China
Africa
Explore chapters and articles related to this topic
The circulatory system and hormones
Published in Frank J. Dye, Human Life Before Birth, 2019
Endocardial cushion tissue provides the valves between the left atrium and left ventricle (mitral valve) and between the right atrium and right ventricle (tricuspid valve), even as it partitions the atrioventricular canal into left and right channels (Figure 15.4C).
Mitral Valve Mechanics
Published in Michel R. Labrosse, Cardiovascular Mechanics, 2018
A. Tran, T. G. Mesana, V. Chan
During embryonic development, the atrioventricular canals form by the fusion of the superior and inferior endocardial cushions. The interatrial and interventricular septa separate the left and right hearts. The mitral valve develops in the left atrioventricular canal. Initially, the microscopic dissection of embryonic hearts found that very little of the septal leaflet consisted of endocardial cushion tissue. This led to the hypothesis that the cushions played a lesser role in the development of the valve [1,2]. Further investigation revealed that the septal (anterior) leaflet derives from the superior and inferior endocardial cushions. At the site of endocardial cushions, endothelial cells migrate and invade the cardiac jelly and differentiate into mesenchymal cells [3]. These cells continue to proliferate, allowing the formation of thin fibrous valve tissue. The mural (posterior) leaflet of the mitral valve develops from a mesenchymal cushion that is laterally located. The leaflets are further defined by undermining of the myocardium, leaving behind trabeculated structures corresponding to chordae tendinae. The leaflets comprise connective tissue, namely collagen, elastin, and glycosaminoglycans, collectively known as an extracellular matrix. Delamination of the valve gives way to the anterior and posterior leaflets. The delamination process ends at the commissures. Still, the precise mechanism of heart valve development remains poorly understood. Overall, it is a complex and intricate process, potentially governed by a network of signaling pathways [4,5].
Postimplantation diabetic embryopathy
Published in Moshe Hod, Lois G. Jovanovic, Gian Carlo Di Renzo, Alberto de Leiva, Oded Langer, Textbook of Diabetes and Pregnancy, 2018
Ulf J. Eriksson, Parri Wentzel
In a recent study of diabetes-induced cardiac malformations, it was found that the rate of atrioventricular septal defects (AVSDs) was increased concomitant with enhanced ER stress in embryonic hearts. Blocking of glucose-induced ER stress with 4-PBA in an endocardial cushion explant culture restored endocardial cell migration. The findings suggest that the development of endocardial cushions is susceptible to the insult of maternal hyperglycemia, and that diabetes-induced ER stress in the developing heart mediates the negative effect on endocardial cell migration.277
A rare association of mitral atresia and double outlet right ventricle (MA-DORV) with unicuspid pulmonary valve
Published in Acta Cardiologica, 2020
Vineeta Ojha, Sh Chandrashekhara, Akash Vadher, Amarinder Singh Malhi, Sanjeet Nayak, Sanjeev Kumar
Congenital mitral atresia is a rare condition, which occurs due to excessive and premature growth of the endocardial cushion. The average age at death is 6 months. The children surviving beyond infancy usually have a combination of large ASD (decompresses left atrium) and moderate PS (protects against PAH). Mitral atresia with a normal aortic valve is classified into those with normal relation of great arteries (Type 1) and those with transposed great arteries, as in the index case (Type 2) occurring with equal incidence. Mitral atresia has been described to be associated with DORV, ASD, VSD, coarctation of aorta, anomalous systemic and pulmonary venous connections (including levoatriocardinal vein). The associated unicuspid pulmonic valve in our patient is of haemodynamic significance as these are inherently stenotic, hence, resulting in valvular PS which is protective for PAH in early infancy. However, they can have a restrictive ASD resulting in PAH due to pulmonary venous hypertension as in our patient. To the best of our knowledge, this is the first reported case of a unicuspid pulmonic valve associated with mitral atresia and DORV.
Incidence and Causes of 30-day Readmissions after Surgical Versus Percutaneous Secundum Atrial Septal Defect Closure: A United States Nationwide Analysis
Published in Structural Heart, 2019
Mohammad K. Mojadidi, Ahmed N. Mahmoud, Dhruv Mahtta, Muhammad O. Zaman, Islam Y. Elgendy, Akram Y. Elgendy, Nayan Agarwal, Nimesh K. Patel, Zachary M. Gertz, Siddharth A. Wayangankar, David C. Lew, Hani Jneid, Creighton W. Don, Bernhard Meier, Jonathan M. Tobis
The NRD database was used to identify hospitalizations with a primary or secondary diagnosis of secundum ASD (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-CM 9] code 745.5) without a prior diagnosis of endocardial cushion defect (ICD-CM codes 745.6x) who underwent surgical repair (ICD-9 procedure codes 35.51, 35.61, 35.71, and 39.61) or percutaneous closure (ICD-9 CM code 35.52) during years 2013 and. 20145 To increase the sample size, on screening, records of all patients with a history of secundum ASD were included even if the primary reason for the index hospitalization was not related to that diagnosis. Hospitalization records were then excluded if: (1) patient age was <18 years; (2) no surgical or percutaneous closure was performed during the index hospitalization; (3) the patient died during the index hospitalization; (4) the discharge month was December since 30-day readmission data would be lacking; (5) the discharge disposition was unknown or the patient left against medical advice (Figure 1).
Wider intraoperative glycemic fluctuation increases risk of acute kidney injury after pediatric cardiac surgery
Published in Renal Failure, 2018
Guo-Huang Hu, Lian Duan, Meng Jiang, Cheng-Liang Zhang, Yan-Ying Duan
During four years, the incidence of AKI was 11.5% (118/1026) in our pediatric cardiac surgery center. Of those with AKI, 53.4% (63/118), 30.5% (36/118), and 16.1% (19/118) were categorized as AKIN stages I, II, and III, respectively. The patients’ perioperative characteristics are shown in Table 1; diseases included but were not limited to tetralogy of Fallot with/without atrial septal defect, pulmonary atresia, anomalous pulmonary veins drainage, endocardial cushion defect, transposition of the great arteries, coronary artery fistula, aorta-pulmonary window, atrioventricular canal malformation, persistent truncus arteriosus, single ventricle or atrium, hypoplastic or interrupted aortic arch, and Ebstein or other valve anomalies. Before matching, the entire sample who experienced AKI were younger and cyanotic, had a higher RACHS-1 score, and less preoperative LVEF (all p < .01) when compared with those who did not experience AKI. They also underwent CPB for a longer time, longer OA time, more frequency of multiple OA, ultrafiltration, DHCA or hypoperfusion (all p < .01) during surgery. They had higher mG, pG, intraGF, IS POD, and more transfusions during the perioperative period (all p < .01).