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Echocardiography (Mount Kisco, N.Y.) Apr 20243D virtual and physical models from ultrasound scan data allow a 3D spatial view of congenital heart anomalies, interactive discussion among a multidisciplinary team,...
3D virtual and physical models from ultrasound scan data allow a 3D spatial view of congenital heart anomalies, interactive discussion among a multidisciplinary team, and improved parental counseling. To the best of our knowledge, this is the first description of 3D physical and virtual models of a fetal Ebstein anomaly.
Topics: Pregnancy; Female; Humans; Ebstein Anomaly; Heart Defects, Congenital; Ultrasonography, Prenatal
PubMed: 38549419
DOI: 10.1111/echo.15806 -
Journal of Cardiovascular... Jun 2024Pacemaker implantation can be challenging in patients with congenital heart disease.
INTRODUCTION
Pacemaker implantation can be challenging in patients with congenital heart disease.
METHODS AND RESULTS
In a patient with Ebstein disease and symptomatic sinus node dysfunction, despite multiple attempts, the Micra® pacemaker could not be implanted in the severely dilated right ventricle. In that context, and after iodine injection to confirm the appropriate location, the Micra® pacemaker was successfully implanted in the right appendage at the first attempt.
CONCLUSION
Despite the recent development of dedicated dual-chamber leadless pacemaker, to the best of our knowledge, this case is the first off-label Micra® implantation in a right appendage.
Topics: Humans; Pacemaker, Artificial; Atrial Appendage; Cardiac Pacing, Artificial; Sick Sinus Syndrome; Ebstein Anomaly; Treatment Outcome; Male; Equipment Design
PubMed: 38534004
DOI: 10.1111/jce.16261 -
CASE (Philadelphia, Pa.) Mar 2024• Ebstein anomaly (EA) has varied presentations that require complex decision-making. • Imaging is important before surgery to optimize timing and choose method of...
• Ebstein anomaly (EA) has varied presentations that require complex decision-making. • Imaging is important before surgery to optimize timing and choose method of repair. • Postoperatively, patients with EA require follow-up with multimodality imaging.
PubMed: 38524980
DOI: 10.1016/j.case.2023.12.003 -
CASE (Philadelphia, Pa.) Mar 2024• IVSH is a rare complication of cardiac surgery. • TTE with UEA is valuable in the diagnosis and follow-up of the hematoma. • Conservative management is allowed...
• IVSH is a rare complication of cardiac surgery. • TTE with UEA is valuable in the diagnosis and follow-up of the hematoma. • Conservative management is allowed under intensive supervision.
PubMed: 38524965
DOI: 10.1016/j.case.2023.12.005 -
Journal of the American Heart... Mar 2024Distances between delivery and cardiac services can make the care of fetuses with cardiac disease at risk of acute cardiorespiratory instability at birth a challenge. In... (Review)
Review
BACKGROUND
Distances between delivery and cardiac services can make the care of fetuses with cardiac disease at risk of acute cardiorespiratory instability at birth a challenge. In 2013 we implemented a fetal echocardiography-based algorithm targeting fetuses considered high risk for acute cardiorespiratory instability at ≤2 hours of birth for delivery in our pediatric cardiac operating room of our children's hospital, and, herein, examine our experience.
METHODS AND RESULTS
We reviewed maternal and postnatal medical records of all fetuses with cardiac disease encountered January 2013 to March 2022 considered high risk for acute cardiorespiratory instability. Secondary analysis was performed including all fetuses with diagnoses of d-transposition of the great arteries/intact ventricular septum (d-TGA/IVS) and hypoplastic left heart syndrome (HLHS) encountered over the study period. Forty fetuses were considered high risk for acute cardiorespiratory instability: 15 with d-TGA/IVS and 7 with HLHS with restrictive atrial septum, 4 with absent pulmonary valve syndrome, 3 with obstructed anomalous pulmonary veins, 2 with severe Ebstein anomaly, 2 with thoracic/intracardiac tumors, and 7 others. Pediatric cardiac operating room delivery occurred for 33 but not for 7 (5 with d-TGA/IVS, 2 with HLHS with restrictive atrial septum). For high-risk cases, fetal echocardiography had a positive predictive value of 50% for intervention/extracorporeal membrane oxygenation/death at ≤2 hours and 70% at ≤24 hours. Of "low-risk" cases, 6/46 with d-TGA/IVS and 0/45 with HLHS required intervention at ≤2 hours. Fetal echocardiography for predicting intervention/extracorporeal membrane oxygenation/death at ≤2 hours had a sensitivity of 67%, specificity 93%, and positive and negative predictive values of 80% and 87%, respectively, for d-TGA/IVS, and 100%, 95%, 71%, and 100% for HLHS, respectively.
CONCLUSIONS
Fetal echocardiography can predict the need for urgent intervention in a majority with d-TGA/IVS and HLHS and in half of the entire spectrum of high-risk cardiac disease.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Child; Transposition of Great Vessels; Operating Rooms; Fetal Heart; Ultrasonography, Prenatal; Heart Defects, Congenital; Hypoplastic Left Heart Syndrome; Retrospective Studies
PubMed: 38497437
DOI: 10.1161/JAHA.123.031184 -
Journal of Interventional Cardiac... Mar 2024
PubMed: 38480673
DOI: 10.1007/s10840-024-01784-0 -
Human & Experimental Toxicology 2024In bipolar women who took lithium during pregnancy, several epidemiology studies have reported small increases in a rare fetal cardiac defect termed Ebstein's anomaly.
INTRODUCTION
In bipolar women who took lithium during pregnancy, several epidemiology studies have reported small increases in a rare fetal cardiac defect termed Ebstein's anomaly.
METHODS
Behavioral, environmental, and lifestyle-associated risk factors associated with bipolar disorder and health insurance status were determined from an Internet search. The search was conducted from October 1, 2023, through October 14, 2023. The search terms employed included the following: bipolar, bipolar disorder, mood disorders, pregnancy, congenital heart defects, Ebstein's anomaly, diabetes, hypertension, Medicaid, Medicaid patients, alcohol use, cigarette smoking, marijuana, cocaine, methamphetamine, narcotics, nutrition, diet, obesity, body mass index, environment, environmental exposures, poverty, socioeconomic status, divorce, unemployment, and income. No quotes, special fields, truncations, etc., were used in the searches. No filters of any kind were used in the searches.
RESULTS
Women who remain on lithium in the United States throughout their pregnancy are likely to be experiencing mania symptoms and/or suicidal ideation refractory to other drugs. Pregnant women administered the highest doses of lithium salts would be expected to have been insufficiently responsive to lower doses. Any small increases in the retrospectively determined risk of fetal cardiac anomalies in bipolar women taking lithium salts cannot be disentangled from potential developmental effects resulting from very high rates of cigarette smoking, poor diet, alcohol abuse, ingestion of illegal drugs like cocaine or opioids, marijuana smoking, obesity, and poverty.
CONCLUSIONS
The small risks in fetal cardiac abnormalities reported in the epidemiology literature do not establish a causal association for lithium salts and Ebstein's anomaly.
Topics: Humans; Pregnancy; Female; Lithium; Ebstein Anomaly; Teratogens; Salts; Retrospective Studies; Antimanic Agents; Teratogenesis; Cocaine; Obesity
PubMed: 38394684
DOI: 10.1177/09603271241236346 -
Indian Journal of Thoracic and... Mar 2024A combination of a ruptured sinus of Valsalva (RSOV) with anomaly is a rare and clinically challenging entity. We describe a case of a 29-year-old female who presented...
UNLABELLED
A combination of a ruptured sinus of Valsalva (RSOV) with anomaly is a rare and clinically challenging entity. We describe a case of a 29-year-old female who presented with progressive dyspnoea and epigastric discomfort with symptoms and clinical findings not consistent with any single definitive diagnosis. In the primary echocardiography assessment, she was diagnosed with Ebstein anomaly. On the grounds of several unexplained clinical features and routine review echocardiography by the cardiology team, she was found to have a rare combination of Ebstein anomaly associated with RSOV. A cath study was performed to study the interplay of the hemodynamics of the two lesions, not described before in the literature, and also explain the clinical features not consistent with any one entity. We emphasize the significance of meticulous history-taking and sound clinical evaluation followed by corroboration with the diagnostic modalities for precise diagnosis and timely planned intervention in such rare associations.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12055-023-01622-4.
PubMed: 38389768
DOI: 10.1007/s12055-023-01622-4 -
Oxford Medical Case Reports Feb 2024Endomyocardial fibrosis (EMF) is a rare and often underdiagnosed form of restrictive cardiomyopathy. Prognosis is generally unfavorable. Early diagnosis, along with...
Endomyocardial fibrosis (EMF) is a rare and often underdiagnosed form of restrictive cardiomyopathy. Prognosis is generally unfavorable. Early diagnosis, along with surgical and medical intervention, is crucial for improved outcomes. We report the case of a 15-year-old girl from Guinea who presented with suspected Ebstein's anomaly and severe right heart failure. Multimodal cardiac imaging revealed right ventricular EMF. Despite counseling on prognosis, the family declined surgery. The patient experienced cardiac arrest two months later.
PubMed: 38370497
DOI: 10.1093/omcr/omad158