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Journal of the College of Physicians... Dec 2019A double-chambered right ventricle (DCRV) is a rare congenital heart defect. The clinical features of DCRV, especially in the pediatric population, have not been...
A double-chambered right ventricle (DCRV) is a rare congenital heart defect. The clinical features of DCRV, especially in the pediatric population, have not been sufficiently elaborated. There are many unanswered questions regarding the surgical indications, surgical timing, natural history, and patient outcomes. This article will discuss the definition, pathophysiology, clinical features and treatment of DCRV. This systematic review showed a higher prevalence of symptomatic patients among children with DCRV with signs of right ventricular pressure overload and associated congenital heart defects. The spatial relation between ventricular septal defect and the anomalous muscle bundle might be a determinant of right ventricular obstruction. Symptomatic patients with an intra-right ventricular pressure gradient of >20 mmHg are indicated for a surgical repair. DCRV has a favourable postoperative course as no postoperative death was reported. Mechanisms of right ventricular obstruction warrant further elucidations based on larger patient population in the near future.
Topics: Child; Echocardiography; Global Health; Heart Defects, Congenital; Heart Ventricles; Humans; Prevalence; Ventricular Pressure
PubMed: 31839094
DOI: 10.29271/jcpsp.2019.12.1193 -
The Journal of Thoracic and... Oct 2023
Topics: Humans; Heart Ventricles; Vascular Surgical Procedures; Coronary Artery Disease; Coronary Circulation
PubMed: 37156361
DOI: 10.1016/j.jtcvs.2023.04.046 -
Herzschrittmachertherapie &... Jun 2022Catheter ablation of ventricular tachycardias (VTs) is one of the most complex tasks in interventional electrophysiology. It is complicated by the fact that VT can recur... (Review)
Review
BACKGROUND
Catheter ablation of ventricular tachycardias (VTs) is one of the most complex tasks in interventional electrophysiology. It is complicated by the fact that VT can recur during treatment which can affect the hemodynamic stability of the patient. In addition, navigation with the ablation or mapping catheter through the valvular apparatus and the trabecularization of the ventricle can be challenging.
MATERIALS AND METHODS
In most cases, a three-dimensional mapping system is used to facilitate orientation and the search for the site where the tachycardia originates. Access to the right ventricle is usually via the tricuspid valve, but in exceptional cases it may also be necessary to use the epicardial venous system. The structures most commonly responsible for an arrhythmia from the right ventricle are the right ventricular outflow tract, the moderator band and the tricuspid valve annulus. The right ventricle is adjacent to vulnerable neighboring structures in many places: In the right ventricular outflow tract, the sinus valsalva, the pulmonary artery and the left ventricular endocardial transition between the aortic and mitral valves must be considered. When ablating along the tricuspid valve annulus, the proximity to the septum and thus to the specific conduction system is particularly important.
CONCLUSION
Knowledge of the surrounding structures helps, on the one hand, to draw the right conclusions about the point of origin in the surface ECG, and, on the other hand, to carry out the ablation successfully and safely.
Topics: Catheter Ablation; Electrocardiography; Heart Ventricles; Humans; Tachycardia, Ventricular; Ventricular Premature Complexes
PubMed: 35552488
DOI: 10.1007/s00399-022-00857-9 -
Trends in Cardiovascular Medicine Nov 2021
Topics: Cardiomyopathies; Echocardiography; Heart Ventricles; Humans
PubMed: 33129974
DOI: 10.1016/j.tcm.2020.10.009 -
Journal of Cardiothoracic and Vascular... May 2023
Topics: Humans; Heart Ventricles; Heart Defects, Congenital; Heart Septal Defects, Ventricular
PubMed: 36828709
DOI: 10.1053/j.jvca.2023.01.031 -
Journal of Cardiothoracic and Vascular... Aug 2022
Topics: Heart Failure; Heart Ventricles; Heart-Assist Devices; Humans
PubMed: 35581052
DOI: 10.1053/j.jvca.2022.04.020 -
BMC Cardiovascular Disorders Dec 2019Hepatocellular carcinoma (HCC) with right ventricle metastasis without inferior vena cava and right atrium involvement is very rare and the prognosis of HCC with RV... (Review)
Review
BACKGROUND
Hepatocellular carcinoma (HCC) with right ventricle metastasis without inferior vena cava and right atrium involvement is very rare and the prognosis of HCC with RV metastasis is generally poor. The mass in the cardiac chamber may lead to lethal instability of hemodynamics, however, the initial symptom is probably non-specific, which means that diagnosis timely becomes even harder.
CASE PRESENTATION
We present a 63-year-old male with isolated metastasis of HCC in the right ventricle which caused inflow obstruction. Moreover, we reviewed a series of studies of isolated metastasis of hepatocellular carcinoma between 1980 and 2018, and summarized the relative outcomes.
CONCLUSIONS
Isolated metastasis of hepatocellular carcinoma in the right ventricle is extraordinarily rare. It may damage cardiac structure and broke hemodynamic balance. Multimodality imaging plays an important in accurate pre-operation assessment. Nowadays, palliative treatments could relieve fatal symptoms to some degree, however, standard treatment has not been well established.
Topics: Carcinoma, Hepatocellular; Cardiac Surgical Procedures; Heart Neoplasms; Heart Ventricles; Humans; Liver Neoplasms; Male; Middle Aged; Recovery of Function; Treatment Outcome
PubMed: 31830920
DOI: 10.1186/s12872-019-01290-6 -
The Journal of Thoracic and... Sep 2023
Topics: Humans; Tricuspid Valve; Heart Ventricles; Tricuspid Valve Insufficiency
PubMed: 34799091
DOI: 10.1016/j.jtcvs.2021.11.002 -
Current Cardiology Reviews Feb 2013Despite ample evidence that right ventricular function is a critical determinant of the clinical response to a spectrum of cardiovascular diseases, there has been only a... (Review)
Review
Despite ample evidence that right ventricular function is a critical determinant of the clinical response to a spectrum of cardiovascular diseases, there has been only a limited analysis of the unique and distinguishing physiologic properties of the RV under normal circumstances and in response to pathologic insults. This knowledge deficit is increasingly acknowledged. This review highlights some of these features and underscores the fact that rational therapy in RV failure needs to acknowledge its unique physiology and ought to be chamber specific. That is proven therapies for LV dysfunction do not necessarily apply to the RV. The updated version of this review now acknowledges recent advances in the understanding of metabolic, inflammatory and gender-specific influences on the right ventricle.
Topics: Heart Ventricles; Humans; Hypertension, Pulmonary; Sex Factors; Ventricular Dysfunction, Right; Ventricular Function, Right
PubMed: 23092273
DOI: 10.2174/157340313805076296 -
The Journal of Thoracic and... Aug 2017Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and...
OBJECTIVES
Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation.
METHODS
The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles.
RESULTS
Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%.
CONCLUSIONS
Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum.
Topics: Double Outlet Right Ventricle; Heart Ventricles; Humans; Ventricular Septum
PubMed: 28528718
DOI: 10.1016/j.jtcvs.2017.03.049