Unilateral absence of pulmonary artery (UAPA) can be either isolated or associated with other congenital cardiac defects. It is a rare congenital lesion with a diverse clinical presentation. We present a case of absent right pulmonary artery and large patent ductus arteriosus (PDA) with severe unilateral pulmonary hypertension. We describe our strategy of staged ductus arteriosus closure in this patient and successful outcome on long term follow up.
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http://dx.doi.org/10.4103/apc.apc_54_23 | DOI Listing |
Multimed Man Cardiothorac Surg
January 2025
• Department of Cardiac Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia • King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia • College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Prostaglandin E1 is a potent vasodilator that prevents the ductus arteriosus from closing. Its use in neonates with cyanotic heart defects has revolutionized the management of children with cyanotic heart defects. Although the use of prostaglandin E1 is a temporary solution, the establishment of dependable pulmonary blood flow is of paramount importance.
View Article and Find Full Text PDFWorld J Pediatr Congenit Heart Surg
January 2025
Department of Pediatrics, Inova Health System, Falls Church, VA, USA.
Pulmonary atresia with ventricular septal defect (PA-VSD) is usually diagnosed by transthoracic or fetal echocardiography, with the prenatal diagnosis being feasible and accurate if fetal cardiology services are available. The limitations of transthoracic echocardiography (TTE) in the evaluation of PA-VSD include the complete evaluation of the pulmonary arteries and patent ductus arteriosus, quantitative evaluation of the right ventricle size and function, and delineation of associated cardiac anomalies such as coronary artery anomalies, anomalies of systemic or pulmonary venous return, and complex arch anomalies. Echocardiography also has limitations in evaluating hemodynamics such as flow volumes, shunts, and regurgitant fraction.
View Article and Find Full Text PDFJ Physiol
January 2025
Heart Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Although the corticosteroid betamethasone is routinely administered to accelerate lung and cardiovascular maturation in the preterm fetus prior to birth, and use of delayed cord clamping (DCC) is recommended at birth by professional bodies, it is unknown whether antenatal betamethasone alters perinatal pulmonary or systemic arterial blood flow accompaniments of DCC. To address this issue, preterm fetal lambs [gestation 127 (1) days, term = 147 days] with (n = 10) or without (n = 10) antenatal betamethasone treatment were acutely instrumented under general anaesthesia with flow probes to obtain left (LV) and right ventricular (RV) outputs, major central arterial blood flows and shunt flow across both the ductus arteriosus and foramen ovale (FO). After delivery, lambs underwent initial ventilation for 2 min prior to DCC.
View Article and Find Full Text PDFMagn Reson Med
January 2025
Department of Radiology & Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Purpose: To correct maternal breathing and fetal bulk motion during fetal 4D flow MRI.
Methods: A Doppler-ultrasound fetal cardiac-gated free-running 4D flow acquisition was corrected post hoc for maternal respiratory and fetal bulk motion in separate automated steps, with optional manual intervention to assess and limit fetal motion artifacts. Compressed-sensing reconstruction with a data outlier rejection algorithm was adapted from previous work.
Am J Perinatol
January 2025
Pediatrics, University of California San Francisco, San Francisco, United States.
Objective: Extremely premature infants are treated with acetaminophen (APAP) for pain and patent ductus arteriosus. High doses of APAP in adults are toxic, and a recent study found an association between APAP metabolite levels in mothers' breast milk and both bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in their premature infants. In this study, we determined levels of APAP metabolites in urine of infants at high risk for BPD and ROP.
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