Cardiovascular system
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
8.19. Which of the following is/are found in children with tetralogy of Fallot?The heart appears enlarged on chest X-ray.Cyanosis is invariably present by the first birthday.Pulmonary valve stenosis must be present to make the diagnosis.A right aortic arch is present in more than 15% of cases.The aortic valve is smaller than usual.
The standard transthoracic echo study
Andrew R. Houghton in MAKING SENSE of Echocardiography, 2013
It may be possible to detect the abnormal jet of a ventricular septal defect (VSD) or a persistent ductus arteriosus with colour Doppler in this view. Use PW Doppler to assess flow in the RVOT, just proximal to the pulmonary valve.Use CW Doppler to: assess the pulmonary valve for stenosis or regurgitation. If pulmonary regurgitation is present, assess pulmonary artery diastolic pressureassess tricuspid valve function. If tricuspid regurgitation is present, assess RV systolic pressure.
Valve Disease
Mary N. Sheppard in Practical Cardiovascular Pathology, 2022
Pulmonary atresia or stenosis is seen in the context of congenital stenosis as in Tetralogy of Fallot, when the valves cusps are often thickened and dysplastic. Bicuspid pulmonary valves (Fig. 3.75) occur but are much rarer than bicuspid aortic valves. Quadricuspid pulmonary valve (Fig. 3.76) is more frequent than aortic quadricuspid valve. Approximately 20% of newborns with CHD have anomalies in the pulmonary valve or right ventricular outflow tract (RVOT), such as Tetralogy of Fallot (TOF), truncus arteriosus, or pulmonary atresia. For these patients, surgical repair of the RVOT is important but these patients are subject to progressive RVOT dysfunction, with pulmonary valve regurgitation, pulmonary valve stenosis or both. Surgical pulmonary valve replacement is the treatment and can be performed with a low mortality rate. However, valved conduits have a limited lifespan with degenerative calcification often lasting less than 10 years, thus necessitating further replacement done percutaneously.
Aortic valve: anatomy and structure and the role of vasculature in the degenerative process
Published in Acta Cardiologica, 2021
Vasiliki Katsi, Nikolaos Magkas, Alexios Antonopoulos, Georgios Trantalis, Konstantinos Toutouzas, Dimitrios Tousoulis
Owing to the semilunar fashion that the leaflets are attached to the wall of the aortic root, three triangles are formed, the interleaflet triangles, each one found between the attachments of two adjacent leaflets and between two adjacent sinuses of Valsalva [3,5] (Figure 2). The interleaflet triangle between the right and left coronary leaflet faces the pulmonary valve and its base is on the septal component of the right ventricle outflow tract [7]. The interleaflet triangle between the left and the non-coronary leaflet along with the larger part of the non-coronary leaflet and a part of the left coronary leaflet are in fibrous continuity with the anterior leaflet of the mitral valve via the aortic-mitral curtain. The two edges of the aortic-mitral curtain are thickened and form the right and left fibrous trigones that anchor the aortic-mitral unit to the roof of the LV [5] (Figures 1(A) and 2). The triangle between the right and non-coronary sinus faces the right atrium [11] and is confluent with the membranous septum; the membranous septum and the right fibrous trigone constitute the central fibrous body of the heart, which is the strongest part of the cardiac skeleton [5,10] (Figures 1(A) and 2).
Heterotopic Implantation of Decellularized Pulmonary Artery Homografts In A Rodent Model: Technique Description and Preliminary Report
Published in Journal of Investigative Surgery, 2018
Arben Dedja, Massimo A. Padalino, Mila Della Barbera, Cosimo Rasola, Paola Pesce, Anna Milan, Michela Pozzobon, David Sacerdoti, Gaetano Thiene, Giovanni Stellin
Replacement of the diseased aortic valve by the autologous pulmonary valve autograft (the so called Ross procedure, proposed for the first time since 1962), is still considered a clinically effective procedure in children with aortic valve disease [18]. Therefore, the use that we have made of the pulmonary homograft in a heterotopic position under systemic pressure “mimics” the clinical use of the pulmonary valve in an aortic position. Furthermore, experimental studies on valve decellularization have been extensively published in recent years and their use is reported in a growing number of groups of patients, but no studies on DPH in a systemic position under increased pressure stress has, to our knowledge, yet been performed. We intended to use this “extreme” rodent model to study the valvular performance and regenerative capacity in this particular hemodynamic condition.
“Unexpected findings in the work-up of abdominal pain”
Published in Acta Cardiologica, 2020
Dupuis Fabien, Dupont Michaël, Postolache Adriana, Schroeder Erwin, Seldrum Stéphanie
To complete the assessment of the suspected pulmonary stenosis, a right heart catheterisation was performed. Ventriculography showed an extrinsic compression of the RV outflow tract (Figure 1(B) and see Supplementary data online, Movie S1–S2) with normal pulmonary valve and pulmonary artery. Haemodynamic assessment displayed a right atrium pressure of 9 mmHg, a RV systolic pressure of 70 mmHg, a mean pulmonary artery pressure of 21 mmHg (systolic 28 mmHg) and low cardiac output of 2.1 L/min. While removing catheter, gradient between pulmonary artery and right ventricle was measured at 54 mmHg. An attempt for left catheterisation via femoral artery revealed complete interruption of the descending aorta before the cross, hitherto unknown. Radial arteries were considered too thin, and no other attempt for left catheterisation was undertaken.
Related Knowledge Centers
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