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Scientific Reports May 2021For CT pulmonary angiograms, a scout view obtained in anterior-posterior projection is usually used for planning. For bolus tracking the radiographer manually locates a...
For CT pulmonary angiograms, a scout view obtained in anterior-posterior projection is usually used for planning. For bolus tracking the radiographer manually locates a position in the CT scout view where the pulmonary trunk will be visible in an axial CT pre-scan. We automate the task of localizing the pulmonary trunk in CT scout views by deep learning methods. In 620 eligible CT scout views of 563 patients between March 2003 and February 2020 the region of the pulmonary trunk as well as an optimal slice ("reference standard") for bolus tracking, in which the pulmonary trunk was clearly visible, was annotated and used to train a U-Net predicting the region of the pulmonary trunk in the CT scout view. The networks' performance was subsequently evaluated on 239 CT scout views from 213 patients and was compared with the annotations of three radiographers. The network was able to localize the region of the pulmonary trunk with high accuracy, yielding an accuracy of 97.5% of localizing a slice in the region of the pulmonary trunk on the validation cohort. On average, the selected position had a distance of 5.3 mm from the reference standard. Compared to radiographers, using a non-inferiority test (one-sided, paired Wilcoxon rank-sum test) the network performed as well as each radiographer (P < 0.001 in all cases). Automated localization of the region of the pulmonary trunk in CT scout views is possible with high accuracy and is non-inferior to three radiographers.
Topics: Adult; Aged; Aged, 80 and over; Angiography; Deep Learning; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Phantoms, Imaging; Pulmonary Artery; Radiation Dosage; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 33986402
DOI: 10.1038/s41598-021-89647-w -
World Journal For Pediatric &... Mar 2023Anomalies of the pulmonary origin of the pulmonary arteries are uncommon; however, the true incidence is unknown and may be underestimated. We sought to review our... (Review)
Review
BACKGROUND
Anomalies of the pulmonary origin of the pulmonary arteries are uncommon; however, the true incidence is unknown and may be underestimated. We sought to review our experience with this unusual pathology and examine its surgical implications.
METHODS
We reviewed medical records between 2011 and 2022.
RESULTS
A total of 24 patients were identified. Genetic syndromes were present in 12 patients (50%). The patients were divided into two main groups. Those with septal defects (14 patients,58.3%), and those without (10 patients, 41.7%). Aortic arch hypoplasia with/without coarctation was present in nine patients (37.5%). Pulmonary arterial branch hypoplasia and/or obstruction was present in six patients (25%) with resultant preoperative systemic or suprasystemic right ventricular pressure. Four patients (16.7%) underwent pulmonary artery branch and/or right ventricular outflow tract interventions prior to surgery. All patients underwent surgical interventions for their associated cardiac defects. The crossed pulmonary arteries were uncrossed for those four patients (16.7%) who required concomitant pulmonary arterioplasties and pulmonary arterial branch rehabilitation and who had elevated right ventricular pressures preoperatively. No early or late mortalities. One Alagille's syndrome underwent liver transplant prior to discharge. Late transcatheter interventions were needed in four (16.7%) during the follow-up period, while four patients required repeat aortic arch augmentation for recurrent arch obstruction.
CONCLUSIONS
Anomalous origin of the pulmonary arteries from the pulmonary trunk including crossed pulmonary arteries is an uncommon anomaly that may be underrecognized. It can occur in isolation or in association with other heart defects. Recognition of this malpositional anomaly is important as it has specific surgical and/or transcatheter implications.
Topics: Humans; Infant; Pulmonary Artery; Hypertension, Pulmonary; Heart Defects, Congenital; Aortic Coarctation; Heart Septal Defects
PubMed: 36511245
DOI: 10.1177/21501351221139833 -
Surgical and Radiologic Anatomy : SRA Nov 2020Previous studies have shown a correlation between axial pulmonary trunk diameter (PTD) on chest computed tomography (CT) and pulmonary artery pressure. However, it is...
PURPOSE
Previous studies have shown a correlation between axial pulmonary trunk diameter (PTD) on chest computed tomography (CT) and pulmonary artery pressure. However, it is not known whether the PTD slices measured on chest CT have been recorded during the systolic or diastolic phase. The aim of this study was to demonstrate the variations in PTD during the cardiac cycle by measuring coronary CT angiography (CCTA) images.
METHODS
A retrospective analysis was made of 101 patients who underwent CCTA for coronary artery disease assessment. CCTA images were reconstructed during a full cardiac cycle and measurements were taken of the systolic and diastolic PTD and ascending aorta diameter (AAD) from the same slice by two independent observers.
RESULTS
Inter-observer agreement was excellent (intraclass correlation coefficient = 0.99) for all CT measurements. The mean systolic PTD of all patients was 26.3 ± 3.6 mm and the mean diastolic PTD was 22.8 ± 3.2 mm (p < 0.001). The mean difference between systole and diastole was found to be 3.5 ± 1.2 mm for PTD, 1.2 ± 0.7 mm for AAD, and 0.1 ± 0.04 for the PTD/AAD ratio (p values < 0.001). There was no statistical significance of PTD variations according to gender, age, height, weight, body mass index, and body surface area.
CONCLUSION
When an increased PTD is detected in a chest CT compared to normal limits or a previous CT scan, this may be the result of the variation in PTD due to the cardiac cycle.
Topics: Adult; Age Factors; Aged; Aorta; Biological Variation, Population; Computed Tomography Angiography; Coronary Angiography; Coronary Artery Disease; Diastole; Female; Humans; Hypertension, Pulmonary; Male; Middle Aged; Pulmonary Artery; Retrospective Studies; Sex Factors; Systole
PubMed: 32405785
DOI: 10.1007/s00276-020-02493-9 -
European Heart Journal Nov 2022
Topics: Humans; Pulmonary Artery; Aneurysm; Fistula; Heart Defects, Congenital; Coronary Artery Disease
PubMed: 35938849
DOI: 10.1093/eurheartj/ehac441 -
The Annals of Thoracic Surgery Feb 2020A patient with main pulmonary artery mass may have severe symptoms and warrants urgent surgical management, whereas in a stable patient with a diagnosis amenable to...
A patient with main pulmonary artery mass may have severe symptoms and warrants urgent surgical management, whereas in a stable patient with a diagnosis amenable to medical treatment, medical management should be started while monitoring the size of the lesion. We report a case in which the patient experienced severe right heart dysfunction due to obstruction of the main pulmonary artery, diagnosed as a probable thrombus, and the patient was taken for urgent surgical excision, later diagnosed as tuberculoma on histopathologic examination.
Topics: Adolescent; Diagnosis, Differential; Echocardiography; Humans; Male; Pulmonary Artery; Stenosis, Pulmonary Artery; Tuberculoma; Tuberculosis, Cardiovascular; Vascular Surgical Procedures
PubMed: 31301274
DOI: 10.1016/j.athoracsur.2019.05.056 -
Current Cardiology Reports Sep 2019Sympathetic overactivity plays an important role in the progression of pulmonary arterial hypertension (PAH). The purpose of this review is to illustrate localization of... (Review)
Review
PURPOSE OF REVIEW
Sympathetic overactivity plays an important role in the progression of pulmonary arterial hypertension (PAH). The purpose of this review is to illustrate localization of pulmonary arterial sympathetic nerves, the key steps of pulmonary artery denervation (PADN) procedure, and to highlight clinical outcomes.
RECENT FINDINGS
Sympathetic nerves mostly occurred in the posterior region of the bifurcation and pulmonary trunk. Emerging preclinical data provided the potential of PADN for PAH. PADN, produced at bifurcation area, improved a profound reduction of pulmonary arterial pressure and ameliorated clinical outcomes with an exclusive ablation catheter. The application of PADN in the patients of PAH or combined pre-capillary and post-capillary PH (CpcPH) improved the hemodynamic parameters and increased 6MWD. Sympathetic overactivity aggravates PAH. PADN is a promising interventional treatment for PAH and CpcPH. Additional clinical trials are warranted to confirm the efficacy of PADN.
Topics: Denervation; Hemodynamics; Humans; Hypertension, Pulmonary; Pressoreceptors; Pulmonary Arterial Hypertension; Pulmonary Artery; Sympathectomy; Sympathetic Nervous System; Treatment Outcome
PubMed: 31486924
DOI: 10.1007/s11886-019-1203-z -
Clinical Cardiology Dec 1997This five-part review focuses on selected nonneoplastic diseases of the aorta and pulmonary trunk. Because many more diseases affect the aorta compared with the... (Review)
Review
This five-part review focuses on selected nonneoplastic diseases of the aorta and pulmonary trunk. Because many more diseases affect the aorta compared with the pulmonary trunk and the right and left main pulmonary arteries, most of this review will be devoted to disorders of the aorta. Part V of this five-part series on diseases of the aorta and the pulmonary trunk focuses on nonneoplastic diseases of the pulmonary trunk and the right and left main pulmonary arteries.
Topics: Aortic Diseases; Humans; Pulmonary Artery
PubMed: 9422842
DOI: 10.1002/clc.4960201210 -
Journal of Cardiovascular... Sep 2018Pulmonary artery-derived ventricular arrhythmia is gradually being recognized, which in a clinical context is recognized as an arterial ectopic beat. Our study aimed to... (Review)
Review
Pulmonary artery-derived ventricular arrhythmia is gradually being recognized, which in a clinical context is recognized as an arterial ectopic beat. Our study aimed to provide new insights on the epidemiological characteristics, origin site, electrocardiogram (ECG) characteristics, intracardiac electrophysiological characteristics and radiofrequency catheter ablation (RFCA) strategies for pulmonary artery-derived ventricular arrhythmia. Patients with a distance between the origin site and the pulmonary valve of >10 mm have what is known as pulmonary trunk-derived ventricular arrhythmia, while patients with a distance between the origin site and the pulmonary valve of ≤10 mm have what is known as pulmonary sinus cusp-derived ventricular arrhythmia. It is very difficult to differentiate pulmonary artery-derived ventricular arrhythmia from right ventricular outflow tract-derived ventricular arrhythmia on ECGs as both share similar anatomical features, but pulmonary artery-derived ventricular arrhythmia shows obvious intracardiac electrophysiological characteristics. Currently, conclusions based on the epidemiological characteristics of pulmonary artery-derived ventricular arrhythmia, relationship between the origin site and the pulmonary valve, electrophysiological characteristics, and RFCA strategies are controversial and still need further study.
Topics: Catheter Ablation; Electrocardiography; Humans; Pulmonary Artery; Ventricular Fibrillation; Ventricular Premature Complexes
PubMed: 29864191
DOI: 10.1111/jce.13652 -
Brazilian Journal of Anesthesiology... 2017The aneurysm in the pulmonary trunk is a rare disease. Because of its location, a rupture can lead to right ventricular failure and sudden death. Aneurysmorraphy is the...
BACKGROUND AND OBJECTIVES
The aneurysm in the pulmonary trunk is a rare disease. Because of its location, a rupture can lead to right ventricular failure and sudden death. Aneurysmorraphy is the most widely used surgical treatment in these cases. The aim of this study is to report a successful balanced general anesthesia for aneurysmorraphy of pulmonary trunk.
CASE REPORT
Male patient, 28 years, asymptomatic, diagnosed with an aneurysm in the pulmonary trunk. According to the location of the aneurysm and the consequent failure of the pulmonary valve, an aneurysmorraphy was indicated, with implantation of vascular-valvular prosthesis (valved tube). We opted for a balanced general anesthesia, seeking to prevent an increase in systemic and pulmonary vascular resistances, thus avoiding to cause stress on the wall of the aneurysmal vessel.
CONCLUSIONS
A balanced general anesthesia, in combination with adequate ventilation to prevent elevation in pulmonary vascular pressure, was appropriate for surgical repair of an aneurysm in the pulmonary trunk.
Topics: Adult; Aneurysm; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Pulmonary Artery; Pulmonary Valve; Radiography
PubMed: 28017178
DOI: 10.1016/j.bjane.2013.03.027 -
Asian Cardiovascular & Thoracic Annals May 2021Coronary artery anomalies are a diverse group of disorders with highly variable manifestations and pathophysiological mechanisms. The origin of a single coronary artery...
Coronary artery anomalies are a diverse group of disorders with highly variable manifestations and pathophysiological mechanisms. The origin of a single coronary artery from an atretic pulmonary trunk is a rare anomaly. We encountered this in an 8-day-old female newborn. This report should alert the cardiac surgical community to this fatal coronary malformation. Surgeons should bear this anomaly in mind when they face unusual myocardial behavior intraoperatively.
Topics: Abnormalities, Multiple; Coronary Vessel Anomalies; Coronary Vessels; Female; Heart Defects, Congenital; Humans; Infant, Newborn; Pulmonary Artery; Pulmonary Atresia
PubMed: 33023303
DOI: 10.1177/0218492320963969