RESUMO
An aclinical Havanese dog was diagnosed with a membranous restrictive ventricular septal defect. The patient was represented later in their natural history due to the development of syncope. At that time the patient was diagnosed with acquired pulmonary infundibular stenosis. Balloon dilation of the stenosis was performed successfully twice over the patient's lifetime. The patient died suddenly approximately 14 months after the second balloon dilation. A discussion regarding primary infundibular pulmonary stenosis versus causes of acquired infundibular pulmonary stenosis including anomalous muscle bundles (double chamber right ventricle), tetralogy of Fallot, and infundibular stenosis is presented.
Assuntos
Doenças do Cão , Comunicação Interventricular , Estenose Subvalvar Pulmonar , Tetralogia de Fallot , Cães , Animais , Estenose Subvalvar Pulmonar/complicações , Estenose Subvalvar Pulmonar/diagnóstico , Estenose Subvalvar Pulmonar/veterinária , Constrição Patológica/complicações , Constrição Patológica/veterinária , Comunicação Interventricular/complicações , Comunicação Interventricular/veterinária , Comunicação Interventricular/diagnóstico , Ventrículos do Coração , Cateterismo/veterinária , Tetralogia de Fallot/complicações , Tetralogia de Fallot/veterinária , Doenças do Cão/diagnósticoRESUMO
We present the case of a 6-year-old patient with double-orifice mitral valve and severe regurgitation, which was successfully repaired. We demonstrate that mitral valve repair may be attempted even in complex anatomy such as the double-orifice mitral valve, where it can offer excellent results.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia Tridimensional/métodos , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Estenose Subvalvar Pulmonar/complicações , Criança , Átrios do Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/diagnóstico , Estenose Subvalvar Pulmonar/diagnóstico , Estenose Subvalvar Pulmonar/cirurgiaRESUMO
This case demonstrates the development of secondary infundibular stenosis in a 10-year-old male child with documented large non-restrictive perimembranous ventricular septal defect in infancy - the classical Gasul phenomenon.
Assuntos
Comunicação Interventricular/complicações , Estenose Subvalvar Pulmonar/etiologia , Função Ventricular/fisiologia , Cateterismo Cardíaco , Criança , Diagnóstico Diferencial , Ecocardiografia Doppler em Cores , Comunicação Interventricular/diagnóstico , Humanos , Masculino , Estenose Subvalvar Pulmonar/diagnóstico , Pressão Ventricular/fisiologiaAssuntos
Dextrocardia/complicações , Aneurisma Cardíaco/etiologia , Comunicação Interventricular/complicações , Estenose Subvalvar Pulmonar/etiologia , Valva Pulmonar , Transposição dos Grandes Vasos/complicações , Procedimentos Cirúrgicos Cardíacos , Pré-Escolar , Cineangiografia , Transposição das Grandes Artérias Corrigida Congenitamente , Dextrocardia/diagnóstico , Ecocardiografia Doppler em Cores , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/fisiopatologia , Aneurisma Cardíaco/cirurgia , Comunicação Interventricular/diagnóstico , Comunicação Interventricular/fisiopatologia , Comunicação Interventricular/cirurgia , Humanos , Masculino , Estenose Subvalvar Pulmonar/diagnóstico , Estenose Subvalvar Pulmonar/fisiopatologia , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/fisiopatologia , Transposição dos Grandes Vasos/diagnóstico , Resultado do TratamentoAssuntos
Cardiomiopatia Hipertrófica/diagnóstico por imagem , Ecocardiografia sob Estresse/métodos , Ventrículos do Coração/diagnóstico por imagem , Estenose Subvalvar Pulmonar/diagnóstico , Adolescente , Cardiomiopatia Hipertrófica/fisiopatologia , Diagnóstico Diferencial , Feminino , Ventrículos do Coração/fisiopatologia , HumanosRESUMO
BACKGROUND: Arterial switch operation became the golden treatment for simple transposition of the great arteries (sTGA). We describe our experience with the arterial switch operation regarding long-term outcome and the need for re-intervention. Nevertheless, supravalvular pulmonary stenosis (SPS) remains a concern in the long run. We assess the evolution of SPS over time and evaluate the effect of technical modifications on SPS during our experience. METHODS: We performed a retrospective study on 133 patients operated with ASO for TGA between October 1991 and November 2009. Last report method was used. We reviewed our pediatric cardiology and cardiac surgery database to examine the echocardiographic data and electrocardiograms. A mean follow-up of 9.2 years (+/- 5.83 SD) was reached. RESULTS: One (0.8%) patient deceased postoperatively due to cardiogenic shock. The overall actuarial freedom from reoperation (open and percutaneous) was 88.1%, 78.5% and 76.9% at 1, 5 and 10 years. SPS needed to be treated in 17 patients. Valve regurgitation at final investigation was maximal moderate in 5 patients for the aortic valve, 10 for pulmonary valve and 3 in tricuspid valve. CONCLUSIONS: ASO shows excellent long-term results in sTGA with a very low morbidity and mortality and is therefore the procedure of choice. Re-intervention rate is determined by SPS. Since the extensive mobilization of the pulmonary arteries and the creation of a longer neo-pulmonary root, reduction in SPS was seen with no re-interventions in the second half of the group. To obtain a final comparison with the atrial switch operation, a longer Follow-up is necessary.
Assuntos
Complicações Pós-Operatórias , Estenose Subvalvar Pulmonar/epidemiologia , Transposição dos Grandes Vasos/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Estenose Subvalvar Pulmonar/diagnóstico , Reoperação , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Transposição dos Grandes Vasos/complicações , Transposição dos Grandes Vasos/mortalidade , Resultado do TratamentoRESUMO
Congenital diseases causing obstruction of the right ventricular outflow tract (RVOT) are common, but the isolated subpulmonary membrane/ring is extremely rare and can be difficult to diagnose precisely, especially in adults. We report a case of surgically resected isolated subpulmonic fibrous ring in a lady with mirror-image dextrocardia and abdominal situs solitus that was misdiagnosed by echocardiography as a subaortic membrane.
Assuntos
Anormalidades Múltiplas , Dextrocardia/diagnóstico , Estenose Subaórtica Fixa/diagnóstico , Cardiopatias Congênitas/diagnóstico , Estenose Subvalvar Pulmonar/diagnóstico , Situs Inversus/diagnóstico , Adulto , Procedimentos Cirúrgicos Cardíacos , Erros de Diagnóstico , Ecocardiografia Transesofagiana , Feminino , Humanos , Valor Preditivo dos Testes , Estenose Subvalvar Pulmonar/complicações , Estenose Subvalvar Pulmonar/cirurgia , Resultado do Tratamento , Obstrução do Fluxo Ventricular Externo/diagnóstico , Obstrução do Fluxo Ventricular Externo/etiologiaRESUMO
We report a case of a 13-year old girl with pectus excavatum who had a Nuss procedure and two years later a new cardiac murmur appeared which on investigation was diagnosed as supravalvular pulmonary artery stenosis. Following removal of the Nuss bar the stenosis resolved.
Assuntos
Remoção de Dispositivo , Tórax em Funil/cirurgia , Estenose Subvalvar Pulmonar/diagnóstico , Estenose Subvalvar Pulmonar/etiologia , Adolescente , Ecocardiografia/métodos , Eletrocardiografia/métodos , Feminino , Seguimentos , Tórax em Funil/diagnóstico por imagem , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Dispositivos de Fixação Ortopédica , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Estenose Subvalvar Pulmonar/fisiopatologia , Radiografia , Reoperação/métodos , Medição de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
LEOPARD syndrome (LS) is a rare hereditary disorder, characterised mainly by skin, facial and cardiac abnormalities. We report on the case of a six-year-old Djiboutian with typical features of LS. Multiple cardiovascular problems are described, including pulmonary infundibular, valvular and supra-valvular stenosis. A favourable course was observed after successful cardiac surgery. This is the first reported case of LS from the horn of Africa.
Assuntos
Síndrome LEOPARD/diagnóstico , Estenose Subvalvar Pulmonar/diagnóstico , Estenose da Valva Pulmonar/diagnóstico , Procedimentos Cirúrgicos Cardíacos , Criança , Ecocardiografia Doppler , Eletrocardiografia , Hemodinâmica , Humanos , Síndrome LEOPARD/fisiopatologia , Síndrome LEOPARD/cirurgia , Masculino , Estenose Subvalvar Pulmonar/fisiopatologia , Estenose Subvalvar Pulmonar/cirurgia , Estenose da Valva Pulmonar/fisiopatologia , Estenose da Valva Pulmonar/cirurgia , Resultado do TratamentoAssuntos
Ecocardiografia , Aneurisma Cardíaco/diagnóstico , Comunicação Interventricular/diagnóstico , Estenose Subvalvar Pulmonar/diagnóstico , Valva Tricúspide , Angiografia , Cateterismo Cardíaco , Criança , Ecocardiografia Transesofagiana , Feminino , Aneurisma Cardíaco/cirurgia , Comunicação Interventricular/cirurgia , Humanos , Estenose Subvalvar Pulmonar/cirurgia , Valva Tricúspide/cirurgia , Obstrução do Fluxo Ventricular Externo/diagnóstico , Obstrução do Fluxo Ventricular Externo/cirurgiaRESUMO
Three eight-week-old Golden Retriever puppy littermates were evaluated because of left basilar systolic murmurs and were diagnosed with primary infundibular stenosis. Pedigree analysis in this line was also performed to identify a mode of inheritance. All dogs were asymptomatic at the time of diagnosis; two of the three had congenital lesions in addition to primary infundibular stenosis. Two additional affected dogs were identified in the line, and pedigree analysis suggested an autosomal recessive mode of inheritance. Another, unrelated golden retriever was also identified with isolated infundibular stenosis in the record database. Primary infundibular stenosis should be considered in the differential diagnoses for golden retriever dogs with a left basilar systolic murmur, and is often associated with complex congenital cardiac disease. Primary infundibular stenosis may worsen in severity with time, and in this line of dogs an autosomal recessive pattern of inheritance is likely.
Assuntos
Cruzamento , Doenças do Cão/diagnóstico , Estenose Subvalvar Pulmonar/veterinária , Animais , Animais Recém-Nascidos , Diagnóstico Diferencial , Doenças do Cão/genética , Cães , Ecocardiografia/veterinária , Feminino , Masculino , Estenose Subvalvar Pulmonar/diagnóstico , Estenose Subvalvar Pulmonar/genéticaAssuntos
Forame Oval Patente/diagnóstico , Hipertrofia Ventricular Direita/diagnóstico , Estenose Subvalvar Pulmonar/diagnóstico , Adulto , Angiografia Coronária , Dispneia , Ecocardiografia Transesofagiana , Feminino , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico por imagem , Humanos , Hipertrofia Ventricular Direita/complicações , Hipertrofia Ventricular Direita/diagnóstico por imagem , Estenose Subvalvar Pulmonar/complicações , Estenose Subvalvar Pulmonar/diagnóstico por imagemRESUMO
Transthoracic echocardiography is the first-line modality for cardiovascular imaging in adults with congenital heart disease (ACHD). The windows of access that are possible with transthoracic echocardiography are, however, rarely adequate for all regions of interest. The choice of further imaging depends on the clinical questions that remain to be addressed. The strengths of MRI include comprehensive access and coverage, providing imaging of all parts of the right ventricle, the pulmonary arteries, pulmonary veins and aorta. Cine images and velocity maps are acquired in specifically aligned planes, with stacks of cines or dynamic contrast angiography providing more comprehensive coverage. Tissues can be characterised if necessary, and MRI provides relatively accurate measurements of biventricular function and volume flow. These parameters are important in the assessment and follow-up of adults after repairs for tetralogy of Fallot or transposition of the great arteries and after Fontan operations. The superior spatial resolution and rapid acquisition of CT are invaluable in selected situations, including the visualisation of anomalous coronary or aortopulmonary collateral arteries, the assessment of luminal patency after stenting and imaging in patients with pacemakers. Ionising radiation is, however, a concern in younger patients who may need repeated investigation. Adults with relatively complex conditions should ideally be imaged in a specialist ACHD centre, where dedicated echocardiographic and cardiovascular MRI services are a necessary facility. General radiologists should be aware of the nature and pathophysiology of congenital heart disease, and should be alert for previously undiagnosed cases presenting in adulthood, including cases of atrial septal defect, aortic coarctation, patent ductus arteriosus, double-chambered right ventricle and congenitally corrected transposition.
Assuntos
Ecocardiografia/métodos , Cardiopatias Congênitas/diagnóstico , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Coartação Aórtica/diagnóstico , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Anomalia de Ebstein/diagnóstico , Doenças das Valvas Cardíacas/diagnóstico , Humanos , Hipertensão Pulmonar/diagnóstico , Síndrome de Marfan/diagnóstico , Estenose Subvalvar Pulmonar/diagnóstico , Tetralogia de Fallot/diagnóstico por imagem , Tetralogia de Fallot/cirurgia , Transposição dos Grandes Vasos/cirurgia , Insuficiência da Valva Tricúspide/diagnósticoRESUMO
The management of adult congenital heart disease is challenging and poses specific problems. We report a patient with ventricular septal defect and pulmonary stenosis who underwent successful repair and coronary artery bypass grafting at the age of 76 years.
Assuntos
Comunicação Interventricular/cirurgia , Ventrículos do Coração/cirurgia , Estenose Subvalvar Pulmonar/cirurgia , Idoso , Procedimentos Cirúrgicos Cardíacos , Ponte de Artéria Coronária , Comunicação Interventricular/complicações , Comunicação Interventricular/diagnóstico , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Estenose Subvalvar Pulmonar/complicações , Estenose Subvalvar Pulmonar/diagnóstico , Valva Pulmonar/cirurgia , Resultado do TratamentoRESUMO
Pseudoaneurysm of the right ventricle outflow tract (RVOT) is a rare complication in pediatric cardiac surgery. We report a patient who developed a right ventricular pseudoaneurysm 8 months after RVOT enlargement using a pericardial patch for infundibular pulmonary stenosis. Our patient was born with severe pulmonary valvular stenosis and treated with percutaneous balloon valvotomy in the neonatal period. Six months later, she developed infundibular pulmonary stenosis, which required surgical resection of right ventricle infundibular trabeculations and bovine pericardial patch enlargement. The postoperative period was normal. She was readmitted to hospital 5 months later complaining of wheezing, coughing and shortness of breath. Echocardiography showed a huge aneurysmal dilatation of the outflow patch in connection with the right ventricular cavity. The patient underwent resection of the pseudoaneurysm and former patch, followed by interposition of a bovine jugular vein conduit between the RVOT and pulmonary bifurcation. The early postoperative period was uncomplicated. On echocardiography, no significant residual gradient was measured through the conduit and there was no insufficiency of the valve. RVOT reconstruction with patch enlargement, homograft or conduit implantation can be the origin of pseudoaneurysms. Although their incidence is rare, they are often asymptomatic before becoming quite large and causing compression symptoms as in our patient with respiratory complaints due to airway compression. It is important to follow up these patients closely, especially in the first year after surgery since most aneurysms develop within 6 months of surgery.
Assuntos
Falso Aneurisma/etiologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Aneurisma Cardíaco/etiologia , Pericárdio/transplante , Estenose Subvalvar Pulmonar/cirurgia , Insuficiência Respiratória/etiologia , Falso Aneurisma/diagnóstico , Falso Aneurisma/cirurgia , Cateterismo , Feminino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/cirurgia , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Estenose Subvalvar Pulmonar/diagnóstico , Reoperação , Resultado do TratamentoAssuntos
Neoplasias Cardíacas/diagnóstico , Melanoma/complicações , Melanoma/tratamento farmacológico , Estenose Subvalvar Pulmonar/diagnóstico , Dispneia/etiologia , Evolução Fatal , Neoplasias Cardíacas/cirurgia , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Embolia Pulmonar/diagnóstico , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/tratamento farmacológico , Trombose Venosa/diagnósticoAssuntos
Cardiomiopatia Hipertrófica/complicações , Imageamento por Ressonância Magnética/métodos , Estenose Subvalvar Pulmonar/diagnóstico , Cardiomiopatia Hipertrófica/diagnóstico , Diagnóstico Diferencial , Ecocardiografia Doppler , Humanos , Masculino , Pessoa de Meia-Idade , Estenose Subvalvar Pulmonar/etiologiaRESUMO
We present a case of a 69 year-old woman complaining of palpitations and worsening heart failure, after the 2nd cycle of fludarabine due to Hodgkin's lymphoma. Echocardiography revealed abnormalities typical for corrected transposition of the great arteries (CTGA), which were confirmed in multislice computed tomography (MSCT), as well as subvalvular pulmonary stenosis. There is the case of one of the oldest patients with CTGA and subvalvular pulmonary stenosis. MSCT seems to be a useful and complementary method in diagnosis such diseases.