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  • Open Access


    Important Newborn Cardiac Diagnostic Dilemmas for the Neonatologist and Cardiologist–A Clinical Perspective

    Samuel Menahem1,2,*, Arvind Sehgal3,4

    Congenital Heart Disease, Vol.16, No.2, pp. 189-196, 2021, DOI:10.32604/CHD.2021.014903

    Abstract Most congenital heart disease (CHD) is readily recognisable in the newborn. Forewarned by previous fetal scanning, the presence of a murmur, tachypnoea, cyanosis and/or differential pulses and saturations all point to a cardiac abnormality. Yet serious heart disease may be missed on a fetal scan. There may be no murmur or clinical cyanosis, and tachypneoa may be attributed to non-cardiac causes. Tachypnoea on day 1 is usually non-cardiac except arising from ventricular failure or a large systemic arteriovenous fistula. A patent ductus arteriosus (PDA) may support either pulmonary or systemic duct dependent circulations. The initially… More >

  • Open Access


    Computational Fluid Dynamics Simulations at Micro-Scale Stenosis for Microfluidic Thrombosis Model Characterization

    Yunduo Charles Zhao1,2,#, Parham Vatankhah1,#, Tiffany Goh1,2,3, Jiaqiu Wang4, Xuanyi Valeria Chen1, Moein Navvab Kashani5,6, Keke Zheng7, Zhiyong Li4, Lining Arnold Ju1,2,3,*

    Molecular & Cellular Biomechanics, Vol.18, No.1, pp. 1-10, 2021, DOI:10.32604/mcb.2021.012598

    Abstract Platelet aggregation plays a central role in pathological thrombosis, preventing healthy physiological blood flow within the circulatory system. For decades, it was believed that platelet aggregation was primarily driven by soluble agonists such as thrombin, adenosine diphosphate and thromboxane A2. However, recent experimental findings have unveiled an intriguing but complementary biomechanical mechanism—the shear rate gradients generated from flow disturbance occurring at sites of blood vessel narrowing, otherwise known as stenosis, may rapidly trigger platelet recruitment and subsequent aggregation. In our Nature Materials 2019 paper [1], we employed microfluidic devices which incorporated micro-scale stenoses to elucidate the… More >

  • Open Access


    FFR-Guided PCI in a 17-Year-Old Patient after Arterial Switch Operation for D-Transposition of the Great Arteries

    Domenico Sirico1, Biagio Castaldi1,*, Giuseppe Tarantini2, Giovanni Di Salvo1

    Congenital Heart Disease, Vol.15, No.6, pp. 441-445, 2020, DOI:10.32604/CHD.2020.012863

    Abstract Asymptomatic coronary artery obstruction represents a significant diagnostic challenge in patients with Dextro-Transposition of the Great Arteries and history of Arterial Switch Operation. We report the case of a 17-year-old boy with anomalous origin of left circumflex artery from the right coronary artery, who underwent neonatal arterial switch operation and developed silent myocardial ischemia under stress on myocardial scintigraphy. Despite coronary angiogram and intravascular ultrasound showed only intermediate stenosis of the right coronary artery ostium, the physiological analysis, through the employment of pressure wire, demonstrated a severe reduction of coronary fractional flow reserve after pharmacologically More >

  • Open Access


    Blood Flow Through a Catheterized Artery Having a Mild Stenosis at the Wall with a Blood Clot at the Centre

    Anber Saleem1,2, Salman Akhtar3, Sohail Nadeem3,*, Alibek Issakhov4, Mehdi Ghalambaz5,6

    CMES-Computer Modeling in Engineering & Sciences, Vol.125, No.2, pp. 565-577, 2020, DOI:10.32604/cmes.2020.011883

    Abstract The blood flow through a catheterized artery having a mild stenosis at the wall together with a blood clot at the centre is studied in the current investigation. Stenosis can occur in vessels carrying blood to brain (i.e., Carotid arteries), Renal arteries that supply blood to kidneys etc. The flow is refined in such vessels by application of catheter. We have used a Newtonian viscous fluid model and also distinct shapes of stenosis, (i.e., symmetric and non-symmetric shapes) are considered for this study. The entropy generation together with viscous dissipation is also taken into account… More >

  • Open Access


    Right ventricular and pulmonary vascular function indices for risk stratification of patients with pulmonary regurgitation

    Alexander C. Egbe, William R. Miranda, Patricia A. Pellikka, Sorin V. Pislaru, Barry A. Borlaug, Srikanth Kothapalli, Sindhura Ananthaneni, Harigopal Sandhyavenu, Maria Najam, Mohamed Farouk Abdelsamid, Heidi M. Connolly

    Congenital Heart Disease, Vol.14, No.4, pp. 657-664, 2019, DOI:10.1111/chd.12768

    Abstract Background: We hypothesized that echocardiographic indices of right ventricular to pulmonary artery (RV‐PA) coupling were comparable to cardiac magnetic resonance imaging (CMRI)‐derived RV volumetric indices in predicting disease severity in chronic pulmonary regurgitation (PR).
    Methods: Patients with ≥ moderate PR (2003‐2015) with and without prior CMRI scans were enrolled into the study cohort and validation cohort, respectively. Endpoint was to determine the association between noninvasive RV‐PA coupling in‐ dices (tricuspid annular plane systolic excursion/right ventricular systolic pressure [TAPSE/RVSP] and fractional area change [FAC]/RVSP ratio) and markers of disease severity, and compared this association to that of CMRI‐derived… More >

  • Open Access


    Fate of the Fontan connection: Mechanisms of stenosis and management

    Donald J. Hagler1,2, William R. Miranda2, Brielle J. Haggerty1, Jason H. Anderson1, Jonathan N. Johnson1, Frank Cetta1,2, Sameh M. Said1,3, Nathaniel W. Taggart1

    Congenital Heart Disease, Vol.14, No.4, pp. 571-581, 2019, DOI:10.1111/chd.12757

    Abstract Background: Stenosis of the venous connections and conduits is a well‐known late complication of the Fontan procedure. Currently, data on the outcomes of percuta‐ neous intervention for the treatment of extra‐ or intracardiac conduits and lateral tunnel baffles obstruction are limited. In an attempt to better define the nature and severity of the stenosis and the results of catheter interventional management, we reviewed Fontan patients with obstructed extra‐ or intracardiac conduits and lateral tunnel baffles.
    Methods: Retrospective review of all Fontan patients who had cardiac catheteriza‐ tion from January 2002 to October 2018 was performed. Hemodynamic and… More >

  • Open Access


    Temporal relationship between instantaneous pressure gradients and peak-to-peak systolic ejection gradient in congenital aortic stenosis

    Brian A. Boe1, Mark D. Norris2, Jeffrey D. Zampi2, Albert P. Rocchini2, Gregory J. Ensing2

    Congenital Heart Disease, Vol.12, No.6, pp. 733-739, 2017, DOI:10.1111/chd.12514

    Abstract Objective: We sought to identify a time during cardiac ejection when the instantaneous pressure gradient (IPG) correlated best, and near unity, with peak-to-peak systolic ejection gradient (PPSG) in patients with congenital aortic stenosis. Noninvasive echocardiographic measurement of IPG has limited correlation with cardiac catheterization measured PPSG across the spectrum of disease severity of congenital aortic stenosis. A major contributor is the observation that these measures are inherently different with a variable relationship dependent on the degree of stenosis.
    Design: Hemodynamic data from cardiac catheterizations utilizing simultaneous pressure measurements from the left ventricle (LV) and ascending aorta (AAo)… More >

  • Open Access


    The effect of balloon valvuloplasty for bioprosthetic valve stenosis at pulmonary positions

    Eun Young Choi1, Jinyoung Song2, Heirim Lee2, Chang Ha Lee3, Jun Huh2, I.-Seok Kang2, Ji Hyuk Yang4, Tae Gook Jun4

    Congenital Heart Disease, Vol.12, No.6, pp. 746-750, 2017, DOI:10.1111/chd.12507

    Abstract Background: Balloon dilatation of a bioprosthetic valve in the pulmonary position could be performed to delay valve replacement. We proposed to identify the long-term effectiveness of such a procedure.
    Methods: We reviewed the medical records of 49 patients who underwent balloon valvuloplasty between January 2000 and December 2015. The primary goal was to determine the time interval until the following surgical or catheter intervention.
    Results: The mean age at bioprosthetic valve insertion was 5.7 years old, and the mean age for ballooning was 11.7 years. The mean interval after pulmonary valve replacement was 71.6 months. The mean ratio… More >

  • Open Access


    Long-term respiratory outcomes after primary total correction for tetralogy of Fallot and absent pulmonary valve in patient with respiratory symptoms

    Takaya Hoashi1, Toru Iwasa2, Koji Kagisaki1, Masatoshi Shimada1, Kenichi Kurosaki2, Isao Shiraishi2, Hajime Ichikawa1

    Congenital Heart Disease, Vol.12, No.4, pp. 441-447, 2017, DOI:10.1111/chd.12477

    Abstract Objective: To review long-term respiratory outcomes for tetralogy of Fallot and absent pulmonary valve (TOF/APV) in respiratory symptomatic populations.
    Methods: Of 25 consecutive patients undergoing primary total correction for TOF/APV between 1987 and 2016, Sixteen patients (64%) with a preoperative respiratory disturbance were enrolled. The median age at operation was 1.9 months old, including 4 neonates and 12 infants. Ten patients (62.5%) preoperatively necessitated mechanical ventilator support. During operation, dilated central pulmonary arteries (cPAs) were plicated and retracted anteriorly in all patients, except for the first patient of the study cohort. VSD was completely closed, and the… More >

  • Open Access


    Pulmonary vein stenosis in patients with Smith-Lemli-Opitz syndrome

    Aaron R. Prosnitz1, Jane Leopold2, Mira Irons3, Kathy Jenkins1, Amy E. Roberts1

    Congenital Heart Disease, Vol.12, No.4, pp. 475-483, 2017, DOI:10.1111/chd.12471

    Abstract Objective: To describe a group of children with co-incident pulmonary vein stenosis and SmithLemli-Opitz syndrome and to generate hypotheses as to the shared pathogenesis of these disorders.
    Design: Retrospective case series.
    Patients: Five subjects in a pulmonary vein stenosis cohort of 170 subjects were diagnosed with Smith-Lemli-Opitz syndrome soon after birth.
    Results: All five cases were diagnosed with Smith-Lemli-Opitz syndrome within 6 weeks of life, with no family history of either disorder. All cases had pathologically elevated 7-dehydrocholesterol levels and two of the five cases had previously reported pathogenic 7-dehydrocholesterol reductase mutations. Smith-Lemli-Opitz syndrome severity scores ranged from mild… More >

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