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Pulmonary Atresia with Ventricular Septal Defect without Major Aorto-Pulmonary Collateral Arteries: Echocardiography and the Role of Computed Tomography and Magnetic Resonance Imaging.
World 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 PDFEncountering Arc of Bühler during pancreaticoduodenectomy surgery.
BMJ Case Rep
January 2025
Upper Gastrointestinal Surgery Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
The Arc of Bühler (AoB) is a rare anatomical variant in gastrointestinal vasculature where there is an aberrant anastomotic vessel between coeliac and superior mesenteric arteries. We present a rare case where AoB was noted intraoperatively to have haemodynamically significant flow in the context of coeliac artery stenosis, supplementing arterial supply to the hepatic artery proper via the gastroduodenal artery (GDA). An interpositional jump graft between the aorta and the GDA stump was created using the long saphenous vein, and flow was restored.
View Article and Find Full Text PDFHigh-risk percutaneous coronary intervention in patients with reduced left ventricular ejection fraction deemed not suitable for surgical revascularisation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the ESC Working Group on Cardiovascular Surgery.
EuroIntervention
January 2025
Department of Cardiac-Thoracic-Vascular Sciences, University of Padua, Padua, Italy.
This clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions was developed in association with the European Society of Cardiology Working Group on Cardiovascular Surgery. It aims to define procedural and contemporary technical requirements that may improve the efficacy and safety of percutaneous coronary intervention (PCI), both in the acute phase and at long-term follow-up, in a high-risk cohort of patients on optimal medical therapy when clinical and anatomical high-risk criteria are present that entail unacceptable surgical risks, precluding the feasibility of coronary artery bypass grafting (CABG). This document pertains to patients with surgical contraindication according to the Heart Team, in whom medical therapy has failed (e.
View Article and Find Full Text PDFComputed tomography derived predictors of left ventricular obstruction after TAVR.
Int J Cardiol
January 2025
Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita Salute San Raffaele University, Milan, Italy.
Background: Left ventricular obstruction (LVO) is an infrequent complication following transcatheter aortic valve replacement (TAVR) that can lead to severe hemodynamic decompensation. Previous studies have analyzed the pathophysiology of this clinical entity; however, little is known about the anatomical characteristics as assessed by computational tomography (CT) of patients at risk.
Methods: Data from 349 patients were retrospectively analyzed from a single center registry of patients undergoing TAVR at San Raffaele Hospital, Milan, Italy, between January 2020 and December 2021.
Anatomy versus Shunt Fraction: Hemodynamic Consequences in Atrial Septal Defects and Partial Anomalous Pulmonary Venous Connection - A comprehensive CMR study.
Eur Heart J Cardiovasc Imaging
January 2025
Department of Radiology, UZ Leuven, Leuven, Belgium.
Aims: Atrial septal defect (ASD) and partial abnormal pulmonary venous connection (PAPVC) are noncyanotic congenital heart defects (CHD) that produce a left-to-right shunt. This single-center retrospective study aimed to assess the hemodynamic impact of isolated ASD, isolated PAPVC, and ASD-associated PAPVC using cardiovascular magnetic resonance (CMR).
Methods And Results: From our CMR registry (2002-2024), 110 patients were included: isolated ASD (n=64), isolated PAPVC (n=18), ASD-associated PAPVC (n=28, mostly sinus venosus septal defects).
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