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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Which of the following radiological signs would be indicative of an atrial septal defect?Enlarged left atriumEnlarged aortic archEnlarged right atriumEnlarged left ventricleLower zone vascular prominence
Lutembacher syndrome
Published in Neeraj Parakh, Ravi S. Math, Vivek Chaturvedi, Mitral Stenosis, 2018
Kikkeri Hemannasetty Srinivas, Anand Subramaniam
The clinical signs of mitral stenosis are less conspicuous. In other words, a more severe mitral stenosis might still not produce characteristic signs in the presence of a large ASD. The signs of an atrial septal defect, on the contrary, are never masked; they only get more accentuated.
Endocrinology
Published in John D Firth, Professor Ian Gilmore, MRCP Part 1 Self-Assessment, 2017
John D Firth, Professor Ian Gilmore
The appearances are typical of Turner’s syndrome, with webbed neck and a wide carrying angle. The thoracotomy scar is a result of surgery to repair an atrial septal defect. The diagnosis is confirmed by finding a 45XO karyotype. The amenorrhoea is due to hypergonadotrophic hypogonadism with low / undetectable levels of oestradiol (E2) and high levels of LH and FSH.
Retrospective Comparison of Endoscopic Versus Open Procedure for Mitral Valve Disease
Published in Journal of Investigative Surgery, 2021
Qin Jiang, Zhilan Wang, Jing Guo, Tao Yu, Xiaoshen Zhang, Shengshou Hu
Minimally invasive MV surgery has been performed with increasing frequency and also evolved over time. Thoracoscopic surgery has been applied in many cardiac conditions, including the closure of congenital heart defects, resection of atrial myxoma, MV procedure as well as anomalous pulmonary venous connection at recent years. The previous study on atrial septal defect closure procedure indicated thoracoscopic surgery provided a better treatment with a less trauma, less bleeding and faster recovery, compared with traditional median sternotomy [8]. However, systemic inflammatory response follows extracorporeal circulation open-heart surgery driven both by major surgical insult and contact activation of blood with artificial surfaces of the cardiopulmonary bypass circuit [9]. Thus, whether the thoracoscopic surgery really provided underlying minimal invasion than traditional median sternotomy remained to be answered in terms of systemic inflammatory and injury response except clinical incision injury.
Current practice in atrial septal defect occlusion in children and adults
Published in Expert Review of Cardiovascular Therapy, 2020
Wail Alkashkari, Saad Albugami, Ziyad M. Hijazi
With nearly 45 years after the first case of transcatheter ASD closure performed by King and Mills in New Orleans, the procedure has become an accepted first choice for majority of patients with an appropriate secundum atrial septal defect. The procedure is safe and effective. However, there is a finite risk of disastrous complications and that is device erosion with hemopericardium and on very rare occasion death. The major issue with this fearful complication is the inability to predict its timing. Some cases of erosions occurred years (after 9 years) after implantation of the device. We know that there are certain risk factors that may predispose to it, such as patients with deficient anterior/superior rim who receive an oversized device (oversizing by more than 150% of the true defect size). However, even with that, we truly cannot predict the timing of this complication, and not all patients who receive an oversized device encounter this complications. Unfortunately, our surgical colleagues claim that what we see now is only the tip of the iceburg! Of course as I mentioned with now over 20 years of experience with the most modern device (Amplatzer), the rate of erison remains extremely low at about 2–3 per 1000 cases.
Clinical outcomes for congenital heart disease patients presenting with infective endocarditis
Published in Expert Review of Cardiovascular Therapy, 2020
For many years prior to the revision of the most recent IE prophylaxis guidelines, congenital heart disease has been classified into three groups: High risk group including cyanotic heart disease, history of IE, valve prostheses, heart disease operated on with residual lesions and during the 6 postoperative months.Moderate risk group including high-speed shunts and nonoperated native mitral and aortic valve disease.At little or no risk group including mainly atrial septal defect.