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Congenital cardiac anomalies
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Mitral insufficiency can be a late manifestation following repair of the mitral valve in infancy, as in repaired complete atrioventricular septal defect, or following repair of de novo mitral insufficiency. It may also be present following repair of anomalous left coronary artery from the pulmonary artery.
Cardiac catheterization for the adult with complex congenital heart disease
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
These can occur isolated or in conjunction with other structural heart disease abnormalities. The recognition and evaluation of coronary anomalies have become a very important part of the evaluation of congenital heart dis- ease. The left coronary artery arises from the left sinus of Valsalva, while the right coronary artery rises from the right sinus of Valsalva. The right or left coronary artery may arise from inappropriate sinus of Valsalva; the most common one is when the left circumflex artery arises from the right coronary sinus. Other types include anom- alous right coronary artery from the left coronary sinus, single coronary artery, and anomalous left coronary artery from the pulmonary artery (ALCAPA), which is also called Bland-White-Garland syndrome. ALCAPA is characterized by pathologic q waves in leads I, aVL, and precordial leads V4 to V6. It is possible to find a small left-to-right shunt at the pulmonary level. The left ven- triculogram demonstrates left ventricular dysfunction (anterolateral wall) and mitral valve regurgitation. The aortogram will demonstrate a large right coronary artery and filling of the left coronary by collaterals from the right coronary artery, with passage of contrast from the left main to the pulmonary artery.
Cardiac regeneration in a newborn: what does this mean for future cardiac repair research?
Published in Expert Review of Cardiovascular Therapy, 2018
Bernhard J Haubner, Thomas Schuetz, Josef M Penninger
Besides the elucidation of the underlying mechanism for neonatal cardiac repair, one key question remained: Can one translate these models to the human heart considering the fundamental differences in basic cardiac physiology? Talking to pediatric cardiologists we learned from their experience that human neonatal hearts still possess an enormous cardiac plasticity and can even recover functions after removal of the causative harmful conditions. For instance, the ALCAPA syndrome (Anomalous Left Coronary Artery From the Pulmonary Artery) designates a congenital pediatric heart disease that causes myocardial ischemia [20]. Currently, the only curative approach is cardiac surgery with correction of the coronary malformation. Whereas early correction within the first year of age leads to complete recovery of the heart, delayed diagnosis most often ends in damage and ultimately ischemic cardiomyopathy [20]. Encouraged by the clinical experience, we found a handful of documented cases of human neonatal myocardial infarctions. Perinatal cardiac infarction is a very rare clinical event, primarily due to malformation of the heart or coagulation diseases. Since such events are accompanied with high mortality, all the clinical case reports focused on the description of diagnosis and emergency, and critical care treatment in the acute setting. In the discussions, the authors hinted at a good outcome as long as the baby survived the initial ischemic event, without further descriptions (References within Reference [20])