Among the congenital defects of the heart diagnosed
|
|
- Daisy Norman
- 5 years ago
- Views:
Transcription
1 Atrial Septal Defect: Anatomoechocardiographic Correlation Luis Muñóz-Castellanos, MD, Nilda Espinola-Zavaleta, MD, PhD, Magdalena Kuri-Nivón, MD, José Francisco Ruíz, MD, and Candace Keirns, MD, Mexico City, Mexico This study was undertaken to enhance understanding of the anatomic abnormalities involved in atrial echocardiography 15 (10.4%) had common atrio- mixed type ASD. Of the 144 patients evaluated with septal defect (ASD) based on the anatomoechocardiographic comparison of equivalent specimens of atrioventricular connection, 105 (72.9%) had ostium ventricular canal, one (0.7%) had right absence of ASD and the echocardiograms of patients with this secundum type ASD (fossa ovalis), 10 (7%) had anomaly. Of the 72 heart specimens, two had common atrioventricular canal (2.8%) and one had ab- type ASD, two (1.4%) had ostium primum type ASD, mixed type ASD, 9 (6.2%) had superior venous sinus sence of right atrioventricular connection (1.4%). In and two (1.4%) had true fossa ovalis type ASD. This all, 46 (63.8%) had fossa ovalis type ASD, two (2.8%) series leads us to conclude that the key to successful had true ostium secundum type ASD, two (2.8%) had management of ASD depends on understanding ostium primum type ASD, two (2.8%) had superior echocardiographic images in terms of anatomic sinus venosus type ASD, and two (2.8%) had inferior specimens to provide appropriate evaluations for sinus venosus type ASD. One (1.4%) specimen had a therapeutic decisions and establishment of prognoses. (J Am Soc Echocardiogr coronary venous sinus type ASD and 14 (19.4%) had 2006;19: ) Among the congenital defects of the heart diagnosed at our institution, 17.13% are atrial septal defect (ASD). 1,2 This corresponds to third place in clinical frequency after patent ductus arteriosus and ventricular septal defect. In the postmortem series 3 of Fontana and Edwards, ASD represented 8.7% and second place after ventricular septal defect, whereas Bankl 4 found that it occupied 3.7% of specimens. ASD can occur as a single malformation or it may be associated with other forms of congenital heart disease. A comprehension of the topographic relationship of these septal defects to cardiac structures facilitates their diagnosis. A classification of ASD is based on the septal areas involved. The interatrial septum is divided into a central portion at the level of the fossa ovale, the area between the latter and the entrance of the superior vena cava, the anteroinferior area of the septum above the atrioventricular septum, the posteroinferior area adjacent to the connection with the inferior vena cava, the highest part of the interatrial septum that separates the sinus portions of the right atrium (RA) and left atrium From the Outpatient Clinic Echocardiography, Instituto Nacional de Cardiología Ignacio Chávez. Reprint requests: Nilda Espinola-Zavaleta, MD, PhD, Outpatient Clinic Echocardiography, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Colonia Sección XVI, Tlalpan, Mexico, D.F. ( niesza2001@hotmail.com) /$32.00 Copyright 2006 by the American Society of Echocardiography. doi: /j.echo (LA), and the area that separates the wall of the coronary venous sinus from the LA. Apart from the types of ASD included in the classification, combinations of these exist that create large septal defects that are not included in the classifications. A grasp of the topology and morphology of an ASD is invaluable to the surgeon or interventionalist in planning and executing corrective therapy. Echocardiography, especially transesophageal technique, is the diagnostic method of choice for ASDs that occur alone or in combination with other forms of congenital heart disease. 5-7 A comparison of echocardiographic examinations of adult patients with ASD and equivalent adult anatomic specimens was undertaken to achieve a greater understanding of the morphology found in different types of ASD. METHODS In all, 72 heart specimens with ASD were examined. Specimens came from the collection of normal and diseased hearts of our embryology department. The morphology of specimen hearts was analyzed using the sequential segmental system established for diagnosis of congenital heart disease The following anatomic elements served as references to determine the topography of the interatrial septum: on the left side the entry of the pulmonary veins, the mitral fibrous ring, and oval fold; on the right side the orifices of the inferior and superior venae cavae and coronary sinus, the cephalic limit of the atrioventric- 1182
2 Volume 19 Number 9 Muñóz-Castellanos et al 1183 ular septum, and the limbus fossae ovalis. Each septal defect was characterized in terms of its relationship to these anatomic structures. The interatrial septum was divided into 5 zones that corresponded to the potential sites of defects. The defects were classified according to their locations; when a defect involved two or more septal zones it was classified as mixed. From May 2002 to May 2005, 144 adult consecutive patients with ASD underwent echocardiographic examination. Studies included transthoracic and transesophageal M-mode, 2-dimensional, and Doppler techniques with an ultrasound machine (Sonos 5500, Hewlett Packard, Andover, Mass) equipped with an S3 probe and a 5-MHz multiplane transesophageal probe. Transthoracic parasternal long- and short-axis sections and apical 4-chamber views were used to evaluate the diameter of the right chambers. The size and type of defect were determined from apical and subcostal (subxyphoid) 4-chamber images. Pulmonary venous return was assessed from apical 4-chamber and suprasternal views and systemic venous return from subcostal and parasternal planes. In the transesophageal study the midesophageal 90- to 100-degree views are more helpful, particularly for defect sizing, detecting multiple defects, and assessing proximity to venae cavae. However, to assess a defect completely, 0-, 30- to 60-, and 90-degree midesophageal views are necessary to completely characterize an ASD and its anatomic relations. The echocardiographic images were chosen to illustrate the anatomic findings and were matched on that basis to establish the degree of diagnostic correlation provided by ultrasound techniques. RESULTS Anatomic Findings All heart specimens analyzed had situs solitus. Of the 72 hearts with situs solitus, two had common atrioventricular canal (2.8%) and one had absence of right atrioventricular connection (1.4%). In all, 46 had ostium secundum (fossa ovalis) (63.8%), of which 45 had complete rings and one had incomplete rings. In the former cases the ring was located away from the inferior vena cava, whereas the incomplete ring was situated in the vicinity of the orifice of this vein to the RA and was contiguous with the eustachian valve. Complete rings varied according to the extension of the septum primum, which functioned as a valve. In 8 specimens (17.8%) the valve was large and covered more than 50% of the fossa ovalis. In 9 (20%) this septum was fenestrated, in 9 (20%) the valve was small, and in 19 (42%) it was absent. Two hearts (2.8%) had true ostium secundum type ASD. Two hearts (2.8%) had Table 1 Anatomic findings Type N 72 (situs solitus) N % Complete AV canal Right absence of AV connection Ostium secundum (fossa ovalis) True foramen ovale Ostium primum Superior sinus venosus Inferior sinus venosus Coronary venous sinus Mixed AV, Atrioventricular. Table 2 Echocardiographic findings Type N 144 (situs solitus) N % Common AV canal Right absence of AV connection Ostium secundum Mixed septal defect 10 7 Superior sinus venosus True foramen ovale Ostium primum AV, Atrioventricular. ostium primum defects situated in front of the entry of the coronary sinus; one of these was associated with mitral stenosis. Two hearts (2.8%) had superior sinus venosus type ASD located above the oval fold in the LA up to the roof of the adjacent zone of both atria and connected the sinus portions of both atria (right pulmonary vein and the entrance of the superior vena cava). Two specimens (2.8%) had inferior sinus venosus type ASDs above the inferior vena cava. One specimen (1.4%) had a septal defect between the roof of the coronary sinus and the wall of the LA. Fourteen specimens (19.4%) had mixed type defects that involved two or more areas of the septum. Ten had fossa ovalis with true ostium secundum, one had fossa ovalis with ostium primum, one had true ostium secundum and superior sinus venosus, and two included areas of the fossa ovalis with true ostium secundum and superior sinus venosus (Table 1). Echocardiographic Findings Of the 144 patients evaluated by echocardiography 94 were women and 50 were men with an average age of 30.3 years (18-73 years). Fifteen patients (10.4%) had common atrioventricular canal defects and one (0.7%) had absence of right atrioventricular connection. In all, 105 patients (72.9%) had ostium secundum type ASD. Of these, 5 had fenestrated septal defects,
3 1184 Muñóz-Castellanos et al September 2006 Figure 1 A, Internal view of one specimen with common atrium (CA) associated with absence of right atrioventricular connection in situs solitus. Note absence of interatrial septum, muscular floor of right atrium (R) (arrow), and loss of continuity between R and right ventricle (RV). Mitral valve (MV) shows left atrioventricular connection. B, Echocardiographic 4-chamber image shows same morphologic characteristics observed in anatomic specimen. Rudimentary RV, ventricular septal defect (VSD), and malalignment between ventricular septum (dotted line) and crux cordis is visualized (*). L, Left atrium; LV, left ventricle. whereas 22 were associated with other defects, including ventricular septal defect (5), partial anomalous connection of pulmonary veins (3), combined pulmonary stenosis and regurgitation (2), pulmonary stenosis (2), patent ductus arteriosus (2), mitral stenosis (2), Chiari network (2), ventricular septal defect and mitral valve prolapse (2), ventricular septal defect and patent ductus arteriosus (1), and prolapse of the anterior mitral leaflet with moderate mitral regurgitation (1). Ten patients (7%) had mixed type ASD, of which 8 combined ostium secundum type defects with inferior sinus venosus and two combined ostium secundum defects with extension of the ostium primum. In 9 cases (6.2%) superior sinus venosus type ASDs were found. Of these, 3 had normal pulmonary venous connection and 6 had anomalous pulmonary venous connection that was complete in 4 (to coronary sinus in one, to RA in one, to vertical vein in two) and partial in two (to RA in one and superior vena cava in one). Two patients (1.4%) had ostium primum type ASDs, both with two atrioventricular valves and two (1.4%) fossa ovalis type defects (Table 2). Anatomoechocardiographic Correlation In cases of common atrioventricular canal more than 50% of the interatrial septum is absent. A single atrial chamber is enclosed by the walls of the two atria. Common atrioventricular canal can occur in any situs; the morphology of the atrial walls and appendages provide the diagnosis. The anatomic characteristics defining situs solitus (Figure 1) can be clearly appreciated in echocardiographic image and specimen. Ostium secundum type ASD is characterized by a greater than normal dimensions of this structure during the period when it forms part of the developing heart, such that it becomes superimposed on the area of the fossa ovalis. It can vary in size and, depending on the characteristics of the septum primum, can have a small, large, absent, or fenestrated valve. In the specimen shown in Figure A, 2, a large septal defect is observed from the LA with a large ring and no valve. The echocardiographic images demonstrate the size, type, and localization of the defect. Color Doppler documents the left-toright shunt (Figure 2, B). Occasionally this type of ASD may be associated with a Chiari network evident in the anatomic specimen and on the echocardiogram (Figure 3). Figure 4 shows the fenestrated variant of this type of defect in the form of a band of tissue that separates two orifices. The two left-toright shunts can be seen on the echocardiogram. In Figure 5, a defect is apparent within the ring of the foramen ovale, which extends to the orifice of the inferior vena cava. Most of the ring is covered by the septum primum. The transesophageal echocardiographic image at 35 degrees reveals the septal defect behind the aortic valve. Figure 6 shows a view of the left chambers of the heart with an atrioventricular septal defect, a common atrioventricular valve, and a large defect that combines the ostium primum, the atrioventricular septal defect, and a ventricular septal defect. This specimen is an example of a type A Rastelli defect on the basis of the insertion of the anterior leaflets in the crest of the ventricular septum. The 4-chamber echocardiographic image demonstrates the same features as the anatomic specimen. The insertion of the anterior leaflets can be
4 Volume 19 Number 9 Muñóz-Castellanos et al 1185 Figure 2 A, Internal view of left atrium (LA). Note large septal defect involving areas of ostium secundum and fossa ovalis. Two-dimensional (B) and color Doppler (C) echocardiographic images show large ostium secundum type defect. ASD, Atrial septal defect; LV, left ventricle; MV, mitral valve; RA, right atrium. clearly seen, as can the ostium primum and ventricular septal defect situated between the chordae tendineae and below the leaflets. The two defects join to form a large canal. Figure 7 reveals an isolated ostium primum viewed from the LA. The proximity of the stenotic mitral valve with fusion of the leaflets at the posterior commissure is evident. The echocardiogram shows the septal defect above the separated atrioventricular valves and a perimembranous ventricular septal defect. In Figure 8, a superior sinus venosus type ASD is seen from the LA. It is noteworthy that the defect extends from the roof of the atrium beneath the connection of the right pulmonary veins. The probe points to the amplification of the fossa ovalis over the septal surface of the LA. The echocardiographic 4-chamber image also shows this type of defect. Figure 9 shows a left view of a mixed type ASD that involves the regions of the ostium primum, fossa ovalis, and superior sinus venosus and the connection of the pulmonary veins. The 2-dimensional and color Doppler echocardiographic images reveal a septal defect that includes the 3 areas described and the connection of the pulmonary veins to the LA. Figure 3 A, Internal view of right atrium (RA) shows ostium secundum type interatrial defect. Note Chiari network (arrow) inside triangle of Koch (dotted line) and above coronary sinus ostium. B, Transesophageal image at 37 degrees shows ostium secundum type interatrial defect and prominent Chiari network beneath defect (arrow). Ao, Aorta; ASD, atrial septal defect; LA, left atrium; PA, pulmonary artery; RV, right ventricle; TV, tricuspid valve. DISCUSSION The analysis of the comparison of anatomic characteristics of ASDs with their echocardiographic images was possible because the selected anatomic specimens had such characteristics that matched with the echocardiographic studies. This comparison provided a high degree of correlation between anatomy and echocardiography in this congenital heart disease. The common atrium constitutes the maximum expression of the ASD. It is defined as a defect involving more than 50% of the atrial septum. It rarely occurs as a single anomaly; it is a constant finding in dextroisomerism and levoisomerism. Each atrium can be identified by the characteristics of its walls, appendage, or venous connections. Total
5 1186 Muñóz-Castellanos et al September 2006 Figure 4 A, Internal view of right atrium (RA) shows ostium secundum type inter-atrial septal defect (ASD) within area of fossa ovale with two fenestrations. Transesophageal 2-dimensional (B) and color Doppler (C) images demonstrate ostium secundum type ASD with two fenestrations (arrows). Ao, Aorta; LA, left atrium. Figure 5 A, Internal view of right atrium (RA) shows atrial septal defect (ASD) within area of fossa ovalis (foramen secundum) in which remnants of left leaflet of sinus venosus can be seen adhering to interatrial septum (arrowheads). B, Two-dimensional echocardiographic image shows fossa ovalis type ASD. Note defect behind aortic valve. Ao, Aorta; IVC, inferior vena cava; LA, left atrium; PA, pulmonary artery; TV, tricuspid valve. absence of the interatrial septum defines a common atrium. The ostium secundum is so called because it is found on the septum primum superimposed on the fossa ovalis, which it augments. It is found on the central part of the atrial septum when the ring of the fossa ovalis is complete. When the ring is incomplete it extends to the orifice of the inferior vena cava and can induce the surgeon to implant the inferior vena cava in the LA during the correction of the defect. The diagnosis of an isolated ostium primum ASD is facilitated by its location in proximity to the mitral valve. In these cases there is not a cleft of the mitral
6 Volume 19 Number 9 Muñóz-Castellanos et al 1187 Figure 6 A, View of left chambers of heart with Rastelli s type A atrioventricular canal. Note confluence of ostium primum, actual atrioventricular defect, and ventricular septal defect (VSD) (asterisks). B, Echocardiographic 4-chamber image shows atrio-vsd with its 3 components: ostium primum, atrioventricular defect, and interchordal spaces of VSD (arrow). LA, Left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle. Figure 7 A, Internal view of left atrium (LA) shows ostium primum type atrial septal defect. Note proximity of mitral fibrous ring (arrowheads). Two-dimensional echocardiographic (B) and color Doppler (C) images demonstrate ostium primum type septal defect (arrow) and two atrioventricular valves. Color-coded Doppler also documents perimembranous ventricular septal defect (VSD) with extension into inlet. LV, Left ventricle; MV, mitral valve; RA, right atrium; RV, right ventricle; TV, tricuspid valve. valve. Most cases of ostium primum ASDs are not actually isolated defects but they are commonly associated with atrioventricular septal defects. The superior sinus venosus type defect connects the sinus portions of both atria on the atrial roof. The proximity of the right pulmonary veins normally connected to the LA allows anomalous pulmonary venous drainage through the ASD as a result of blood pressure differences between the right pulmonary veins and the RA. In a partial anomalous connection of pulmonary veins into the RA this type of ASD is also present. When the pulmonary venous connection is in structures other than the RA, the ASD more commonly associated is ostium secundum type. Isolated drainage of right pulmonary veins only occurs in the presence of superior sinus venosus ASD. Hudson 11 interpreted this defect as persistence of the vestibule of the pulmonary venous sinus, such that Becker and Anderson 12 did not consider it to be a true septal defect. We included one anatomic specimen with a septal defect between the coronary sinus and the LA. This is not a true ASD but it allows a shunt similar to that observed in ASD. Mixed type ASDs are large because they involve two or more regions of the atrial septum. The most common mixed type defect includes the fossa ovalis and the ostium secundum. When the defect includes areas of the fossa ovalis and the superior sinus venosus it reaches the roof of the atria. Echocardiography provides the characteristics of the type, size, extent, and geometry of ASDs, and their relationships to cardiac structures, connection of pulmonary veins, and hemodynamic repercussions on the right heart. Therapeutic decisions and
7 1188 Muñóz-Castellanos et al September 2006 Figure 8 A, Internal view of left atrium (LA) of heart with superior sinus venosus type atrial septal defect (ASD). Note proximity of connection of right pulmonary veins (white arrows) with ASD (black arrow) and persistent oval fold (white arrow). B, Two-dimensional apical 4-chamber image shows superior sinus venosus type ASD that extends from atrial roof. LV, Left ventricle; RA, right atrium; RV, right ventricle. Figure 9 A, Internal view of left atrium (LA) with large atrial septal defect (ASD) involving areas of superior sinus venosus, ostium secundum, and ostium primum. Note mitral valve (MV) in inferior portion of septal defect and connection of right pulmonary vein (RPV) in superior portion. B, Two-dimensional and color Doppler 4-chamber echocardiographic images show large septal defect that involves areas of septum described in A and connection of pulmonary veins. LPV, Left pulmonary vein; RA, right atrium; RV, right ventricle. prognosis of treatment by surgery or catheterization depend on these variables. The data that this study provides should be used to select optimal patients for percutaneous or surgical closure of ASDs. Both options require accurate information regarding the anatomy of the defect, such as its maximal diameter, to choose a device with appropriate size, and the tissue rim dimensions all around the defect to optimize the placement of the device. The ASD ostium secundum and fossa ovalis types are more suitable for transcatheter closure. Surgical closure is also performed when this defect has a large size or multiple holes. The superior and inferior sinus venosus ASDs always require surgical closure, because there is not a superior rim and the device could migrate and embolize. Nonsurgical closure is contraindicated for foramen primum type, because the atrioventricular node is close to this defect and there is no inferior rim. These anatomic relationships must be kept in mind.
8 Volume 19 Number 9 Muñóz-Castellanos et al 1189 On the basis of these findings we conclude that the key to successful management of ASD depends on understanding echocardiographic images in terms of anatomic specimens to provide appropriate evaluations for therapeutic decisions and establishment of prognoses. This study taught us that the key for obtaining good results in the treatment of patients with ASD is a precise definition of the anatomy and a full and complete interpretation of the imaging studies. REFERENCES 1. Espino Vela J, Alvarado-Toro A. Natural history of atrial septal defect. Cardiovasc Clin 1971;2: Salazar E, García-Alfogeme A, Dávila R. La comunicación interauricular: análisis de 462 casos estudiados en el Instituto Nacional de Cardiología. Arch Inst Cardiol Mex 1972; 42: Fontana RS, Edwards JE. Congenital cardiac disease: a review of 357 cases studied pathologically. Philadelphia: WB Saunders Co; Bankl H. Congenital malformations of the heart and great vessels: synopsis of pathology, embryology and natural history. Baltimore and Munich: Urban-Schwarzenberg; 1977, pp Mehmood F, Verngala S, Nanda NC, Dod HS, Sinha A, Miller APO, et al. Usefulness of live three-dimensional transthoracic echocardiography in the characterization of atrial septal defects in adults. Echocardiography 2004;21: Prokselj K, Kozelj M, Zadnik V, Podnar T. Echocardiographic characteristics of secundum-type atrial septal defects in adult patients: implications for percutaneous closure using Amplatzer septal occluders. J Am Soc Echocardiogr 2004;17: Hopkins RA, Bert AA, Buchholz B, Guarino K, Meyers M. Surgical patch closure of atrial septal defects. Ann Thorac Surg 2004;77: Shinebourne EA, Macartney FJ, Anderson RH. Sequential chamber localization: logical approach to diagnosis in congenital heart disease. Br Heart J 1976;38: Tynan MJ, Becker AE, Macartney FJ, Quero-Jimenez M, Shinebourne EA, Anderson RH. Nomenclature and classification of congenital heart disease. Br Heart J 1979;41: Díaz-Góngora G, Attie F, Quero-Jiménez M, Muñoz-Castellanos L, Anderson RH, Tynam M. La secuencia diagnóstica de las cardiopatías congénitas. Arch Inst Cardiol Mex 1982;52: Hudson REB. The normal and abnormal interatrial septum. Br Heart J 1955;17: Becker AE, Anderson RH. Pathology of congenital heart disease. London: Butterworths; 1981.
Atrial Septal Defects
Supplementary ACHD Echo Acquisition Protocol for Atrial Septal Defects The following protocol for echo in adult patients with atrial septal defects (ASDs) is a guide for performing a comprehensive assessment
More information2D/3D in Evaluation of Atrial Septum
2D/3D in Evaluation of Atrial Septum Roberto M Lang, MD OSTIUM SECUNDUM ASD: 2D AND 3D TNSESOPHAGEAL ECHO 1 Biplane views 90 0 3D Acquisi on Acquire 3D volume Lang RM et al. JASE 2012;25:3 46. Right atrial
More informationAnatomy of Atrioventricular Septal Defect (AVSD)
Surgical challenges in atrio-ventricular septal defect in grown-up congenital heart disease Anatomy of Atrioventricular Septal Defect (AVSD) S. Yen Ho Professor of Cardiac Morphology Royal Brompton and
More informationHeart and Lungs. LUNG Coronal section demonstrates relationship of pulmonary parenchyma to heart and chest wall.
Heart and Lungs Normal Sonographic Anatomy THORAX Axial and coronal sections demonstrate integrity of thorax, fetal breathing movements, and overall size and shape. LUNG Coronal section demonstrates relationship
More informationAdult Echocardiography Examination Content Outline
Adult Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 Anatomy and Physiology Pathology Clinical Care and Safety Measurement Techniques, Maneuvers,
More informationTHE NORMAL AND ABNORMAL INTER-ATRIAL SEPTUM
THE NORMAL AND ABNORMAL INTER-ATRIAL SEPTUM BY REGINALD HUDSON From the Institute of Cardiology and National Heart Hospital Received April 5, 1954 This paper is an elementary study of the normal and abnormal
More informationThe role of intraoperative TOE in congenital cardiac surgery
The role of intraoperative TOE in congenital cardiac surgery Justiaan Swanevelder Dept of Anaesthesia Groote Schuur and Red Cross War Memorial Children s Hospitals University of Cape Town, South Africa
More informationJOINT MEETING 2 Tricuspid club Chairpersons: G. Athanassopoulos, A. Avgeropoulou, M. Khoury, G. Stavridis
JOINT MEETING 2 Tricuspid club Chairpersons: G. Athanassopoulos, A. Avgeropoulou, M. Khoury, G. Stavridis Similarities and differences in Tricuspid vs. Mitral Valve Anatomy and Imaging. Echo evaluation
More informationList of Videos. Video 1.1
Video 1.1 Video 1.2 Video 1.3 Video 1.4 Video 1.5 Video 1.6 Video 1.7 Video 1.8 The parasternal long-axis view of the left ventricle shows the left ventricular inflow and outflow tract. The left atrium
More informationPediatric Echocardiography Examination Content Outline
Pediatric Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 Anatomy and Physiology Normal Anatomy and Physiology 10% 2 Abnormal Pathology and Pathophysiology
More informationECHOCARDIOGRAPHIC APPROACH TO CONGENITAL HEART DISEASE: THE UNOPERATED ADULT
ECHOCARDIOGRAPHIC APPROACH TO CONGENITAL HEART DISEASE: THE UNOPERATED ADULT Karen Stout, MD, FACC Divisions of Cardiology University of Washington Medical Center Seattle Children s Hospital NO DISCLOSURES
More informationCardiac ultrasound protocols
Cardiac ultrasound protocols IDEXX Telemedicine Consultants Two-dimensional and M-mode imaging planes Right parasternal long axis four chamber Obtained from the right side Displays the relative proportions
More informationEchocardiography in the Adult with Congenital Heart Disease
1 1 Echocardiography in the Adult with Congenital Heart Disease Julie A. Kovach Indications for Echocardiography in the Evaluation of the Adult with Congenital Heart Disease........ 279 Indications and
More informationISUOG Basic Training. Obtaining & Interpreting Heart Views Correctly Alfred Abuhamad, USA. Basic training. Editable text here
ISUOG Basic Training Obtaining & Interpreting Heart Views Correctly Alfred Abuhamad, USA Learning Objectives 6, 7 & 8 At the end of the lecture you will be able to: describe how to assess cardiac situs
More informationGiovanni Di Salvo MD, PhD, FESC Second University of Naples Monaldi Hospital
Giovanni Di Salvo MD, PhD, FESC Second University of Naples Monaldi Hospital VSD is one of the most common congenital cardiac abnormalities in the newborn. It can occur as an isolated finding or in combination
More informationCardiovascular Ultrasound
Cardiovascular Ultrasound BioMed Central Research Ebstein's Anomaly: Anatomo-echocardiographic correlation Luis Muñoz-Castellanos 1, Nilda Espinola-Zavaleta* 2, Magdalena Kuri- Nivón 3 and Candace Keirns
More informationDEVELOPMENT OF THE CIRCULATORY SYSTEM L E C T U R E 5
DEVELOPMENT OF THE CIRCULATORY SYSTEM L E C T U R E 5 REVIEW OF CARDIAC ANATOMY Heart 4 chambers Base and apex Valves Pericardial sac 3 layers: epi, myo, endo cardium Major blood vessels Aorta and its
More informationAnomalous Systemic Venous Connection Systemic venous anomaly
World Database for Pediatric and Congenital Heart Surgery Appendix B: Diagnosis (International Paediatric and Congenital Cardiac Codes (IPCCC) and definitions) Anomalous Systemic Venous Connection Systemic
More informationhuman anatomy 2016 lecture thirteen Dr meethak ali ahmed neurosurgeon
Heart The heart is a hollow muscular organ that is somewhat pyramid shaped and lies within the pericardium in the mediastinum. It is connected at its base to the great blood vessels but otherwise lies
More informationDiversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia
Marshall University Marshall Digital Scholar Internal Medicine Faculty Research Spring 5-2004 Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia Ellen A. Thompson
More informationCARDIAC DEVELOPMENT CARDIAC DEVELOPMENT
CARDIAC DEVELOPMENT CARDIAC DEVELOPMENT Diane E. Spicer, BS, PA(ASCP) University of Florida Dept. of Pediatric Cardiology Curator Van Mierop Cardiac Archive This lecture is given with special thanks to
More informationWhen to close an Atrial Septal Defect (ASD) in adulthood?
When to close an Atrial Septal Defect (ASD) in adulthood? Philippe ALDEBERT Hôpital de la Timone, CHU Marseille Département de cardiologie pédiatrique et congénitale médico-chirurgical Abbott Incidence
More informationEchocardiographic Guidance During Placement of the Buttoned Double-Disk Device for Atrial Septa1 Defect Closure
Echocardiographic Guidance During Placement of the Buttoned Double-Disk Device for Atrial Septa1 Defect Closure L. LUANN MINICH, M.D., and A. REBECCA SNIDER, M.D. Department of Pediatrics, C.S. Mott Children
More informationAtrial Septal Defect Closure. Stephen Brecker Director, Cardiac Catheterisation Labs
Stephen Brecker Director, Cardiac Catheterisation Labs ADVANCED ANGIOPLASTY Incorporating The Left Main 5 Plus Course Conflicts of Interest The following companies have supported educational courses held
More informationAdult Congenital Heart Disease: What All Echocardiographers Should Know Sharon L. Roble, MD, FACC Echo Hawaii 2016
1 Adult Congenital Heart Disease: What All Echocardiographers Should Know Sharon L. Roble, MD, FACC Echo Hawaii 2016 DISCLOSURES I have no disclosures relevant to today s talk 2 Why should all echocardiographers
More informationCommunication of Mitral Valve with Both Ventricles Associated with Double Outlet Right Ventricle
Communication of Mitral Valve with Both Ventricles Associated with Double Outlet Right Ventricle By RAJENTDRA TANDON, M.D., JAMES H. MOLLR, MD, AND JESSE E. EDWARDS, M.D. SUMMARY A rare case of an infant
More informationSegmental Analysis. Gautam K. Singh, M.D. Washington University School of Medicine St. Louis
Segmental Analysis Gautam K. Singh, M.D. Washington University School of Medicine St. Louis Segmental Analysis Segmental Analysis: From Veins to Ventricles Segmental Approach to Evaluation of Congenital
More informationULTRASOUND OF THE FETAL HEART
ULTRASOUND OF THE FETAL HEART Cameron A. Manbeian, MD Disclosure Statement Today s faculty: Cameron Manbeian, MD does not have any relevant financial relationships with commercial interests or affiliations
More informationCongenital Heart Defects
Normal Heart Congenital Heart Defects 1. Patent Ductus Arteriosus The ductus arteriosus connects the main pulmonary artery to the aorta. In utero, it allows the blood leaving the right ventricle to bypass
More informationSurgical Experience with Unroofed Coronary Sinus
Surgical Experience with Unroofed Coronary Sinus Jan Quaegebeur, M.D., John W. Kirklin, M.D., Albert D. Pacifico, M.D., and Lionel M. Bargeron, Jr., M.D. ABSTRACT Between January, 1967, and October, 1977,
More informationthe Cardiovascular System I
the Cardiovascular System I By: Dr. Nabil A Khouri MD, MsC, Ph.D MEDIASTINUM 1. Superior Mediastinum 2. inferior Mediastinum Anterior mediastinum. Middle mediastinum. Posterior mediastinum Anatomy of
More informationCASE REPORT: DOUBLE ORIFICE MITRAL VALVE WITH CLEFT IN ANTERIOR LEAFLET OF DOMINANT VALVE IN AN AFRO-CARIBBEAN
CASE REPORT: DOUBLE ORIFICE MITL VAE WITH CLEFT IN ANTERIOR LEAFLET OF DOMINANT VAE IN AN AFRO-CARIBBEAN Disclosure: No potential conflict of interest. Received: 27.08.13 Accepted: 23.06.14 Citation: EMJ
More informationDouble Outlet Right Ventricle with Anterior and Left-Sided Aorta and Subpulmonary Ventricular Septal Defect
Case Report Double Outlet Right Ventricle with Anterior and Left-Sided rta and Subpulmonary Ventricular Septal Defect Luciana Braz Peixoto, Samira Morhy Borges Leal, Carlos Eduardo Suaide Silva, Sandra
More informationImaging Evaluation of the Ventricular Septum
Imaging Evaluation of the Ventricular Septum Craig E Fleishman, MD FACC FASE The Heart Center at Arnold Palmer Hospital for Children, Orlando SCAI Fall Fellows Course 2013 Las Vegas Disclosure Information
More informationCertificate in Clinician Performed Ultrasound (CCPU) Syllabus. Rapid Cardiac Echo (RCE)
Certificate in Clinician Performed Ultrasound (CCPU) Syllabus Rapid Cardiac Echo (RCE) Purpose: Rapid Cardiac Echocardiography (RCE) This unit is designed to cover the theoretical and practical curriculum
More informationMost common fetal cardiac anomalies
Most common fetal cardiac anomalies Common congenital heart defects CHD % of cardiac defects Chromosomal Infants Fetuses anomaly (%) 22q11 deletion (%) VSD 30 5~10 20~40 10 PS 9 5 (PA w/ VSD) HLHS 7~9
More informationPART II ECHOCARDIOGRAPHY LABORATORY OPERATIONS ADULT TRANSTHORACIC ECHOCARDIOGRAPHY TESTING
PART II ECHOCARDIOGRAPHY LABORATORY OPERATIONS ADULT TRANSTHORACIC ECHOCARDIOGRAPHY TESTING STANDARD - Primary Instrumentation 1.1 Cardiac Ultrasound Systems SECTION 1 Instrumentation Ultrasound instruments
More informationAnatomy of Atrial and Ventricular Septal Defects
Anatomy of Atrial and Ventricular Septal Defects SIEW YEN HO, PH.D., F.R.C.PATH, KAREN P. MCCARTHY, B.Sc., and MICHAEL RIGBY, M.D. From the Paediatrics, National Heart & Lung Institute, Imperial College
More informationRevealing new insights. irotate electronic rotation and xplane adjustable biplane imaging. Ultrasound cardiology. irotate and xplane
Ultrasound cardiology irotate and xplane Revealing new insights irotate electronic rotation and xplane adjustable biplane imaging Annemien van den Bosch and Jackie McGhie Department of Cardiology, Erasmus
More informationPerimembranous VSD: When Do We Ask For A Surgical Closure? LI Xin. Department of Cardiothoracic Surgery Queen Mary Hospital Hong Kong
Perimembranous VSD: When Do We Ask For A Surgical Closure? LI Xin Department of Cardiothoracic Surgery Queen Mary Hospital Hong Kong Classification (by Kirklin) I. Subarterial (10%) Outlet, conal, supracristal,
More informationAppendix A.1: Tier 1 Surgical Procedure Terms and Definitions
Appendix A.1: Tier 1 Surgical Procedure Terms and Definitions Tier 1 surgeries AV Canal Atrioventricular Septal Repair, Complete Repair of complete AV canal (AVSD) using one- or two-patch or other technique,
More informationCOMPREHENSIVE EVALUATION OF FETAL HEART R. GOWDAMARAJAN MD
COMPREHENSIVE EVALUATION OF FETAL HEART R. GOWDAMARAJAN MD Disclosure No Relevant Financial Relationships with Commercial Interests Fetal Echo: How to do it? Timing of Study -optimally between 22-24 weeks
More informationConcomitant procedures using minimally access
Surgical Technique on Cardiac Surgery Concomitant procedures using minimally access Nelson Santos Paulo Cardiothoracic Surgery, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal Correspondence to:
More informationAbsent Pulmonary Valve Syndrome
Absent Pulmonary Valve Syndrome Fact sheet on Absent Pulmonary Valve Syndrome In this condition, which has some similarities to Fallot's Tetralogy, there is a VSD with narrowing at the pulmonary valve.
More informationCardiac Catheterization Cases Primary Cardiac Diagnoses Facility 12 month period from to PRIMARY DIAGNOSES (one per patient)
PRIMARY DIAGNOSES (one per patient) Septal Defects ASD (Atrial Septal Defect) PFO (Patent Foramen Ovale) ASD, Secundum ASD, Sinus venosus ASD, Coronary sinus ASD, Common atrium (single atrium) VSD (Ventricular
More informationJournal of American Science 2014;10(9) Congenital Heart Disease in Pediatric with Down's Syndrome
Journal of American Science 2014;10(9) http://www.jofamericanscience.org Congenital Heart Disease in Pediatric with Down's Syndrome Jawaher Khalid Almaimani; Maryam Faisal Zafir; Hanan Yousif Abbas and
More informationTransposition of the Great Arteries Preoperative Diagnostic Considerations. John Simpson Evelina Children s Hospital London, UK
Transposition of the Great Arteries Preoperative Diagnostic Considerations John Simpson Evelina Children s Hospital London, UK Areas to be covered Definitions Scope of occurrence of transposition of the
More informationTechniques for repair of complete atrioventricular septal
No Ventricular Septal Defect Patch Atrioventricular Septal Defect Repair Carl L. Backer, MD *, Osama Eltayeb, MD *, Michael C. Mongé, MD *, and John M. Costello, MD For the past 10 years, our center has
More informationCMR for Congenital Heart Disease
CMR for Congenital Heart Disease * Second-line tool after TTE * Strengths of CMR : tissue characterisation, comprehensive access and coverage, relatively accurate measurements of biventricular function/
More informationAnatomy of left ventricular outflow tract'
Anatomy of left ventricular outflow tract' ROBERT WALMSLEY British Heart Journal, 1979, 41, 263-267 From the Department of Anatomy and Experimental Pathology, The University, St Andrews, Scotland SUMMARY
More informationHISTORY. Question: What category of heart disease is suggested by this history? CHIEF COMPLAINT: Heart murmur present since early infancy.
HISTORY 18-year-old man. CHIEF COMPLAINT: Heart murmur present since early infancy. PRESENT ILLNESS: Although normal at birth, a heart murmur was heard at the six week check-up and has persisted since
More information5.8 Congenital Heart Disease
5.8 Congenital Heart Disease Congenital heart diseases (CHD) refer to structural or functional heart diseases, which are present at birth. Some of these lesions may be discovered later. prevalence of Chd
More informationATRIAL SEPTAL CLOSURE AND LEFT ATRIAL APPENDAGE OCCLUSION: INDICATIONS AND GUIDANCE ECHOCARDIOGRAPHY IN INTERVENTIONAL CARDIOLOGY
ATRIAL SEPTAL CLOSURE AND LEFT ATRIAL APPENDAGE OCCLUSION: INDICATIONS AND GUIDANCE Aristides G. Panlilio, MD, FPCP, FPCC,FPSE, FASE Philippine Heart Center Chinese General Hospital and Medical Center
More informationA SURGEONS' GUIDE TO CARDIAC DIAGNOSIS
A SURGEONS' GUIDE TO CARDIAC DIAGNOSIS PART II THE CLINICAL PICTURE DONALD N. ROSS B. Sc., M. B., CH. B., F. R. C. S. CONSULTANT THORACIC SURGEON GUY'S HOSPITAL, LONDON WITH 53 FIGURES Springer-Verlag
More informationAnatomy & Physiology
1 Anatomy & Physiology Heart is divided into four chambers, two atrias & two ventricles. Atrioventricular valves (tricuspid & mitral) separate the atria from ventricles. they open & close to control flow
More informationAtrioventricular Canal (Septal) Defects. Norman H Silverman MD. D Sc (Med),FACC, FAHA
Atrioventricular Canal (Septal) Defects Norman H Silverman MD. D Sc (Med),FACC, FAHA Embryology of the A-V Canal Looping NHS. Formation of the Atrial Septum Embryology of the A-V Canal NHS. Development
More informationSystematic approach to Fetal Echocardiography. Objectives. Introduction 11/2/2015
Systematic approach to Fetal Echocardiography. Pediatric Echocardiography Conference, JCMCH November 7, 2015 Rajani Anand Objectives Fetal cardiology pre-test Introduction Embryology and Physiology of
More informationLarge Arteries of Heart
Cardiovascular System (Part A-2) Module 5 -Chapter 8 Overview Arteries Capillaries Veins Heart Anatomy Conduction System Blood pressure Fetal circulation Susie Turner, M.D. 1/5/13 Large Arteries of Heart
More informationNormal TTE/TEE Examinations
Normal TTE/TEE Examinations Geoffrey A. Rose, MD FACC FASE Sanger Heart & Vascular Institute Before you begin imaging... Obtain the patient s Height Weight BP PLAX View PLAX View Is apex @ 9-10 o clock?
More informationLab Activity 23. Cardiac Anatomy. Portland Community College BI 232
Lab Activity 23 Cardiac Anatomy Portland Community College BI 232 Cardiac Muscle Histology Branching cells Intercalated disc: contains many gap junctions connecting the adjacent cell cytoplasm, creates
More informationChapter 2 Cardiac Interpretation of Pediatric Chest X-Ray
Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray Ra-id Abdulla and Douglas M. Luxenberg Key Facts The cardiac silhouette occupies 50 55% of the chest width on an anterior posterior chest X-ray
More informationAnatomy lab -1- Imp note: papillary muscle Trabeculae Carneae chordae tendineae
Anatomy lab -1- Imp note: the arrangement of this sheet is different than the lab recording, it has been arranged in a certain way to make it easier to study. When you open the left ventricle you can see
More informationCommon Defects With Expected Adult Survival:
Common Defects With Expected Adult Survival: Bicuspid aortic valve :Acyanotic Mitral valve prolapse Coarctation of aorta Pulmonary valve stenosis Atrial septal defect Patent ductus arteriosus (V.S.D.)
More informationBreakout Session: Transesophageal Echocardiography
Breakout Session: Transesophageal Echocardiography Doris Ockert, MD Andrew Schroeder, MD University of Wisconsin School of Medicine and Public Health Jutta Novalija, MD, PhD Medical College of Wisconsin
More informationAppendix II: ECHOCARDIOGRAPHY ANALYSIS
Appendix II: ECHOCARDIOGRAPHY ANALYSIS Two-Dimensional (2D) imaging was performed using the Vivid 7 Advantage cardiovascular ultrasound system (GE Medical Systems, Milwaukee) with a frame rate of 400 frames
More informationSurgical Management Of TAPVR. Daniel A. Velez, M.D. Congenital Cardiac Surgeon Phoenix Children s Hospital
Surgical Management Of TAPVR Daniel A. Velez, M.D. Congenital Cardiac Surgeon Phoenix Children s Hospital No Disclosures Goals Review the embryology and anatomy Review Surgical Strategies for repair Discuss
More informationCongenital heart disease. By Dr Saima Ali Professor of pediatrics
Congenital heart disease By Dr Saima Ali Professor of pediatrics What is the most striking clinical finding in this child? Learning objectives By the end of this lecture, final year student should be able
More informationData Collected: June 17, Reported: June 30, Survey Dates 05/24/ /07/2010
Job Task Analysis for ARDMS Pediatric Echocardiography Data Collected: June 17, 2010 Reported: Analysis Summary For: Pediatric Echocardiography Exam Survey Dates 05/24/2010-06/07/2010 Invited Respondents
More informationpulmonary valve on, 107 pulmonary valve vegetations on, 113
INDEX Adriamycin-induced cardiomyopathy, 176 Amyloidosis, 160-161 echocardiographic abnormalities in, 160 intra-mural tumors similar to, 294 myocardial involvement in, 160-161 two-dimensional echocardiography
More informationSimple Congenital Heart Lesions
Journal of Cardiovascular Magnetic Resonance (2006) 8, 619 631 Copyright c 2006 Taylor & Francis Group, LLC ISSN: 1097-6647 print / 1532-429X online DOI: 10.1080/10976640600721510 CONGENITAL HEART DISEASE
More informationDevelopment of the heart
Development of the heart Prof. Abdulameer Al-Nuaimi E-mail: a.al-nuaimi@sheffield.ac.uk abdulameerh@yahoo.com Early Development of the Circulatory System Appears in the middle of the third week, when the
More informationCardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 P a g e
Cardiology Fellowship Manual Goals & Objectives -Cardiac Imaging- 1 P a g e UNIV. OF NEBRASKA CHILDREN S HOSPITAL & MEDICAL CENTER DIVISION OF CARDIOLOGY FELLOWSHIP PROGRAM CARDIAC IMAGING ROTATION GOALS
More informationwas judged subjectively. The left ventricle was considered to be slightly hypoplastic when the cardiac
British Heart J7ournal, 1976, 38, 1124-1132. Double outlet right ventricle Study of 27 cases A. H. Cameron, F. Acerete, M. Quero, and M. C. Castro From the Department of Patlology, Children's Hospital,
More informationType Size AP/PS RP/RS Qp/Qs. Ia Resistive <0.3 < Ib Resistive <0.3 < IIa Resistive <0.5 >2
Transcatheter closure of VSD using Duct Occluder device Nguyen Lan Hieu, MD, PhD Hanoi Medical University Vietnam Heart Institute Anatomy of VSD 1. Perimembranous VSD: Aneurysm septal membranous(tv or
More informationPartial anomalous pulmonary venous connection to superior
Cavo-Atrial Anastomosis Technique for Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava The Warden Procedure Robert A. Gustafson, MD Partial anomalous pulmonary venous connection
More informationCongenital Heart Disease An Approach for Simple and Complex Anomalies
Congenital Heart Disease An Approach for Simple and Complex Anomalies Michael D. Pettersen, MD Director, Echocardiography Rocky Mountain Hospital for Children Denver, CO None Disclosures 1 ASCeXAM Contains
More informationTranscatheter closure of interatrial
372 Br HeartJf 1994;72:372-377 PRACTICE REVIEWED Department of Paediatric Cardiology, Royal Brompton Hospital, London A N Redington M L Rigby Correspondence to: Dr A N Redington, Department of Paediatric
More informationACTIVITY 9: BLOOD AND HEART BLOOD
ACTIVITY 9: BLOOD AND HEART OBJECTIVES: 1) How to get ready: Read Chapters 21 & 22, McKinley et al., Human Anatomy, 4e. All text references are for this textbook. Read dissection instructions BEFORE YOU
More informationAnatomy of the Heart. Figure 20 2c
Anatomy of the Heart Figure 20 2c Pericardium & Myocardium Remember, the heart sits in it s own cavity, known as the mediastinum. The heart is surrounded by the Pericardium, a double lining of the pericardial
More informationNormal TTE Examination, Doppler Echocardiography and Normal Antegrade Flow Patterns
Normal TTE Examination, Doppler Echocardiography and Normal Antegrade Flow Patterns Pravin Patil, MD FACC FASE Associate Professor of Medicine Director, Cardiovascular Disease Training Program Lewis Katz
More informationMultidetector computed tomography in the evaluation of atrial septal defects
Multidetector computed tomography in the evaluation of atrial septal defects Poster No.: C-0502 Congress: ECR 2010 Type: Educational Exhibit Topic: Cardiac Authors: S. Espejo, R. Ysamat, B. Cajal, M. Pan,
More informationEmbryology of the Heart
*Page 1A: Embryology of the Heart Human embryonic disc is divided into three layers: ectoderm, intraembryonic mesoderm, and endoderm. The embryonic disc lies between the amniotic cavity and the primary
More informationRecent technical advances and increasing experience
Pediatric Open Heart Operations Without Diagnostic Cardiac Catheterization Jean-Pierre Pfammatter, MD, Pascal A. Berdat, MD, Thierry P. Carrel, MD, and Franco P. Stocker, MD Division of Pediatric Cardiology,
More informationEchocardiography in adult congenital heart disease
S12 Department of Cardiology, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK A Houston S Lilley T Richens University Department of Medicine and Therapeutics, Western Infirmary, Glasgow G11 6NT, UK
More informationCJ Shuster A&P2 Lab Addenum Beef Heart Dissection 1. Heart Dissection. (taken from Johnson, Weipz and Savage Lab Book)
CJ Shuster A&P2 Lab Addenum Beef Heart Dissection 1 Heart Dissection. (taken from Johnson, Weipz and Savage Lab Book) Introduction When you have finished examining the model, you are ready to begin your
More informationDevelopment of the Heart
Development of the Heart Thomas A. Marino, Ph.D. Temple University School of Medicine Stages of Development of the Heart 1. The horseshoe-shaped pericardial cavity. 2. The formation of the single heart
More informationINTEGRATING ECHOCARDIOGRAPHY WITH CATHETER INTERVENTIONS FOR CONGENITAL HEART DISEASE. Krishna Kumar SevenHills Hospital, Mumbai, India
INTEGRATING ECHOCARDIOGRAPHY WITH CATHETER INTERVENTIONS FOR CONGENITAL HEART DISEASE Krishna Kumar SevenHills Hospital, Mumbai, India Why talk about it? What is the big deal? Are we not stating the obvious?
More informationSri Endah Rahayuningsih,
TRANSPOSITION OF THE GREAT ARTERIES: CLINICAL ANATOMI, COMORBIDITIES AND TYPES OF TRANSPOSISITION Sri Endah Rahayuningsih, Department of Pediatrics Hospital Dr. Hasan Sadikin, Padjadjaran University School
More informationSegmental approach to normal and abnormal situs arrangement - Echocardiography -
Segmental approach to normal and abnormal situs arrangement - Echocardiography - Jan Marek Great Ormond Street Hospital & Institute of Cardiovascular Sciences, University College London No disclosures
More informationWe present the case of an asymptomatic, 75-year-old
Images in Cardiovascular Medicine Asymptomatic Rupture of the Left Ventricle Lech Paluszkiewicz, MD; Stefan Ożegowski, MD; Mohammad Amin Parsa, MD; Jan Gummert, PhD, MD We present the case of an asymptomatic,
More informationStenosis of Pulmonary Veins
Stenosis of Pulmonary Veins Report of a Patient Corrected Surgically Yasunaru Kawashima, M.D., Takeshi Ueda, M.D., Yasuaki Naito, M.D, Eiji Morikawa, M.D., and Hisao Manabe, M.D. ABSTRACT A 15-year-old
More informationHypoplastic Left Heart Syndrome: Echocardiographic Assessment
Hypoplastic Left Heart Syndrome: Echocardiographic Assessment Craig E Fleishman, MD, FACC, FASE Director, Non-invasive Cardiac Imaging The Hear Center at Arnold Palmer Hospital for Children, Orlando SCAI
More informationThe Cardiovascular System (Part I) 黃敏銓 解剖學暨細胞生物學研究所
The Cardiovascular System (Part I) 黃敏銓 解剖學暨細胞生物學研究所 1 Congenital heart defects (CHDs) 台灣兒童心臟學會 Sinus venarum Membranous septum Conus arteiosus (infundibulum) Aortic vestibule The Cardiovascular System
More informationEchocardiography in Congenital Heart Disease
Chapter 44 Echocardiography in Congenital Heart Disease John L. Cotton and G. William Henry Multiple-plane cardiac imaging by echocardiography can noninvasively define the anatomy of the heart and the
More informationThe Heart. Happy Friday! #takeoutyournotes #testnotgradedyet
The Heart Happy Friday! #takeoutyournotes #testnotgradedyet Introduction Cardiovascular system distributes blood Pump (heart) Distribution areas (capillaries) Heart has 4 compartments 2 receive blood (atria)
More informationIdentification of congenital cardiac malformations by echocardiography in midtrimester fetus*
Br Heart J 1981; 46: 358-62 Identification of congenital cardiac malformations by echocardiography in midtrimester fetus* LINDSEY D ALLAN, MICHAEL TYNAN, STUART CAMPBELL, ROBERT H ANDERSON From Guy's Hospital;
More informationOstium primum defects with cleft mitral valve
Thorax (1965), 20, 405. VIKING OLOV BJORK From the Department of Thoracic Surgery, University Hospital, Uppsala, Sweden Ostium primum defects are common; by 1955, 37 operated cases had been reported by
More informationW.S. O The University of Hong Kong
W.S. O The University of Hong Kong Objectives: Describe early angiogenesis. Describe the heart tube formation. Describe the partitioning into a 4- chambered heart. List the formation of heart valves and
More informationHeart Development and Congenital Heart Disease
Heart Development and Congenital Heart Disease Sally Dunwoodie s.dunwoodie@victorchang.edu.au Developmental and Stem Cell Biology Division Victor Chang Cardiac Research Institute for the heart of Australia...
More informationAdel Hasanin Ahmed 1 ASD
Adel Hasanin Ahmed 1 ASD Atrial septal defect (ASD) is the commonest form of congenital heart disease seen in adults. The commonest form of defect is the secundum ASD, accounting for two thirds of cases,
More information