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AORN Journal Mar 2007Total anomalous pulmonary venous connection (TAPVC) is a congenital heart defect in which there is no connection between the pulmonary veins and the left atrium. An... (Review)
Review
Total anomalous pulmonary venous connection (TAPVC) is a congenital heart defect in which there is no connection between the pulmonary veins and the left atrium. An anomalous connection is established that allows the pulmonary veins to deliver pulmonary venous blood to the right side of the heart rather than to the left side. A patent foramen ovale or an atrial septal defect develops in utero, allowing a right-to-left shunting of blood without which the infant would die. This article describes normal embryology, abnormal embryology that results in TAPVC, types of anomalous connections, how TAPVC is diagnosed, surgical correction, and nursing interventions when caring for patients with TAPVC and dealing with the concerns of their family members.
Topics: Heart Atria; Humans; Infant; Infant, Newborn; Patient Care Planning; Perioperative Nursing; Professional-Family Relations; Pulmonary Veins
PubMed: 17352891
DOI: 10.1016/S0001-2092(07)60123-9 -
ASAIO Journal (American Society For... Aug 2022A pumpless artificial lung has the potential to provide a bridge to recovery or transplantation in children with respiratory failure. Pulmonary artery inflow and left...
A pumpless artificial lung has the potential to provide a bridge to recovery or transplantation in children with respiratory failure. Pulmonary artery inflow and left atrial outflow are necessary for low-gradient, pumpless systems; however, long-term cannulation of the fragile left atrium remains problematic. In this technique, the left atrium and pulmonary artery were exposed through a left anterior thoracotomy. Inflow to the artificial lung was created using an end-to-side anastomosis with the pulmonary artery. Device outflow was established through the left atrium. A single-stage venous cannula was passed through a free PTFE graft. Using polypropylene with pledgets, two concentric purse-string sutures were placed in the dome of the left atrium. The venous cannula was inserted. The graft was slid down the cannula and circumferentially secured to the adjacent left atrial tissue and pledgets. The other end of the graft was secured to the cannula with silk ties. The procedure was successful in 10 sheep. Initial device blood flow was 969 ± 222 ml/min, which remained stable for up to 7 days with no anastomotic complications. This is an effective method of achieving secure, long-term left atrial cannulation without cardiopulmonary bypass for use in a low-resistance, pumpless artificial lung. And, most importantly, improves the ease and safety of cannula replacement and final decannulation when AL support is no longer required.
Topics: Animals; Cardiopulmonary Bypass; Catheterization; Heart Atria; Heart-Assist Devices; Lung; Sheep
PubMed: 35905308
DOI: 10.1097/MAT.0000000000001693 -
Journal of the American Heart... Apr 2020Historically, atrial fibrillation has been observed in clinical settings of prolonged hemodynamic stress, eg, hypertension and valvular heart disease. However, recently,... (Review)
Review
Historically, atrial fibrillation has been observed in clinical settings of prolonged hemodynamic stress, eg, hypertension and valvular heart disease. However, recently, the most prominent precedents to atrial fibrillation are metabolic diseases that are associated with adipose tissue inflammation (ie, obesity and diabetes mellitus) and systemic inflammatory disorders (ie, rheumatoid arthritis and psoriasis). These patients typically have little evidence of left ventricular hypertrophy or dilatation; instead, imaging reveals abnormalities of the structure or function of the atria, particularly the left atrium, indicative of an atrial myopathy. The left atrium is enlarged, fibrotic and noncompliant, potentially because the predisposing disorder leads to an expansion of epicardial adipose tissue, which transmits proinflammatory mediators to the underlying left atrium. The development of an atrial myopathy not only leads to atrial fibrillation, but also contributes to pulmonary venous hypertension and systemic thromboembolism. These mechanisms explain why disorders of systemic or adipose tissue inflammation are accompanied an increased risk of atrial fibrillation, abnormalities of left atrium geometry and an enhanced risk of stroke. The risk of stroke exceeds that predicted by conventional cardiovascular risk factors or thromboembolism risk scores used to guide the use of anticoagulation, but it is strongly linked to clinical evidence and biomarkers of systemic inflammation.
Topics: Adipose Tissue; Animals; Atrial Fibrillation; Atrial Function, Left; Atrial Remodeling; Fibrosis; Heart Atria; Humans; Inflammation; Inflammation Mediators; Prognosis; Risk Assessment; Risk Factors
PubMed: 32242478
DOI: 10.1161/JAHA.119.015343 -
Annals of Palliative Medicine Jan 2021To observe the changes of left atrial and left ventricular function in patients with hypertensive disorders of pregnancy (HDP) based on myocardial strain.
BACKGROUND
To observe the changes of left atrial and left ventricular function in patients with hypertensive disorders of pregnancy (HDP) based on myocardial strain.
METHODS
A total of 66 HDP patients admitted to our hospital were retrospectively analyzed, and 36 normal pregnant admitted during the same period women were selected as the control group. The maximum volume of the left atrium (LAVmax), minimum volume of the left atrium (LAVmin), left atrial active ejection fraction (LAAEF), mitral ratio of peak early to late diastolic filling velocity (E/A), and left ventricular active ejection fraction (LVEF) were measured by conventional echocardiography. The peak systolic strain rate (SRs) of each wall of the left atrium during early systole (SRe) and late diastole (SRa) was detected by speckle-tracking imaging (STI). The longitudinal (LS), radial (RS), and circumferential strain (CS) parameters of each wall of the left ventricle were also measured. The above parameters were compared between the two groups, and the correlation between mean SRa (mSRa) and LAAEF as well as left ventricular global longitudinal strain (GLS) and LVEF in HDP patients was analyzed.
RESULTS
LAVmax, LAVmin, and LAAEF in the HDP group were higher than those in the control group, while the E/A ratio was lower than that in control group (all P<0.05). However, there was no significant difference in LVEF between the two groups (P>0.05). In the HDP group, the absolute values of SRs and SRe in each wall of the left atrium were lower than those in the control group, while the absolute values of SRa were higher than those in the control group. In addition, the absolute values of LS, CS, and RS values in each wall of left ventricle in the HDP group were lower than those in the control group (all P<0.05). Pearson correlation analysis showed that mSRa was negatively correlated with LAAEF (r=-0.895, P=0.000) and that left ventricular long-axis GLS was negatively correlated with LVEF (r=-0.646, P=0.000) in HDP patients.
CONCLUSIONS
According to the STI results, HDP patients experience significant left atrial and left ventricular myocardial strain injury. Therefore, monitoring of cardiac function and early intervention should be strengthened in clinical practice.
Topics: Echocardiography; Female; Heart Atria; Humans; Hypertension, Pregnancy-Induced; Pregnancy; Retrospective Studies; Ventricular Function, Left
PubMed: 33545789
DOI: 10.21037/apm-20-2573 -
Europace : European Pacing,... Nov 2008The emergence of catheter based ablation therapy for the prevention of recurrent atrial fibrillation has increased interest in the anatomy of the left atrium and... (Review)
Review
The emergence of catheter based ablation therapy for the prevention of recurrent atrial fibrillation has increased interest in the anatomy of the left atrium and pulmonary veins. In this article, we review the magnetic resonance imaging method of imaging the left atrium and the pulmonary veins, normal and variant anatomy, and the utility of imaging before and after atrial fibrillation ablation.
Topics: Atrial Fibrillation; Heart Atria; Heart Conduction System; Humans; Magnetic Resonance Imaging; Pulmonary Veins; Surgery, Computer-Assisted
PubMed: 18955395
DOI: 10.1093/europace/eun223 -
Journal of the American College of... Jan 2008Left atrial (LA) structural and functional remodeling reflects a spectrum of pathophysiological changes that have occurred in response to specific stressors. These... (Review)
Review
Left atrial (LA) structural and functional remodeling reflects a spectrum of pathophysiological changes that have occurred in response to specific stressors. These changes include alterations at the levels of ionic channels, cellular energy balance, neurohormonal expression, inflammatory response, and physiologic adaptations. There is convincing evidence demonstrating an important pathophysiological association between LA remodeling and atrial fibrillation (AF). Measures that will prevent, attenuate, or halt these processes of LA remodeling may have a major public health impact with respect to the epidemic of AF. In this review, we describe the mechanisms involved in LA remodeling and highlight the existing and potential therapeutic options for its reversal, and implications for AF development.
Topics: Aging; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Antifibrinolytic Agents; Atrial Fibrillation; Catheter Ablation; Clinical Trials as Topic; Electric Countershock; Electrophysiologic Techniques, Cardiac; Heart Atria; Humans
PubMed: 18174029
DOI: 10.1016/j.jacc.2007.09.026 -
International Heart Journal Dec 2017Primary cardiac osteosarcomas are rare entities, mostly arising from the left atrium. Because of their rarity, few reports have described this uncommon lesion. We herein...
Primary cardiac osteosarcomas are rare entities, mostly arising from the left atrium. Because of their rarity, few reports have described this uncommon lesion. We herein report a case of primary cardiac osteosarcoma originating from the left atrium in a 34-year-old woman, who underwent tumor debulking surgery and died 3 months after being diagnosed.
Topics: Adult; Fatal Outcome; Female; Heart Atria; Heart Neoplasms; Humans; Osteosarcoma
PubMed: 29118303
DOI: 10.1536/ihj.16-521 -
Journal of the American College of... Aug 2012
Topics: Aged; Cardiomegaly; Echocardiography, Transesophageal; Female; Heart Atria; Humans; Mitral Valve Insufficiency; Rheumatic Heart Disease; Tomography, X-Ray Computed
PubMed: 22898074
DOI: 10.1016/j.jacc.2012.02.078 -
Journal of Cardiothoracic Surgery Nov 2023Primary cardiac myxofibrosarcoma is rare and commonly occurs in the left atrium. Myxofibrosarcoma is aggressive and has a high mortality rate due to its high rate of...
BACKGROUND
Primary cardiac myxofibrosarcoma is rare and commonly occurs in the left atrium. Myxofibrosarcoma is aggressive and has a high mortality rate due to its high rate of recurrence. Complete surgical resection is considered important; however, effective treatment options have not been established.
CASE PRESENTATION
We report the case of a 75-year-old woman who developed a myxofibrosarcoma spreading to the left atrium and pericardium. We performed surgical resection of the tumor to prevent sudden death due to mitral valve obstruction or cerebral infarction due to embolism of the scattered mass. However, we were unable to complete the resection of the tumors. The patient developed brain metastasis 2 months after surgery and eventually died due to brain hemorrhage 3 months after surgery.
CONCLUSIONS
In this report, we described a rare case of primary cardiac myxofibrosarcoma located not only in the left atrium but also in the pericardium. Considering preoperative laboratory findings, surgical and adjuvant therapy, and the patient's wishes are important for the best therapeutic course for an individual.
Topics: Female; Adult; Humans; Aged; Fibrosarcoma; Heart Neoplasms; Heart Atria; Pericardium; Histiocytoma, Malignant Fibrous; Mediastinal Neoplasms; Thymus Neoplasms
PubMed: 37974190
DOI: 10.1186/s13019-023-02441-9 -
Medicina (Kaunas, Lithuania) 2014Pulmonary vein (PV) sleeves are established as the main substrate taking part in the mechanisms of atrial fibrillation (AF) initiation. However, we have extremely few...
BACKGROUND AND OBJECTIVE
Pulmonary vein (PV) sleeves are established as the main substrate taking part in the mechanisms of atrial fibrillation (AF) initiation. However, we have extremely few data concerning their physiological role in the heart contractility. The aim of the study was to estimate the mechanical function of the left atrium (LA) and PV sleeves before and early after their isolation.
MATERIALS AND METHODS
A total of 17 patients with a mean age of 57.4±8.3 years who underwent PVs isolation due to AF were enrolled in the study. A day before the procedure a computed tomography (CT) of the LA and PVs and dopplerography of transmitral flow were performed. During the procedure the mechanical function of the LA and PV sleeves were estimated by transesophageal echocardiography and manometry in the left heart chambers.
RESULTS
During the invasive study the patterns of the heart chambers and PV sleeves pressure were identified. These patterns confirmed the active role of the PV sleeves in LA filling and active LA relaxation during left ventricular systole. After PV isolation an alteration of transmitral blood flow and increase of LA pressure were registered. However, diastolic dysfunction was ruled out by LV manometry, thereby testifying LA mechanical function disturbance. The change in PV hemodynamics also occurred as a result of the decrease in PV sleeves contractility, revealed by manometry and paired CT scans.
CONCLUSIONS
The PVs take an active part in left atrial filling by contraction of their sleeves. Antrum isolation of the PVs leads to the deterioration of their contractility and LA reservoir function.
Topics: Aged; Atrial Fibrillation; Catheter Ablation; Echocardiography, Doppler; Female; Heart Atria; Hemodynamics; Humans; Mechanical Phenomena; Middle Aged; Multidetector Computed Tomography; Myocardial Contraction; Pulmonary Veins; Systole
PubMed: 25541269
DOI: 10.1016/j.medici.2014.11.008