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Clinical and Translational Medicine Jul 2024
Topics: Forkhead Transcription Factors; Humans; Heart Septal Defects, Atrial; Animals
PubMed: 38924312
DOI: 10.1002/ctm2.1676 -
Journal of Cardiothoracic and Vascular... Jun 2024
"Concomitant Percutaneous Atrial Septal Defect Closure With an Amplatzer Septal Occluder and HeartMate 3 Implantation for High-risk Heart Failure Patients: A Novel Hybrid Strategy".
PubMed: 38918093
DOI: 10.1053/j.jvca.2024.06.005 -
Cureus Jun 2024Sinus venosus atrial septal defects (SVASD) associated with partial anomalous pulmonary venous return (PAPVR) can be overlooked as a source of dyspnea in adult patients...
Sinus venosus atrial septal defects (SVASD) associated with partial anomalous pulmonary venous return (PAPVR) can be overlooked as a source of dyspnea in adult patients with pulmonary hypertension. We present the case of a 61-year-old male with exertional dyspnea initially attributed to pulmonary hypertension, who was subsequently diagnosed with SVASD and right superior PAPVR. This case underscores the critical importance of maintaining high clinical awareness and utilizing multimodal imaging techniques in cardiology to accurately diagnose and manage pulmonary hypertension secondary to congenital heart disease. Timely surgical correction can significantly improve morbidity and mortality outcomes.
PubMed: 38915839
DOI: 10.7759/cureus.62935 -
European Heart Journal. Case Reports Jun 2024Fontan surgery aims to palliate univentricular congenital heart diseases in which biventricular repair is not feasible. A large spectrum of early and late complications...
BACKGROUND
Fontan surgery aims to palliate univentricular congenital heart diseases in which biventricular repair is not feasible. A large spectrum of early and late complications has been described in literature. However, pulmonary thromboembolism represents a rare complication in these patients, leading to a scarcity of evidence regarding diagnosis and treatment strategies.
CASE SUMMARY
We present a case of a 27-year-old woman born with a complex cyanotic congenital heart disease, namely pulmonary and tricuspid stenosis with subaortic interventricular communication and atrial septal defect, who underwent palliation surgery with Blalock-Taussig shunt, bidirectional Glenn, and extracardiac Fontan. She developed acute respiratory failure and was admitted to the hospital, being diagnosed with bilateral thromboembolism. Since she was haemodynamically stable, initially, a conservative approach was chosen. However, due to no clinical improvement, she subsequently underwent bilateral thromboaspiration with restoration of pulmonary circulation.
DISCUSSION
Due to the unique Fontan pathophysiology, the possible physiological and clinical implications of pulmonary thromboembolism in this condition are profound. Thus, care and imaging tests in specialized centres are important as the management of these patients is different from those with biventricular physiology.
PubMed: 38915741
DOI: 10.1093/ehjcr/ytae190 -
Journal of Cardiology Jun 2024The left atrium approach for atrial fibrillation (AF) ablation requires an atrial transseptal puncture that may cause an iatrogenic atrial septal defect (iASD). This...
BACKGROUND
The left atrium approach for atrial fibrillation (AF) ablation requires an atrial transseptal puncture that may cause an iatrogenic atrial septal defect (iASD). This study aimed to investigate the incidence and predictors of iASD in catheter ablation, assessed by transthoracic echocardiography (TTE), a relatively non-invasive technique frequently employed in follow-up.
METHODS
This retrospective study included 639 patients (489 male; 60.2 ± 10.7 years) who underwent initial catheter ablation for AF between May 2005 and June 2018. All patients underwent preprocedural transesophageal echocardiography (pre-TEE), preprocedural TTE (pre-TTE), and TTE one day after the procedure (post-TTE). iASD incidence after 6 months (6 M), preprocedural characteristics, and procedure methods were evaluated.
RESULTS
Patent foramen ovale (PFO) was diagnosed in 42 patients (6.6 %) using pre-TEE and in 11 patients using pre-TTE (26.2 % of the patients with PFO in pre-TEE). Among the 597 patients without PFO, 497 underwent 6 M-TTE. iASD was observed in 59.6 % of patients using post-TTE and 4.6 % using 6 M-TTE. In the univariate logistic regression analysis, the total diameter of the sheath through the septum (odds ratio 1.15, p < 0.001) or two sheaths through a single puncture (odds ratio 4.17, p = 0.001) were independent risk factors on iASD incidence in 6 M-TTE. iASD was also more likely to occur via cryoballoon ablation using a larger sheath than radiofrequency catheter ablation.
CONCLUSIONS
iASD was not a rare complication. A larger sheath diameter or two sheaths through a single puncture were associated with the incidence of iASD.
PubMed: 38914280
DOI: 10.1016/j.jjcc.2024.06.007 -
JACC. Case Reports Jul 2024A patient presented with severe right heart failure due to a large LV-to-RA shunt with left-to-right shunting and torrential tricuspid regurgitation 6-weeks following...
A patient presented with severe right heart failure due to a large LV-to-RA shunt with left-to-right shunting and torrential tricuspid regurgitation 6-weeks following surgical sub-aortic stenosis resection. Retrograde delivery of an Occlutech ventricular septal defect device produced instantaneous resolution of shunt, reduction in tricuspid regurgitation, and impressive diuresis of 28 kg.
PubMed: 38912319
DOI: 10.1016/j.jaccas.2024.102389 -
Pediatric Investigation Jun 2024In patients with transposition of the great arteries, the continuation of prostaglandin E1 is more frequent in patients with intact ventricular septum in comparison to...
In patients with transposition of the great arteries, the continuation of prostaglandin E1 is more frequent in patients with intact ventricular septum in comparison to patients with ventricular septal defect. Ballon atrial septostomy did not eliminate the need for prostaglandin E1 infusion until the time of surgery in both subgroups of patients.
PubMed: 38910849
DOI: 10.1002/ped4.12425 -
Cureus May 2024Cyclin-dependent kinase 13 (CDK13)-related disorder is a rare autosomal dominant disease caused by pathogenic variants in the gene. This disorder was found to be...
Cyclin-dependent kinase 13 (CDK13)-related disorder is a rare autosomal dominant disease caused by pathogenic variants in the gene. This disorder was found to be related to several clinical features, including structural cardiac anomalies, developmental delay, anomalies of the corpus callosum, and a variety of facial dysmorphisms. In addition, feeding difficulties and neonatal hypotonia might also present. The diagnosis of this disorder is based on molecular genetic testing to detect the causative pathogenic variants. Here, we report a case of a one-year-old girl from Yemen, residing in Bahrain, with a CDK13-related disorder who was found to have an unusual association of abdominal situs inversus along with multiple structural cardiac anomalies, including atrial septal defect, ventricular septal defect, patent ductus arteriosus, interrupted inferior vena cava, bilateral superior vena cava, mild coarctation of the aorta, dilated coronary sinuses, and mild regurgitation in the tricuspid valve. Moreover, facial dysmorphism including medial epicanthal folds, posteriorly rotated ears, and a depressed nasal bridge was also noted. Further assessment showed a delay in reaching developmental milestones, including speech and motor delay. The patient also presented with recurrent episodes of upper respiratory tract infections, acute bronchiolitis, and lobar pneumonia which required admission to the intensive care unit and ventilation. The last infection episode was at the age of one year. Thereafter, the patient underwent cardiac repair of the ventricular septal defect followed by no more infection episodes until the age of one year and two months. The diagnosis of CDK13 was confirmed by a whole exome sequencing test which demonstrated a novel missense variant in exon 14 of the gene as a variant of uncertain significance in a heterozygous state.
PubMed: 38910624
DOI: 10.7759/cureus.60970 -
Cureus May 2024This case report presents a rare incidence of a persistent Eustachian valve (EV) causing notable venous dilation in the abdominal and pelvic regions of a 44-year-old...
This case report presents a rare incidence of a persistent Eustachian valve (EV) causing notable venous dilation in the abdominal and pelvic regions of a 44-year-old healthy male. Initially presenting with left flank pain, diagnostic evaluations identified a 4.8-mm calculus in the distal left ureterovesical junction. Incidentally, imaging also revealed unexplained venous distensions, subsequently attributed to a prominent EV obstructing the inferior vena cava (IVC). The EV, an embryological structure in fetal circulation that helps divert blood from the IVC to the left atrium via the foramen ovale, typically regresses postnatally. Its persistence into adulthood is uncommon and often does not necessitate intervention. However, a persistent EV is often associated with other cardiac findings, especially a patent foramen ovale (PFO) of an atrial septal defect (ASD). There were some reports demonstrating that persistent EV may play a role in an increased risk of paradoxical cerebral embolism in such cases. Therefore, the case underscores the importance of considering such embryological remnants in the differential diagnoses of unexplained venous distension and cryptogenic stroke. It also highlighted the need for a personalized approach to management, especially during the preparation phase before interventional procedures, such as an ASD closure, to minimize the risks during the operation. Furthermore, it also contributed to a broader understanding of the clinical implications of persistent embryological structures and emphasized the value of meticulous diagnostic processes in identifying the underlying causes of observed anomalies.
PubMed: 38910619
DOI: 10.7759/cureus.60994 -
Cardiology Clinics Aug 2024Patent foramen ovale (PFO) and atrial septal defects (ASDs) are two types of interatrial communications with unique clinical presentations and management strategies. The... (Review)
Review
Patent foramen ovale (PFO) and atrial septal defects (ASDs) are two types of interatrial communications with unique clinical presentations and management strategies. The PFO is a normal part of fetal development that typically closes shortly after birth but may persist in as many as 25% to 30% of adults. The communication between atria may result in paradoxic embolism and embolic stroke. On the other hand, ASDs (anatomically defined as secundum, primum, sinus venosus, and coronary sinus in order of prevalence) typically result in right heart volume overload and are often associated with other congenital defects. The diagnostic methods, treatment options including surgical and percutaneous approaches, and potential complications are described. Both conditions underline the significance of precise diagnosis and appropriate management to mitigate risks and ensure optimal patient outcomes.
Topics: Humans; Foramen Ovale, Patent; Heart Septal Defects, Atrial; Cardiac Surgical Procedures; Echocardiography, Transesophageal; Cardiac Catheterization; Septal Occluder Device; Global Health
PubMed: 38910025
DOI: 10.1016/j.ccl.2024.02.019