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Automated Biventricular Cardiovascular Modelling from MRI for Big Heart Data Analysis
Published in Ervin Sejdić, Tiago H. Falk, Signal Processing and Machine Learning for Biomedical Big Data, 2018
Kathleen Gilbert, Xingyu Zhang, Beau Pontré, Avan Suinesiaputra, Pau Medrano-Gracia, Alistair Young
Congenital heart disease (CHD) is the most common birth defect occurring in 75 out of every 1000 births [62], with moderate to severe malformations affecting 6 out of every 1000 infants [63,64]. Some defects are life-threatening and need immediate surgical treatment following birth. Improved diagnosis and treatment of CHD mean that the population of adult CHD patients is growing at approximately 5% per year and is now larger than the pediatric population [65]. Many of these patients, particularly those with tetralogy of Fallot, functional single right ventricle and transposition of the great vessels, are at risk of RV dilatation and dysfunction with associated morbidity and mortality. RV function measurement is an important prognostic marker, and RV size and function indices are used as indications for intervention [66]. These patients must be imaged repeatedly to determine the progression of remodelling. However, the quantitative assessment of changes in shape and function is problematic in CHD, largely because there is no detailed map of normal and abnormal hearts for comparison [67]. Recent model-based analysis of RV shape identified increased eccentricity and decreased systolic function in patients with pulmonary hypertension [68]. Another recent statistical shape analysis in repaired tetralogy of Fallot patients finds correlation of RV dilatation, outflow tract bulging and apical dilatation with the presence of pulmonary regurgitation [69].
Mechanotransduction in Heart Formation
Published in Juhyun Lee, Sharon Gerecht, Hanjoong Jo, Tzung Hsiai, Modern Mechanobiology, 2021
A number of genes and chromosome mutations have been associated with cardiac defects. For example, a mutation in JAGGED-1 has been associated with tetralogy of Fallot (TOF) [19], as well as deletion of chromosome 22q11.2 [20]; a mutation in NKX2.5 was associated with atrial septal defect [21] [22]; mutations in ZIC3 and TBX20 were associated with double-outlet right ventricle (DORV) [22, 23]; and a mutation in MYH7 was associated with ventricular septal defects (VSDs) [24]. Mutations of several other genes that play important roles in cardiac development have also been linked to CHD, including mechanotransduction genes [21–23, 25, 26].
Intermediate outcomes of transcatheter pulmonary valve replacement with the Edwards Sapien 3 valve – German experience
Published in Expert Review of Medical Devices, 2019
Anja Lehner, Tsvetina Dashkalova, Sarah Ulrich, Silvia Fernandez Rodriguez, Guido Mandilaras, Andre Jakob, Robert Dalla-Pozza, Marcus Fischer, Heike Schneider, Gleb Tarusinov, Christoph Kampmann, Michael Hofbeck, Ingo Dähnert, Majed Kanaan, Nikolaus A. Haas
From 01/2015 to 12/2017, 56 TPVR procedures with the Edwards Sapien 3 valve were reported by 7 heart centers in Germany (for detailed demographics see Table 1). Patient age ranged between 4 and 82 years and weight between 11,8 and 114 kg. In this patient cohort, more patients were female (60,7%) with a majority of an underlying diagnosis of Tetralogy of Fallot (53,6%). Indication for TPVR was stated with PR as leading problem in 48% of patients, in 14% with PS as leading problem and in 34% with both (PS ≥ 20 mmHg RVOT gradient and PR ≥ moderate); residual 4% underwent TPVR due to right ventricular impairment but PS < 20 mmHg RVOT gradient and trivial/mild PI. Patients were status post-RVOT reconstruction with a transannular patch plasty in 32% (n = 18). Conduits were found in 50% of patients (n = 28). Biplane angiography of the RVOT before intervention revealed a minimal diameter at the proximal RVOT of 26,9 mm (SD 7,9), minimal diameter or ‘waist’ of the RVOT of 19,6 mm (SD 5,1; range 8–31 mm) and a distal minimal diameter of 23,8 mm (SD 8,9); lateral measurements were 25,8 mm (SD 7,9), 19,2 mm (SD 5,2; range 9,5–30 mm) and 23,5 mm (SD 9,5) respectively. Prestenting was also used to relieve RVOT stenosis where necessary. Additional procedures performed to the proximal left or right pulmonary artery were mentioned in 10 cases, of these were predominantly previous patch plasty or additional stent placement during prestenting procedures.