Cardiopulmonary Syndromes: Conditions With Concomitant Cardiac and Pulmonary Abnormalities

Size: px
Start display at page:

Download "Cardiopulmonary Syndromes: Conditions With Concomitant Cardiac and Pulmonary Abnormalities"

Transcription

1 Cardiopulmonary Syndromes: Conditions With Concomitant Cardiac and Pulmonary Abnormalities Carlos S. Restrepo M.D. Professor of Radiology The University of Texas HSC at San Antonio

2 Cardiopulmonary Syndromes Heterotaxia syndrome Primary ciliary diskinesia Ring-sling complex TAPVR PAPVR (Scimitar syndrome (Hypogenetic lung) Interrupted pulmonary artery Pulmonary sequestration Congenital lobar emphysema Tetralogy of Fallot Pentalogy of Cantrell Pulmonary agenesis / hypoplasia VACTERL association Down syndrome (Pulmonary hypoplasia and lung cysts) (NEJM Cooney 1982)

3 PAPVR / Scimitar Syndrome Four features Hypoplasia of right lung with dextroposition of the heart Hypoplastic right pulmonary artery Anomalous arterial supply to right lower lobe from aorta Anomalous pulmonary venous connection to inferior vena cava

4 Scimitar Syndrome >75% have congenital heart disease - ASD (secundum type) in 65% - VSD in 16% - PDA in 9% 28% complex congenital heart disease - TOF - Hypoplastic left heart syndrome - TAPVR Vida VL, et al. Circulation 2010;122:1159

5

6 IVC I V C PAPVR associated with diaphragmatic hernia. Contrast enhanced CT shows the anomalous vein (small arrow) and the liver herniated into the right hemithorax (large arrow).

7 b. d. Scimitar syndrome associated with pulmonary sequestration. Chest x-ray shows a round mass in the right upper quadrant (black arrows).venous phase catheter angiography shows the anomalous vein (white arrow).

8 PAPVR + Sinus Venosus ASD + PLSVC

9 PAPVR Extracardiac Associated Anomalies 25% are associated with other congenital abnormalities: - Aortic coarctation (20%) - ASD - VSD - Tetralogy of Fallot - Diaphragmatic hernia - Diaphragmatic duplication

10 IVC Inferior Vena cava PAPVR associated with diaphragmatic hernia. Contrast enhanced CT shows the anomalous vein (small arrow) and the liver herniated into the right hemithorax (large arrow).

11 Primary Ciliary Diskinesia Recessive genetic disorder characterized by sinopulmonary disease 2ary to abnormal ciliary structure and function Prevalence of congenital heart disease in PCD with heterotaxy is 200-fold higher Situs inversus totalis occur in 48% (Kartagener s syndrome) Situs solitus in 46% Situs ambiguus in 6% (Heterotaxy) - most have CV abnormalities Kennedy MP et al. Circulation 2007;115: 2814

12 Kartagener s Syndrome Primary Ciliary Dyskinesia (PCD) was previously referred to as immotile cilia syndrome until it was discovered that most of the cilia moved but are dysfunctional. PCD is also referred to as Kartagener s Syndrome if situs inversus is present. About half of patients with respiratory ciliary disease have situs inversus. PCD follows an autosomal recessive mode of inheritance.

13

14 Heterotaxia Syndrome (situs ambiguus) Right isomerism Ivemark syndrome Asplenia syndrome Both lungs have 3 lobes Eparterial bronchi CHD in 100% M >F Left isomerism Polysplenia syndrome Both lungs have 2 lobes Hyparterial bronchi CHD in 70% Azygos continuation 80% F>M

15 Bronchial Isomerism Right isomerism Left isomerism

16

17

18 Right bronchial isomerism Three lobes in the bilateral lungs

19 Congenital interruption of the PA Congenital absence of the PA Term interruption is preferred Only the mediastinal segmen of the right or left PA is absent Interrupted artery is in the opposite side of the aortic arch May be seen associated with CHD (ASD, VSD, TA and TOF) Restrepo CS et al. Anomalies and malformations of the pulmonary circulation. Multidetector-row CT of the Thorax. Springer 2016

20 Congenital interruption of the PA Right pulmonary artery more commonly affected than the left May be associated with hypogenetic lung Systemic collateral circulation from bronchial arteries Women are affected more than men Cystic changes in the ipsilateral lung demonstrated in HRCT Ryu DS, et al. J Thorac Imaging 2004;19(3):171

21 Fem 22 y/o.

22 LUNG CYSTS IN DOWN SYNDROME Multiple small cystic dilatations of the alveoli aligned along the subpleural surface or diffuse in advanced cases. Pathophysiology is not clear. Frequently associated with congenital heart disease. Might contribute to the development of pulmonary hypertension. Joshi et al. Pediatr Pathol 1986; 5:79 Gonzalez et al. Pediatr Pathol 1991; 11:623 Gyves-Ray et al. Pediatr Radiol 1994; 24:137 Tyrrel et al. Pediatr Pulmonol1999; 28:145

23 2 y/o Male Down syndrome

24 Aberrant Left Pulmonary Artery Pulmonary sling Failure of development / obliteration of left 6 th aortic arch. Development of a collateral branch of right pulmonary artery to supply the left lung. LPA passes above right mainstem bronchus and between trachea and esophagus.

25 Aberrant Left Pulmonary Artery Associated with Napkin-ring trachea (absent pars membranacea) 50% carrot-shaped trachea (long segment tracheal narrowing) Obstructive emphysema PDA (most common) ASD, persistent LSVC

26

27

28 Branch PA Stenosis Commonly associated with CHD -TOF, TGA, ASD, VSD Also associate with Noonan syndrome and Williams syndrome Maternal rubella syndrome Ehler-Danlos syndrome Cutis laxa syndrome Alagille s syndrome

29 Branch PA Stenosis (TOF)

Situs inversus. Dr praveena pulmonology- final year post graduate

Situs inversus. Dr praveena pulmonology- final year post graduate Situs inversus Dr praveena pulmonology- final year post graduate Definiton History Types Cause Clinical features Diagnosis Treatment Definition The term situs inversus is a short form of the latin phrase

More information

9/8/2009 < 1 1,2 3,4 5,6 7,8 9,10 11,12 13,14 15,16 17,18 > 18. Tetralogy of Fallot. Complex Congenital Heart Disease.

9/8/2009 < 1 1,2 3,4 5,6 7,8 9,10 11,12 13,14 15,16 17,18 > 18. Tetralogy of Fallot. Complex Congenital Heart Disease. Current Indications for Pediatric CTA S Bruce Greenberg Professor of Radiology Arkansas Children s Hospital University of Arkansas for Medical Sciences greenbergsbruce@uams.edu 45 40 35 30 25 20 15 10

More information

PULMONARY VENOLOBAR SYNDROME. Dr.C.Anandhi DNB Resident, Southern Railway Headquarters Hospital.

PULMONARY VENOLOBAR SYNDROME. Dr.C.Anandhi DNB Resident, Southern Railway Headquarters Hospital. PULMONARY VENOLOBAR SYNDROME Dr.C.Anandhi DNB Resident, Southern Railway Headquarters Hospital. Presenting complaint: 10 yrs old girl with recurrent episodes of lower respiratory tract infection from infancy.

More information

Congenital Heart Disease Systematic Interpretation of CT Suhny Abbara, MD

Congenital Heart Disease Systematic Interpretation of CT Suhny Abbara, MD Congenital Heart Disease Systematic Interpretation of CT Suhny Abbara, MD Chief, Cardiothoracic Imaging Division Professor of Radiology UT Southwestern Medical Center, Dallas, TX Suhny.Abbara@UTSouthwestern.edu

More information

NASCI 2012 Segmental Analysis

NASCI 2012 Segmental Analysis NASCI 2012 Segmental Analysis Frandics Chan, M.D., Ph.D. Stanford University Medical Center Lucile Packard Department Children s of Radiology Hospital Menagerie of Congenital Cardiac Lesions 1. Absent

More information

Lung sequestration and Scimitar syndrome

Lung sequestration and Scimitar syndrome Lung sequestration and Scimitar syndrome Imaging approaches M. Mearadji International Foundation for Pediatric Imaging Aid Rotterdam, The Netherlands Pulmonary sequestration Pulmonary sequestration (PS)

More information

Heart and Lungs. LUNG Coronal section demonstrates relationship of pulmonary parenchyma to heart and chest wall.

Heart 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 information

Cardiac Catheterization Cases Primary Cardiac Diagnoses Facility 12 month period from to PRIMARY DIAGNOSES (one per patient)

Cardiac 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 information

Heart and Soul Evaluation of the Fetal Heart

Heart and Soul Evaluation of the Fetal Heart Heart and Soul Evaluation of the Fetal Heart Ivana M. Vettraino, M.D., M.B.A. Clinical Associate Professor, Michigan State University College of Human Medicine Objectives Review the embryology of the formation

More information

Anomalous Systemic Venous Connection Systemic venous anomaly

Anomalous 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 information

CMR for Congenital Heart Disease

CMR 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 information

HOW TO IMAGE AND DESCRIBE CONGENITAL LUNG MALFORMATIONS

HOW TO IMAGE AND DESCRIBE CONGENITAL LUNG MALFORMATIONS HOW TO IMAGE AND DESCRIBE CONGENITAL LUNG MALFORMATIONS Paul Thacker, MD Assistant Professor Departments of Radiology and Pediatrics Medical University of South Carolina DISCLOSURES I have no relevant

More information

Congenital Lung Malformations: Radiologic-Pathologic Correlation

Congenital Lung Malformations: Radiologic-Pathologic Correlation Acta Radiológica Portuguesa, Vol.XVIII, nº 70, pág. 51-60, Abr.-Jun., 2006 Congenital Lung Malformations: Radiologic-Pathologic Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington

More information

Pediatric Echocardiography Examination Content Outline

Pediatric 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 information

3/14/2011 MANAGEMENT OF NEWBORNS CARDIAC INTENSIVE CARE CONFERENCE FOR HEALTH PROFESSIONALS IRVINE, CA. MARCH 7, 2011 WITH HEART DEFECTS

3/14/2011 MANAGEMENT OF NEWBORNS CARDIAC INTENSIVE CARE CONFERENCE FOR HEALTH PROFESSIONALS IRVINE, CA. MARCH 7, 2011 WITH HEART DEFECTS CONFERENCE FOR HEALTH PROFESSIONALS IRVINE, CA. MARCH 7, 2011 MANAGEMENT OF NEWBORNS WITH HEART DEFECTS A NTHONY C. CHANG, MD, MBA, MPH M E D I C AL D I RE C T OR, HEART I N S T I T U T E C H I LDRE N

More information

Common Defects With Expected Adult Survival:

Common 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 information

CONGENITAL HEART DISEASE (CHD)

CONGENITAL HEART DISEASE (CHD) CONGENITAL HEART DISEASE (CHD) DEFINITION It is the result of a structural or functional abnormality of the cardiovascular system at birth GENERAL FEATURES OF CHD Structural defects due to specific disturbance

More information

DR. DO NGUYEN TIN CHILDREN HOSPITAL 1

DR. DO NGUYEN TIN CHILDREN HOSPITAL 1 DR. DO NGUYEN TIN CHILDREN HOSPITAL 1 BACKGROUND Congenital extrahepatic porto-systemic shunt (CEPS), known as Abernethy malformation, is a rare malformation. Intestinal and/or splenic venous blood bypasses

More information

ORIGINAL RESEARCH PAPER

ORIGINAL RESEARCH PAPER ORIGINAL RESEARCH PAPER ROLE OF CT PULMONARY ANGIOGRAPHY IN CONGENITAL HEART DISEASES IN PAEDIATRIC POPULATION Radiology KEY WORDS: Congenital heart disease, CT pulmonary angiography, pediatric heart disease,

More information

Preoperative Echocardiographic Assessment of Uni-ventricular Repair

Preoperative Echocardiographic Assessment of Uni-ventricular Repair Preoperative Echocardiographic Assessment of Uni-ventricular Repair Salem Deraz, MD Pediatric Cardiologist, Aswan Heart Centre Magdi Yacoub Heart Foundation Uni-ventricular repair A single or series of

More information

Situs at the mirror: from situs inversus to situs ambiguus

Situs at the mirror: from situs inversus to situs ambiguus Situs at the mirror: from situs inversus to situs ambiguus Poster No.: C-0605 Congress: ECR 2013 Type: Educational Exhibit Authors: C. Maciel, J. Maciel, A. Silva, A. F. L. Carneiro ; Porto/PT, 1 2 1 1

More information

in PAEDIATRIC CARDIOLOGY

in PAEDIATRIC CARDIOLOGY IMAGES in PAEDIATRIC CARDIOLOGY Morrison ML, 1 Sands AJ, 1 Paterson A. 2 Primitive hepatic venous plexus in a child with scimitar syndrome and pulmonary 1 Department of Paediatric Cardiology, Royal Belfast

More information

ISUOG Basic Training. Assessing the Neck & Chest Gihad Chalouhi, Lebanon

ISUOG Basic Training. Assessing the Neck & Chest Gihad Chalouhi, Lebanon ISUOG Basic Training Assessing the Neck & Chest Gihad Chalouhi, Lebanon Learning objectives 9 & 10 At the end of the lecture you will be able to: recognise the differences between the normal & most common

More information

Segmental approach to normal and abnormal situs arrangement - Echocardiography -

Segmental 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 information

ISUOG 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. 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 information

Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray

Chapter 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 information

Appendix A.1: Tier 1 Surgical Procedure Terms and Definitions

Appendix 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 information

Thoracic vascular anatomical variants

Thoracic vascular anatomical variants Thoracic vascular anatomical variants Poster No.: C-0944 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest - Vascular Authors: R. dos Santos, Â. Marques, H. M. R. Marques, N. Costa, O. Fernandes,

More information

What do we know about Heterotaxy Syndrome? - An illustrated guide.

What do we know about Heterotaxy Syndrome? - An illustrated guide. What do we know about Heterotaxy Syndrome? - An illustrated guide. Poster No.: C-2369 Congress: ECR 2015 Type: Educational Exhibit Authors: M. C. Ageitos Casais, A. X. Martínez de Alegría Alonso, 1 1 2

More information

A Classic Case Of Polysplenia Syndrome With A Pancreatic Mass And SOLs In Liver

A Classic Case Of Polysplenia Syndrome With A Pancreatic Mass And SOLs In Liver ISPUB.COM The Internet Journal of Radiology Volume 13 Number 2 A Classic Case Of Polysplenia Syndrome With A Pancreatic Mass And SOLs In Liver V Gupta, N Agarwal Citation V Gupta, N Agarwal. A Classic

More information

An Approach to Cardiac Malposition and the Heterotaxy Syndrome Using 99mTc Sulfur Colloid Imaging

An Approach to Cardiac Malposition and the Heterotaxy Syndrome Using 99mTc Sulfur Colloid Imaging An Approach to Cardiac Malposition and the Heterotaxy Syndrome Using 99mTc Sulfur Colloid Imaging P. M. FITZER A diagnostic approach to cardiac malposition and the heterotaxy syndrome is outlined. The

More information

Imaging of the Lung in Children

Imaging of the Lung in Children Imaging of the Lung in Children Imaging methods X-Ray of the Lung (Anteroposterior, ) CT, HRCT MRI USG Congenital developmental defects of the lungs Agenesis, aplasia, hypoplasia Tension pulmonary anomalies

More information

Two Cases of Incidentally Picked Up Adult Unilateral Pulmonary Artery Atresia with Variable Imaging Features

Two Cases of Incidentally Picked Up Adult Unilateral Pulmonary Artery Atresia with Variable Imaging Features IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 12 Ver. III (Dec. 2017), PP 45-49 www.iosrjournals.org Two Cases of Incidentally Picked Up

More information

Pulmonary vascular anatomy & anatomical variants

Pulmonary vascular anatomy & anatomical variants Review Article Pulmonary vascular anatomy & anatomical variants Asha Kandathil, Murthy Chamarthy Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA Contributions:

More information

Lecturer: Ms DS Pillay ROOM 2P24 25 February 2013

Lecturer: Ms DS Pillay ROOM 2P24 25 February 2013 Lecturer: Ms DS Pillay ROOM 2P24 25 February 2013 Thoracic Wall Consists of thoracic cage Muscle Fascia Thoracic Cavity 3 Compartments of the Thorax (Great Vessels) (Heart) Superior thoracic aperture

More information

Case Report Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration

Case Report Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration Canadian Respiratory Journal Volume 2016, Article ID 1460480, 4 pages http://dx.doi.org/10.1155/2016/1460480 Case Report Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration Nao

More information

J Somerville and V Grech. The chest x-ray in congenital heart disease 2. Images Paediatr Cardiol Jan-Mar; 12(1): 1 8.

J Somerville and V Grech. The chest x-ray in congenital heart disease 2. Images Paediatr Cardiol Jan-Mar; 12(1): 1 8. IMAGES in PAEDIATRIC CARDIOLOGY Images Paediatr Cardiol. 2010 PMCID: PMC3228330 The chest x-ray in congenital heart disease 2 J Somerville and V Grech Paediatric Department, Mater Dei Hospital, Malta Corresponding

More information

Congenital Heart Disease. Disharmonious Patterns of Heterotaxy and Isomerism How Often Are the Classic Patterns Breached?

Congenital Heart Disease. Disharmonious Patterns of Heterotaxy and Isomerism How Often Are the Classic Patterns Breached? Congenital Heart Disease Disharmonious Patterns of Heterotaxy and Isomerism How Often Are the Classic Patterns Breached? Deane Yim, MBchB; Hazumu Nagata, MD; Christopher Z. Lam, MD; Lars Grosse-Wortmann,

More information

Right Sided Aortic Arch and its rare Associations- A Case Series

Right Sided Aortic Arch and its rare Associations- A Case Series DOI: 10.7860/IJARS/2018/35392:2410 Radiology Section Case Series Right Sided Aortic Arch and its rare Associations- A Case Series Nidhi Aggarwal, Narender kumar kardam, Kushal Babu Gehlot ABSTRACT Right

More information

Two Cases Report of Scimitar Syndrome: The Classical one with Subaortic Membrane and the Scimitar Variant

Two Cases Report of Scimitar Syndrome: The Classical one with Subaortic Membrane and the Scimitar Variant Bahrain Medical Bulletin, Vol.22, No.1, March 2000 Two Cases Report of Scimitar Syndrome: The Classical one with Subaortic Membrane and the Scimitar Variant F Hakim, MD* A Madani, MD* A Abu Haweleh, MD,MRCP*

More information

September 28-30, 2018

September 28-30, 2018 September 28-30, 2018 Course Director Optimizing Detection of Congenital Heart Disease: Important Anatomic Cardiac Regions The Top 5 Critical Anatomic Regions in Fetal Cardiac Imaging Alfred Abuhamad,

More information

Venous Anomalies of the Thorax

Venous Anomalies of the Thorax Venous Anomalies of the Thorax Poster No.: C-0266 Congress: ECR 2012 Type: Educational Exhibit Authors: L. M. GARCIA POSADA, A. Zuluaga, J. Mejía, N. Aldana ; 1 1 2 2 3 3 3 Envigado/CO, Medellin, Antioquia/CO,

More information

Chest radiographic findings in children with asplenia syndrome

Chest radiographic findings in children with asplenia syndrome Asian Biomedicine Vol. 4 No. 4 August 2010; 585-594 Original article Chest radiographic findings in children with asplenia syndrome Panruethai Trinavarat a, Kullana Tantiprawan a, Apichai Khongphatthanayothin

More information

Supplemental Information

Supplemental Information ARTICLE Supplemental Information SUPPLEMENTAL TABLE 6 Mosaic and Partial Trisomies Thirty-eight VLBW infants were identified with T13, of whom 2 had mosaic T13. T18 was reported for 128 infants, of whom

More information

Adult Congenital Heart Disease: What All Echocardiographers Should Know Sharon L. Roble, MD, FACC Echo Hawaii 2016

Adult 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 information

The Fetal Cardiology Program

The Fetal Cardiology Program The Fetal Cardiology Program at Texas Children s Fetal Center About the program Since the 1980s, Texas Children s Fetal Cardiology Program has provided comprehensive fetal cardiac care to expecting families

More information

Children with Single Ventricle Physiology: The Possibilities

Children with Single Ventricle Physiology: The Possibilities Children with Single Ventricle Physiology: The Possibilities William I. Douglas, M.D. Pediatric Cardiovascular Surgery Children s Memorial Hermann Hospital The University of Texas Health Science Center

More information

VASCULAR RINGS A CASE - BASED REVIEW

VASCULAR RINGS A CASE - BASED REVIEW VASCULAR RINGS A CASE - BASED REVIEW Beverley Newman, BSc. MB.Bch. FACR Professor of Radiology Stanford University and Lucile Packard Children s Hospital Q1,2,3 Frontal chest radiographs on three different

More information

The Chest X-ray for Cardiologists

The Chest X-ray for Cardiologists Mayo Clinic & British Cardiovascular Society at the Royal College of Physicians, London : 21-23-October 2013 Cases-Controversies-Updates 2013 The Chest X-ray for Cardiologists Michael Rubens Royal Brompton

More information

Right isomerism with complex cardiac anomalies presenting with dysphagia - A case report

Right isomerism with complex cardiac anomalies presenting with dysphagia - A case report Right isomerism with complex cardiac anomalies presenting with dysphagia - A case report Himanshu Agarwal 1, Shireesh Kumar Mittal 1*, Chaitanya D Kulkarni 1, Ashok Kumar Verma 1, Saurabh Kumar Srivastava

More information

All You Need to Know About Situs and Looping Disorders: Embryology, Anatomy, and Echocardiography

All You Need to Know About Situs and Looping Disorders: Embryology, Anatomy, and Echocardiography All You Need to Know About Situs and Looping Disorders: Embryology, Anatomy, and Echocardiography Helena Gardiner Co-Director of Fetal Cardiology, The Fetal Center, University of Texas at Houston Situs

More information

When is Risky to Apply Oxygen for Congenital Heart Disease 부천세종병원 소아청소년과최은영

When is Risky to Apply Oxygen for Congenital Heart Disease 부천세종병원 소아청소년과최은영 When is Risky to Apply Oxygen for Congenital Heart Disease 부천세종병원 소아청소년과최은영 The Korean Society of Cardiology COI Disclosure Eun-Young Choi The author have no financial conflicts of interest to disclose

More information

Incidence and treatment of chylothorax after cardiac surgery in children: analysis of a large multi-institutional database. Carlos M.

Incidence and treatment of chylothorax after cardiac surgery in children: analysis of a large multi-institutional database. Carlos M. Incidence and treatment of chylothorax after cardiac surgery in children: analysis of a large multi-institutional database Carlos M. Mery, MD, MPH Assistant Professor, and Pediatrics Congenital Heart Texas

More information

Outline. Congenital Heart Disease. Special Considerations for Special Populations: Congenital Heart Disease

Outline. Congenital Heart Disease. Special Considerations for Special Populations: Congenital Heart Disease Special Considerations for Special Populations: Congenital Heart Disease Valerie Bosco, FNP, EdD Alison Knauth Meadows, MD, PhD University of California San Francisco Adult Congenital Heart Program Outline

More information

Index. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A ACHD. See Adult congenital heart disease (ACHD) Adult congenital heart disease (ACHD), 503 512 across life span prevalence of, 504 506

More information

DGPK guideline: PAPVC

DGPK guideline: PAPVC DGPK guideline: PAPVC Partial anomalous pulmonary venous connection (PAPVC) Harald Bertram, Hannover Oliver Dewald, Bonn Angelika Lindinger, Kaiserslautern & Trier DGPK guideline committee No disclosures

More information

Large veins of the thorax Brachiocephalic veins

Large veins of the thorax Brachiocephalic veins Large veins of the thorax Brachiocephalic veins Right brachiocephalic vein: formed at the root of the neck by the union of the right subclavian & the right internal jugular veins. Left brachiocephalic

More information

Data Collected: June 17, Reported: June 30, Survey Dates 05/24/ /07/2010

Data 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 information

Congenital Heart Defects

Congenital 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 information

Aortic Arch Abnormalities

Aortic Arch Abnormalities Aortic Arch Abnormalities IPOK Norman H Silverman MD, D Sc (Med.). FACC, FAHA. Stanford University & Lucile Packard Children s Hospital E mail: norm.silverman@stanford.edu. NHS. www.md1world.com Abnormalities

More information

Individual Pulmonary Vein Atresia in Adults: Report of Two Cases

Individual Pulmonary Vein Atresia in Adults: Report of Two Cases Case Report DOI: 10.3348/kjr.2011.12.3.395 pissn 1229-6929 eissn 2005-8330 Korean J Radiol 2011;12(3):395-399 Individual Pulmonary Vein Atresia in Adults: Report of Two Cases Hyoung Nam Lee, MD, Young

More information

Signs in Chest Radiology

Signs in Chest Radiology Signs in Chest Radiology Jonathan H. Chung, MD Disclosures No pertinent disclosures Jonathan H. Chung, MD Assistant Professor Institute t of fadvanced d Biomedical Imaging National Jewish Health Denver,

More information

CASE OF HETEROTAXY SYNDROME WITH POLYSPLENIA AND INTESTINAL MALROTATION

CASE OF HETEROTAXY SYNDROME WITH POLYSPLENIA AND INTESTINAL MALROTATION CASE OF HETEROTAXY SYNDROME WITH POLYSPLENIA AND INTESTINAL MALROTATION *Sagar H S, Basanta Manjari Swain, Jayashree Mohanty and Sasmita Parida Department of Radio diagnosis, S.C.B. Medical College, Cuttack

More information

Paediatric Cardiology. Acyanotic CHD. Prof F F Takawira

Paediatric Cardiology. Acyanotic CHD. Prof F F Takawira Paediatric Cardiology Acyanotic CHD Prof F F Takawira Aetiology Chromosomal Down syndrome, T13, T18 Genetic syndromes (gene defects) Velo-Cardio-facial (22 del) Genetic syndromes (undefined aetiology)

More information

Surgical Procedures. Direct suture of small ASDs Patch repair Transcatheter closure with a prosthetic device called occluder

Surgical Procedures. Direct suture of small ASDs Patch repair Transcatheter closure with a prosthetic device called occluder PEDIATRIC Review Surgical Procedures Atrial Septal Defect repair: Direct suture of small ASDs Patch repair Transcatheter closure with a prosthetic device called occluder Balloon atrial septostomy (Rashkind)

More information

Bronchiectasis: An Imaging Approach

Bronchiectasis: An Imaging Approach Bronchiectasis: An Imaging Approach Travis S Henry, MD Associate Professor of Clinical Radiology Cardiac and Pulmonary Imaging Section University of California, San Francisco Large Middle Small 1 Bronchiectasis

More information

Segmental 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 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 information

Chest and cardiovascular

Chest and cardiovascular Module 1 Chest and cardiovascular A. Doss and M. J. Bull 1. Regarding the imaging modalities of the chest: High resolution computed tomography (HRCT) uses a slice thickness of 4 6 mm to identify mass lesions

More information

Journal of Radiology Case Reports

Journal of Radiology Case Reports Situs Ambiguous, Levocardia, Right Sided Stomach, Obstructing Duodenal Web, and Intestinal Tomas Mujo 1*, Tess Finnegan 2, Jonathan Joshi 1, Kathirene A. Wilcoxen 3, James C. Reed 1 1. Department of Radiology,

More information

Dextrocardia in patients with Poland syndrome: Phenotypic characterization provides insight into the pathogenesis

Dextrocardia in patients with Poland syndrome: Phenotypic characterization provides insight into the pathogenesis Dextrocardia in patients with Poland syndrome: Phenotypic characterization provides insight into the pathogenesis Anwar Baban Dipartimento Medico Chirurgico di Cardiologia Pediatrica. Ospedale Pediatrico

More information

MEDICAL SCIENCES Vol.I -Adult Congenital Heart Disease: A Challenging Population - Khalid Aly Sorour

MEDICAL SCIENCES Vol.I -Adult Congenital Heart Disease: A Challenging Population - Khalid Aly Sorour ADULT CONGENITAL HEART DISEASE: A CHALLENGING POPULATION Khalid Aly Sorour Cairo University, Kasr elaini Hospital, Egypt Keywords: Congenital heart disease, adult survival, specialized care centers. Contents

More information

Anatomy & Physiology

Anatomy & 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 information

Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience Ximing Wang, M.D., Zhaoping Cheng, M.D., Dawei Wu, M.D., Lebin

More information

Glenn Shunts Revisited

Glenn Shunts Revisited Glenn Shunts Revisited What is a Super Glenn Patricia O Brien, MSN, CPNP-AC Nurse Practitioner, Pediatric Cardiology No Disclosures Single Ventricle Anatomy Glenn Shunt Cavopulmonary Anastomosis Anastomosis

More information

Congenital tracheal stenosis (CTS) in neonates and infants is an underdiagnosed,

Congenital tracheal stenosis (CTS) in neonates and infants is an underdiagnosed, Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants Tsvetomir Loukanov, MD, a Christian Sebening, MD, a Wolfgang Springer, MD, b Herbert Ulmer, MD, PhD, b and Siegfried

More information

5.8 Congenital Heart Disease

5.8 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 information

Absent Pulmonary Valve Syndrome

Absent 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 information

Respiratory Symptoms due to Vascular Ring in Children

Respiratory Symptoms due to Vascular Ring in Children HK J Paediatr (new series) 2016;21:14-21 Respiratory Symptoms due to Vascular Ring in Children GM ZHENG, XH WU, LF TANG Abstract Aim: To highlight the clinical features, signs and diagnosis of vascular

More information

Lab #3. Mohammad Hisham Al-Mohtaseb. Jumana Jihad. Ammar Ramadan. 0 P a g e

Lab #3. Mohammad Hisham Al-Mohtaseb. Jumana Jihad. Ammar Ramadan. 0 P a g e Lab #3 Mohammad Hisham Al-Mohtaseb Jumana Jihad Ammar Ramadan 0 P a g e Last anatomy lab: Lungs and structure on the mediastinal surfs: 1-the right lung: How do we know it s the right lung??? -the 3 lobes

More information

Summary. HVRA s Cardio Vascular Genetic Detailed L2 Obstetrical Ultrasound. CPT 76811, 76825, _ 90% CHD detection. _ 90% DS detection.

Summary. HVRA s Cardio Vascular Genetic Detailed L2 Obstetrical Ultrasound. CPT 76811, 76825, _ 90% CHD detection. _ 90% DS detection. What is the role of fetal echocardiography (2D 76825, cardiovascular color flow mapping 93325) as performed in conjunction with detailed fetal anatomy scan (CPT 76811) now that AIUM requires limited outflow

More information

This is the left, right?

This is the left, right? This is the left, right? Poster No.: C-1214 Congress: ECR 2013 Type: Educational Exhibit Authors: L.-L. Huang, L. Mitchell, S. Andronikou, F. Suleman, Z. I. Lockhat; Pretoria/ZA Keywords: Congenital, Diagnostic

More information

Congenital Heart Disease: a Pictorial Illustration of Putting Segmental Approach into Practice

Congenital Heart Disease: a Pictorial Illustration of Putting Segmental Approach into Practice pissn 2384-1095 eissn 2384-1109 imri 2015;19:205-211 http://dx.doi.org/10.13104/imri.2015.19.4.205 Congenital Heart Disease: a Pictorial Illustration of Putting Segmental Approach into Practice Tse Hang

More information

بسم هللا الرحمن الرحيم. The cardio vascular system By Dr.Rawa Younis Mahmood

بسم هللا الرحمن الرحيم. The cardio vascular system By Dr.Rawa Younis Mahmood بسم هللا الرحمن الرحيم The cardio vascular system By Dr.Rawa Younis Mahmood Introduction Evaluation of the cardio vascular system depend on history and physical examination by : Asking about cyanosis,blueness

More information

Congenital Absence of the Right Pulmonary Artery: Four Cases Report

Congenital Absence of the Right Pulmonary Artery: Four Cases Report Chin J Radiol 2004; 29: 35-40 35 Congenital Absence of the Right Pulmonary Artery: Four Cases Report CHUN-HO YUN CHIN-YIN SHEU SHIN-LIN SHIH Department of Radiology, Mackay Memorial Hospital is an uncommon

More information

63-year old female with dyspnea

63-year old female with dyspnea Indiana University Pulmonary and Critical Care Fellowship Fellows Case Archive Case #1 63-year old female with dyspnea Gabriel Bosslet, MD; Chadi Hage MD A 63-year-old female presented to pulmonary clinic

More information

X-Rays. Prepared by Prof.Dr. Magda Hassab Allah Assist.lecturer Marwa Al Hady

X-Rays. Prepared by Prof.Dr. Magda Hassab Allah Assist.lecturer Marwa Al Hady X-Rays Prepared by Prof.Dr. Magda Hassab Allah Assist.lecturer Marwa Al Hady CHEST X-RAYS Normal Chest X-ray Comments on chest X ray includes examination of 1- Bony cage (ribs,clavicles &vertebral column

More information

CT Chest. Verification of an opacity seen on the straight chest X ray

CT Chest. Verification of an opacity seen on the straight chest X ray CT Chest Indications: To assess equivocal plain x-ray findings Staging of lung neoplasm Merastatic workup of extra thoraces malignancies Diagnosis of diffuse lung diseases with HRCT Assessment of bronchietasis

More information

Partial Anomalous Pulmonary Venous Connection in Adults: Evaluation with MDCT

Partial Anomalous Pulmonary Venous Connection in Adults: Evaluation with MDCT Partial Anomalous Pulmonary Venous Connection in Adults: Evaluation with MDCT e-poster: 349 Congress: 2WCTI 2009 Type: Educational poster Topic: Pulmonary circulation Authors: MeSH: Bhatti W, Maldjian

More information

Slide 1. Slide 2. Slide 3 CONGENITAL HEART DISEASE. Papworth Hospital NHS Trust INTRODUCTION. Jakub Kadlec/Catherine Sudarshan INTRODUCTION

Slide 1. Slide 2. Slide 3 CONGENITAL HEART DISEASE. Papworth Hospital NHS Trust INTRODUCTION. Jakub Kadlec/Catherine Sudarshan INTRODUCTION Slide 1 CONGENITAL HEART DISEASE Jakub Kadlec/Catherine Sudarshan NHS Trust Slide 2 INTRODUCTION Most common congenital illness in the newborn Affects about 4 9 / 1000 full-term live births in the UK 1.5

More information

Role of multi slice computed tomography in the evaluation of congenital anomalies of tracheobronchial tree and lungs

Role of multi slice computed tomography in the evaluation of congenital anomalies of tracheobronchial tree and lungs The Egyptian Journal of Radiology and Nuclear Medicine (2011) 42, 315 325 Egyptian Society of Radiology and Nuclear Medicine The Egyptian Journal of Radiology and Nuclear Medicine www.elsevier.com/locate/ejrnm

More information

Disclosures. Outline. Learning Objectives. Introduction. Introduction. Sonographic Screening Examination of the Fetal Heart

Disclosures. Outline. Learning Objectives. Introduction. Introduction. Sonographic Screening Examination of the Fetal Heart Sonographic Screening Examination of the Fetal Heart Lami Yeo, MD Director of Fetal Cardiology Perinatology Research Branch of NICHD / NIH / DHHS Bethesda, MD and Detroit, Michigan, USA Professor, Division

More information

Original Article. Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU. Key words. Background

Original Article. Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU. Key words. Background HK J Paediatr (new series) 2018;23:233-238 Original Article Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU Abstract Key words Background: This study aimed to report the diagnosis,

More information

September 26, 2012 Philip Stockwell, MD Lifespan CVI Assistant Professor of Medicine (Clinical)

September 26, 2012 Philip Stockwell, MD Lifespan CVI Assistant Professor of Medicine (Clinical) September 26, 2012 Philip Stockwell, MD Lifespan CVI Assistant Professor of Medicine (Clinical) Advances in cardiac surgery have created a new population of adult patients with repaired congenital heart

More information

5/22/2013. Alan Zuckerman 1, Swapna Abhyankar 1, Tiffany Colarusso 2, Richard Olney 2, Kristin Burns 3, Marci Sontag 4

5/22/2013. Alan Zuckerman 1, Swapna Abhyankar 1, Tiffany Colarusso 2, Richard Olney 2, Kristin Burns 3, Marci Sontag 4 Alan Zuckerman 1, Swapna Abhyankar 1, Tiffany Colarusso 2, Richard Olney 2, Kristin Burns 3, Marci Sontag 4 1 National Library of Medicine, NIH, Bethesda, MD, USA, 2 Centers for Disease Control and Prevention,

More information

Devendra V. Kulkarni, Rahul G. Hegde, Ankit Balani, and Anagha R. Joshi. 2. Case Report. 1. Introduction

Devendra V. Kulkarni, Rahul G. Hegde, Ankit Balani, and Anagha R. Joshi. 2. Case Report. 1. Introduction Case Reports in Radiology, Article ID 614647, 4 pages http://dx.doi.org/10.1155/2014/614647 Case Report A Rare Case of Pulmonary Atresia with Ventricular Septal Defect with a Right Sided Aortic Arch and

More information

OBJECTIVES. To emphasize the important components of a detailed obstetrical scan versus a routine 2 nd or 3 rd trimester scan

OBJECTIVES. To emphasize the important components of a detailed obstetrical scan versus a routine 2 nd or 3 rd trimester scan OBJECTIVES To discuss the different types of OB ultrasound examinations with emphasis on what is done here at CHOP at the time of the initial evaluation To emphasize the important components of a detailed

More information

Systematic approach to Fetal Echocardiography. Objectives. Introduction 11/2/2015

Systematic 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 information

Approach to Dextrocardia in Adults: Review

Approach to Dextrocardia in Adults: Review AJR Integrative Imaging LIFELONG LEARNING FOR RADIOLOGY Approach to Dextrocardia in Adults: Review Pierre D. Maldjian 1 and Muhamed Saric 2 OBJECTIVE The educational objectives of this article are to describe

More information

Foetal Cardiology: How to predict perinatal problems. Prof. I.Witters Prof.M.Gewillig UZ Leuven

Foetal Cardiology: How to predict perinatal problems. Prof. I.Witters Prof.M.Gewillig UZ Leuven Foetal Cardiology: How to predict perinatal problems Prof. I.Witters Prof.M.Gewillig UZ Leuven Cardiopathies Incidence : 8-12 / 1000 births ( 1% ) Most frequent - Ventricle Septum Defect 20% - Atrium Septum

More information

The Upper Airway. Trachea. The Human Airway. Nasopharynx Oropharynx Larynx

The Upper Airway. Trachea. The Human Airway. Nasopharynx Oropharynx Larynx The Human Airway (with thanks to David N. Hager, MD, PhD Johns Hopkins University) The Upper Airway Nasopharynx Oropharynx Larynx voice airflow Gray, Anatomy of the Human Body Trachea Length: 9-15 cm Internal

More information