Explore chapters and articles related to this topic
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].
Transcatheter pulmonary valve replacement in pediatric patients
Published in Expert Review of Medical Devices, 2020
Wail Alkashkari, Saad Albugami, Mosa Abbadi, Akram Niyazi, Amani Alsubei, Ziyadi M. Hijazi
CHD is the most common of all congenital defects. Almost 1% of live births are affected. Twenty percent of the newborns with CHD have anomalies affecting the right ventricular outflow tract (RVOT), such as tetralogy of Fallot (TOF) with or without pulmonary atresia, truncus arteriosus, transposition of the great vessels, common arterial trunk, and others [1]. Additionally, RVOT abnormalities are introduced after both the Ross Procedure, used for the correction of congenital aortic valve disease, and after surgical correction of complex transposition of the great arteries. Improvements in surgical techniques have substantially enhanced short- and long-term outcomes in this patient cohort over the last decades. Nowadays, over 90% of affected children will reach adulthood [2,3]. Early surgical management for dysfunctional RVOT includes valvuloplasty, trans-annular patch (TAP) with surgical valvotomy, valved conduit placement between the right ventricle (RV) and pulmonary artery (PA) or bioprosthetic valve placement (BPV).
Teleology and Defining Sex
Published in The New Bioethics, 2018
Nathan K. Gamble, Michal Pruski
This paper will use a teleological framework that will only make sense if the aforementioned premises are understood. Teleology is fundamental to practicing medicine well. If a pulmonologist does not understand what lungs are for, he will not be able to address asthma and restore a patient to health. A cardiac surgeon who does not understand the purpose of the cardiorespiratory system – that deoxygenated blood needs to go to the lungs and oxygenated blood to the body – she will not be able to fix a patient who has transposition of the great vessels. The same is true of sex, sex determination, and DSD. Unless a physician understands what the purpose of sex and the reproductive system is, he will not be able to fundamentally assess and help someone with DSD. Hence, starting from a description of scientifically objective embryological concepts, this paper employs a teleological analysis to identify and resolve various dissonances that occur when determining sex in cases of DSD.