Patent foramen ovale
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček in Congenital Heart Disease in Adults, 2008
Patent foramen ovale (PFO) is a relatively frequent variant of physiological state and a common finding in the general population; it is not classified as an atrial septal defect or heart disease. PFO plays an important role in fetal circulation, whereby oxygenated blood from umbilical veins and the vena cava inferior is preferentially directed through the Eustachian valve and PFO to the left atrium and into systemic circulation. PFO is judged to be present with the visualization of microbubbles in the left atrium within three cardiac cycles from the right atrial opacification. The potential for paradoxical microembolism into the cerebral arteries can also be assessed using transcranial Doppler with concomitant venous administration of an echo-contrast medium not passing through the pulmonary capillary bed. Depending on the type of occluder to be used, the length of the PFO tunnel, septum secundum width, and PFO size on an inflated balloon are determined prior to the transcatheter closure.
Oedema, Haemorrhage and Thrombosis
Jeremy R. Jass in Understanding Pathology, 2020
The natural philosophers of ancient Greece believed that ‘pneuma’ (roughly equivalent to spirit or air) was endowed with the properties of life and intelligence. Oedema describes the abnormal collection of fluid within the extracellular compartment. Such collections will occur within the body cavities (as effusions in the pleural and pericardial cavities or ascites in the peritoneal cavity), within loose and relatively acellular connective tissue (dermis of skin, subcutaneous tissue or submucosa of gut), within the brain or within the alveolar spaces of the lungs. When swollen oedematous tissue is viewed microscopically, one sees only a widening of the clear space between cells. Pulmonary congestion and oedema is caused by left heart failure, but is most marked when there is stenosis (narrowing) of the mitral valve resulting in compensatory work hypertrophy of the muscular wall of the left atrium.
Functions of the Cardiovascular System
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal in Principles of Physiology for the Anaesthetist, 2020
The cardiovascular system circulates blood through the vessels of pulmonary and systemic capillaries for the purpose of exchange of oxygen, carbon dioxide, metabolic nutrients, waste products and water in the tissues and in the lungs. It has an immune role, transporting antibodies and immune cells around the body. The heart is a muscular pump with four chambers: the right atrium and ventricle and the left atrium and ventricle. The pressures developed within the cardiac chambers determine the thickness of the muscle wall. The cardiac muscle cells are arranged in spiral layers anchored to the fibrous ring at the base of the heart, which encircle the chambers. The main substrate used by the heart is esterified and non-esterified fatty acid, which accounts for 60% of cardiac oxygen consumption. Cardiac muscle functions as a syncytium due to the presence of low-resistance connections between adjacent cells, and when an action potential is generated, the atria or the ventricles contract together.
Papillary fibroelastoma in the left atrium
Published in Baylor University Medical Center Proceedings, 2019
Charles S. Roberts, Melissa M. Carry, James W. Choi, Paul A. Grayburn, William C. Roberts
Described herein is a 71-year-old woman with previous angina pectoris who suddenly developed slurred speech and right-arm weakness. She was found to have significant coronary narrowing, a small mass in the left atrium attached to the endocardium near the orifice of the appendage, and multifocal punctate cerebral lesions in the distribution of the left middle cerebral artery. The left atrial mass was excised and confirmed to be a papillary fibroelastoma. Coronary bypass was also performed. It is believed that fibrin thrombus developed within the fronds of the fibroelastoma and embolized to the brain. Such lesions in the left atrium are exceedingly uncommon. She had no further emboli events.
Multiple cerebral infarction as the initial manifestation of left atrial myxoma: a case report and literature review
Published in Acta Cardiologica, 2014
Dujuan Sha, Guofeng Fan, Jun Zhang
Left atrial myxoma is a rare cause of cardioembolic stroke in adults and when stroke occurs, it is mainly due to arterial embolism in cerebral vessels. Cerebral infarction is the first clinical manifestation in one-third of cases. We report a 24-year-old female patient with left atrial myxoma, and no other conventional vascular risk factors such as hypertension, diabetes or hyperlipidaemia. The patient presented with multiple infarctions as the first clinical manifestation and was diagnosed with a left atrial myxoma. The literature on similar cases was also reviewed.
Intraoperative left atrium inversion after implantation of HeartMate III ventricular assist device
Published in Acta Chirurgica Belgica, 2017
Ayşegül Ozgök, Z. Asli Demir, Gökçe Sert, Doğan Sert, Zehra Gölbaşı, Umit Kervan
We report here a case of left atrium inversion after implanting HeartMate III LVAD, which is known to be the first in literature. LVAD can be functional only if there is adequate inflow to the device. Parameters and filling of left ventricle can be assessed by TEE. In our case, initial examination with TEE showed thrombus like images. HeartMate III has a reliable algorithm that automatically reduces pump speed if ‘suction effect’ is detected. HeartMate III demonstrates clean flow properties and good surface wash. Despite these positive features of the HeartMate III, left atrium inversion can still be seen with it, so users should be alert in this regard.
Related Knowledge Centers
- Pulmonary Vein
- Blood
- Systole
- Heart
- Left Ventricle
- Heart Chamber
- Atria