Incidence ◽  
Left And Right ◽  
The Right ◽  
Left Heart Syndrome

AbstractRecent evidence has suggested that persistence of the left superior caval vein is associated with a high incidence of obstructive lesions of the left heart. To shed more light on this issue 1085 patients with congenital heart disease were studied retrospectively, with the aim of estimating the prevalence of a persistent left superior caval vein and its associated anomalies, focusing attention on obstructive lesions in the left and right ventricles. Patients with isomerism of the atrial appendages, or hypoplastic left heart syndrome, were excluded. A persisting left superior caval vein was present in 57 patients (5.2%). The overall incidence of obstructive lesions of the left heart was higher in patients with than in those without a persistent left superior caval vein (31.6 versus 7.8%,p< 0.001). Relative hypoplasia of the left ventricle was also higher in patients with persistent left superior caval vein (14 versus 0.8%,p< 0.001). The obstructive lesions found in the left heart, compared with the number in those without a left caval vein, were: mitral stenosis, 5.2 versus 0.7%; subaortic stenosis, 5.3 versus 0.9%; aortic coarctation, 17.5 versus 5.8% (p< 0.01); all of these in association, 3.5 versus 0.4%. In contrast, the incidence of obstructive lesions of the right heart was similar in the two groups of patients. It is concluded that persistence of the left superior caval vein can perturb the normal development of the left ventricle, being strongly associated with obstructions to left ventricular inflow and outflow.

scholarly journals Arthroplasty of a Charcot knee

2010 ◽  
Vol 2 (2) ◽  
pp. 17 ◽  
Author(s):  
Sina Babazadeh ◽  
James D. Stoney ◽  
Keith Lim ◽  
Peter F.M. Choong
Keyword(s):  
Surgical Techniques ◽  
Font Size ◽  
Neuropathic Arthropathy ◽  
Traditional Management ◽  
Specific Patient ◽  
Patient Demographics ◽  
Limited Success ◽  
Charcot Joint ◽  
The Right

<p class="MsoNormal" style="line-height: normal; margin: 0cm 0cm 10pt;"><span style="font-family: "><span style="font-size: small;">The Charcot knee - or neuropathic arthropathy - presents a considerable challenge to the orthopaedic surgeon. Caused by a combination of sensory, motor and autonomic neuropathy, it was originally described as an arthritic sequelae of neurosyphilis. In today’s western orthopaedics it is more often caused by diabetes. A Charcot knee is often symptomatically painful and unstable. Traditional management has usually been conservative or arthrodesis, with limited success. Arthroplasty of a Charcot joint has commonly been avoided at all costs. However, in the right patient, using the right technique, arthroplasty can significantly improve the symptoms of a Charcot joint. This article explores the evidence surrounding the role of arthroplasty in the management of a Charcot knee. Arthroplasty is compared to other forms of treatment and specific patient demographics and surgical techniques are explored in an attempt to define the role of arthroplasty in the management of a Charcot knee.</span></span></p>

The role of the right hemisphere in psychological function

1983 ◽  
Author(s):  
Jerre Levy
Keyword(s):  
Right Hemisphere ◽  
Psychological Function ◽  
The Right

Ruffling the Right Feathers When I am Around Others: The Role of Social Goals in Consumers' Service Experience

2010 ◽  
Author(s):  
Fang Wan ◽  
Pingping Qiu ◽  
L. J. Shrum
Keyword(s):  
Social Goals ◽  
Service Experience ◽  
The Right

The role of the right inferior frontal gyrus following reversal of consistent stimulus-stop mappings

2013 ◽  
Author(s):  
Maisy Best ◽  
Tobias Stevens ◽  
Fraser Milton ◽  
Christopher D. Chambers ◽  
Ian P. McLaren ◽  
...  
Keyword(s):  
Inferior Frontal Gyrus ◽  
The Right

Managing Landscape Irrigation to Avoid Soil and Nutrient Losses

EDIS ◽  
2013 ◽  
Vol 2013 (11) ◽  
Author(s):  
George Hochmuth ◽  
Laurie Trenholm ◽  
Don Rainey ◽  
Esen Momol ◽  
Claire Lewis ◽  
...  
Keyword(s):  
Natural Environment ◽  
Management Practices ◽  
Root Zone ◽  
Irrigation Management ◽  
Critical Factor ◽  
Nutrient Losses ◽  
County Agents ◽  
The Right ◽  
Soil And Water

Proper irrigation management is critical to conserve and protect water resources and to properly manage nutrients in the home landscape. How lawns and landscapes are irrigated directly impacts the natural environment, so landscape maintenance professionals and homeowners must adopt environmentally-friendly approaches to irrigation management. After selecting the right plant for the right place, water is the next critical factor to establish and maintain a healthy lawn and landscape. Fertilization is another important component of lawn and landscape maintenance, and irrigation must be applied correctly, especially following fertilization, to minimize potential nutrient losses. This publication supplements other UF/IFAS Extension publications that also include information on the role of soil and the root zone in irrigation management. This publication is designed to help UF/IFAS Extension county agents prepare materials to directly address nutrient losses from lawns and landscapes caused by inadequate irrigation management practices. This 6-page fact sheet was written by George Hochmuth, Laurie Trenholm, Don Rainey, Esen Momol, Claire Lewis, and Brian Niemann, and published by the UF Department of Soil and Water Science, October 2013. http://edis.ifas.ufl.edu/ss586

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