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Features of localization coronary arterial orifices and angles of origin their proximal segments in usually formed hearts and with transposition of the great vessels  [PDF]
Malov A.E.
Морфолог?я , 2011,
Abstract: The work purpose was revealing of features of localization coronary arterial orifices, angles of origin and acourse of their proximal segments in usually formed hearts and with transposition of the great vessels. Research is executedon 31 specimens of usually formed hearts and 31 specimens with transposition of the great vessels. For the estimation ofposition the orifices in aortic sinuses and orientation of a course of proximal segments of coronary arteries the morphologicalresearches was carried out. For the purpose of carrying out of the statistical processing, the obtained data has been presentedon schematic images. As a result of research statistically authentic differences in localization distribution coronary arterialorifices on a vertical axis are established at a transposition of the great vessels, in comparison with usually formed hearts.Peculiarities of an arrangement orifices with acute angles of origin their proximal segments of coronary arteries and themintramural course are established.
Anatomically corrected malposition of great arteries
Sridhar Anuradha,Subramanyan Raghavan,Verma Sudeep,Abraham Smartin
Annals of Pediatric Cardiology , 2010,
Abstract: Anatomically corrected malposition of great arteries (ACMGA) is a rare form of congenital heart disease in which the great arteries arise above the anatomically correct ventricles but have abnormal spatial relationship. We report the case of a 26-year-old female with ACMGA and tunnel type of subaortic obstruction. The abnormal relationship and segmental arrangement necessitates systematic approach in evaluation for proper diagnosis and surgical repair. This unusual case is reported for its rarity and to highlight the need for awareness to differentiate it from other more common conditions.
One-year outcome of Senning operation in children with transposition of the great vessels
Shahmohammadi A,Mortezaian H,Alipour MR
Tehran University Medical Journal , 2011,
Abstract: "nBackground: Nowadays, the treatment of choice for anatomical correction of transposition of great arteries is arterial switch but some children are not good candidates for this operation. In these cases atrial switch or Senning procedure is an accepted method, thus outcome of this procedure needs to be better delineated."n "nMethods: This prospective study included 65 patients that underwent Senning operation in Shahid Rajaee Hospital in Tehran, Iran from 2002 to 2009 and were followed-up for one year."n "nResults: The early and late mortality rates were 16.9% and 1.5%, respectively. 51.8% of early deaths were due to simple Senning procedure, 38.9% due to a Senning with the closure of ventricular septal defect, with or without the repair of pulmonary artery stenosis, 9.3% related to palliative Senning and one late death due to simple Senning. The most common arrhythmia was accelerated junctional rhythm (18.5%). 15% of cases had Senning pathway obstruction and 1.7% had baffle leaks. Regardless of the mortalities, three patients (5.7%) had significant tricuspid regurgitation. Right ventricular systolic dysfunction was found in 13.3% of the cases, primarily in Senning with ventricular septal defect closure (37.5%). One case (1.9%) had visible cyanosis and three (5.7%) had exertional dyspnea but 94.3% of cases remained in functional class I."n "nConclusion: Since the majority of deaths following Senning procedure occur during the first month, especially on the second day post-operatively, assiduity during early post-operative period is crucial. Tricuspid regurgitation or right ventricular systolic dysfunction was not detected in most patients, suggesting optimistic prognosis for these patients.
Congenitally corrected transposition
Gonzalo A Wallis, Diane Debich-Spicer, Robert H Anderson
Orphanet Journal of Rare Diseases , 2011, DOI: 10.1186/1750-1172-6-22
Abstract: Congenitally corrected transposition of the great arteries, corrected transposition of the great arteries, L-transposition of the great arteries, ventricular inversion.The Baron Rokitansky, in his atlas of 1875, was the first to describe the entity we now know as congenitally corrected transposition (Figure 1). It is also known as "L-transposition" or ventricular inversion, although, as we will describe, these terms are less than precise.The essence of the lesion is the combination of discordant atrioventricular and ventriculo-arterial connections (Figure 2 and Figure 3). Thus, the morphologically right atrium is connected to a morphologically left ventricle across the mitral valve, with the left ventricle then connected to the pulmonary trunk (Figure 4). The morphologically left atrium is connected to the morphologically right ventricle across the tricuspid valve, with the morphologically right ventricle connected to the aorta (Figure 5). When the atrial chambers are arranged in their usual fashion, the morphologically left ventricle is usually positioned to the right, and the aorta, arising from the right ventricle, is left-sided. The malformed heart can also be found with the atrial chambers in mirror-image arrangement. In this setting, the morphologically left ventricle is left-sided, and the aorta is typically positioned to the right. Hence, such patients do not have "L-transposition", but do have congenitally corrected transposition.Congenitally corrected transposition is also described as "double discordance". As the name implies, the discordant connections at both the atrioventricular and ventriculo-arterial junctions results in normal physiology - hence the congenital correction of the transposition. Because of the double discordance, the systemic venous return is pumped to the lungs, while the pulmonary venous return is directed to the body. Symptoms are produced not by the segmental arrangement of the cardiac components, but by the presence of associated
Congenitally corrected transposition of great vessels in fetus. A study case presentation.
Carlos García Guevara,Elsa Fleitas Ruisanchez,Carlos García Morejón,Andrés Savío Benavides
Revista Cubana de Cardiología y Cirugía Cardiovascular , 2011,
Abstract: The congenitally corrected transposition refers to a malformation in which the atrial andventricular chambers present discordant connections, being also discordant the ventricularchambers with the originated from each of them vessels. It is presented a case with aforementioned characteristics, diagnosed by the second quarter of pregnancy, which at momentof birth presented a rhythm disorder. We propose to report the current case, evidencing theimportance of adequate interpretation of four chambers, left ventricle short axis and threevessels echocardiographic views in the prenatal diagnosis of congenital cardiopathies.
Anatomical reorganization of walls ventricles hearts of children in the place of arise muscles capillaries at the full form of the transposition of the great vessels  [PDF]
Malov A.E.,Vasilev V.A.
Морфолог?я , 2010,
Abstract: For the purpose of the definition of the features of anatomic reorganization of anterior ventricular heart walls inthe place of arise of papillary muscles at children with the full form of the transposition of the great vessels 31 specimenswith the given pathology from a birth till 11 months and 31 specimens of usually formed hearts of the same age group havebeen investigated. The distinguish features of abnormal hearts were: atrial and ventricular septal defects, patent ductus arteriosus.For reception of quantitative parameters of the object of the research - thickness of forward walls ventricles made themeasurement. The statistical analysis of the received data depending on age, type and quantity of communications is made.At a combination of a transposition with ventricular septal defect the thickening of right ventricular walls in the place of ariseof papillary muscles more often came to light. The transposition was accompanied by atrial septal defect, thinning of a leftventricular wall after 1 month was established. The transposition with patent ductus arteriosus and septal defects characterizedby thickening of wall of the right ventricle since 3 week. The combination of the transposition with ventricular and atrialseptal defects leads to the thickening of the wall of both ventricles.
Anestesia en la transposición de los grandes vasos ANESTHESIA IN THE TRANSPOSITION OF THE GREAT VESSELS
Lincoln de la Parte Pérez
Revista Cubana de Pediatr?-a , 2005,
Abstract: La transposición de los grandes vasos es una cardiopatía compleja que se acompa a de una elevada mortalidad. Se conoce que el 45 % de los pacientes fallece durante el primer mes de vida y alrededor del 90 % antes del a o. Las principales causas de la muerte son la hipoxia y la insuficiencia cardíaca. El desarrollo de las especialidades que trabajan en cirugía cardiovascular pediátrica ha permitido aumentar la supervivencia de estos ni os, especialmente con el uso de prostaglandinas para mantener el ductus permeable, la técnica de Raskind-Miller ( septostomía de balón) y una tendencia cada vez mayor a la corrección anatómica temprana (operación de Jatene) en lugar de los clásicos procedimientos paliativos y las técnicas de corrección fisiológica de Senning y Mustard . Se presenta una revisión bibliográfica sobre los factores a tener en cuenta en el manejo anestésico de estos pacientes. The transposition of the great vessels is a complex heart disease accompanied of a high mortality. It is known that 45 % of the patients die during the first month of life and at about 90 % do it before being one year old. The main causes of death are hypoxia and heart failure. The development of the specialties working in pediatric cardiovascular surgery has allowed to increase the survival of these children, specially with the use of prostaglandins to maintain the ductus permeable, the Raskind-Miller's technique (balloon septostomy), and an increasing trend towards an early anatomical correction (Jatene's operation) to replace the classical palliative procedures and Senning and Mustartd's techniques of physiological correction. A bibliographic review of the factors to be taken into account in the anesthetic management of these patients is presented.
Complete transposition of the aorta and pulmonary artery in a Belgian Blue crossbreed calf: A case report
Walter Grünberg, Leonie WL van Bruggen, Susanne WF Eisenberg, Erik AWS Weerts, Alan Wolfe
BMC Veterinary Research , 2011, DOI: 10.1186/1746-6148-7-22
Abstract: A 6-week old male Belgian Blue cross-breed calf was examined for respiratory distress and exercise intolerance. The patient was bright, alert and responsive without any neurologic abnormalities but was exercise intolerant, had marked cyanosis, tachycardia, tachypnea, a pansystolic heart murmur as well as a bilaterally palpable thrill over the heart. Arterial blood gas analysis revealed marked hypoxemia (PaO2 = 23 mmHg, O2sat = 41.1%), mild hypercapnia and compensated respiratory acidosis. Echocardiographic examination revealed a complete transposition of the great arteries in combination with a ventricular septal defect through which blood shunted bidirectionally. Cardiac catheterization confirmed that arterialization of blood of the systemic circulation solely occurred in the right ventricle through blood shunting from the left into the right ventricle. Results of post mortem examination are presented.Complete transposition of the great arteries is a cyanotic congenital anomaly repeatedly reported in calves that should be considered as differential diagnosis in patients presenting with hypoxemia more severe than commonly encountered with other congenital cyanotic heart conditions. We give a comprehensive summary of the clinical presentation, diagnostic work-up and post mortem examination of a Belgian Blue cross-breed calf with complete transposition of the great arteriesCongenital heart defects, among which ventricular septal defects (VSD) and atrial septal defects have been reported to be the most common, are occasionally encountered in food animal practice [1,2]. The most frequently encountered congenital heart defects causing cyanosis in cattle are the Tetralogy of Fallot and the Eisenmenger's complex [3]. A congenital malformation of the heart representing the cyanotic cardiac abnormality with the highest incidence in humans (5-7% of all congenital heart anomalies) is the complete transposition of the great arteries (TGA) [4]. This defect is characterized by an
Characterizaton of the Vessel Geometry, Flow Mechanics and Wall Shear Stress in the Great Arteries of Wildtype Prenatal Mouse  [PDF]
Choon Hwai Yap, Xiaoqin Liu, Kerem Pekkan
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0086878
Abstract: Introduction Abnormal fluid mechanical environment in the pre-natal cardiovascular system is hypothesized to play a significant role in causing structural heart malformations. It is thus important to improve our understanding of the prenatal cardiovascular fluid mechanical environment at multiple developmental time-points and vascular morphologies. We present such a study on fetal great arteries on the wildtype mouse from embryonic day 14.5 (E14.5) to near-term (E18.5). Methods Ultrasound bio-microscopy (UBM) was used to measure blood velocity of the great arteries. Subsequently, specimens were cryo-embedded and sectioned using episcopic fluorescent image capture (EFIC) to obtain high-resolution 2D serial image stacks, which were used for 3D reconstructions and quantitative measurement of great artery and aortic arch dimensions. EFIC and UBM data were input into subject-specific computational fluid dynamics (CFD) for modeling hemodynamics. Results In normal mouse fetuses between E14.5–18.5, ultrasound imaging showed gradual but statistically significant increase in blood velocity in the aorta, pulmonary trunk (with the ductus arteriosus), and descending aorta. Measurement by EFIC imaging displayed a similar increase in cross sectional area of these vessels. However, CFD modeling showed great artery average wall shear stress and wall shear rate remain relatively constant with age and with vessel size, indicating that hemodynamic shear had a relative constancy over gestational period considered here. Conclusion Our EFIC-UBM-CFD method allowed reasonably detailed characterization of fetal mouse vascular geometry and fluid mechanics. Our results suggest that a homeostatic mechanism for restoring vascular wall shear magnitudes may exist during normal embryonic development. We speculate that this mechanism regulates the growth of the great vessels.
Intrahepatic Transposition of Bile Ducts  [PDF]
Jasmin Deli?,Admedina Savkovi?,Eldar Isakovi?,Sergije Markovi?,Alma Bajtarevic,Amir Denjali?
ISRN Surgery , 2012, DOI: 10.5402/2012/283527
Abstract: Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications. 1. Introduction Biliary drainage has long been called Achilles heel liver transplantion, and biliary complications compromise the succese of liver transplantation [1]. A precise understanding of general anatomic principles and common variations is the key to safe living donor liver transplantation [2]. This procedure requires not only a precise understanding of liver anatomy but also the means of assessing them. One of the most important challenges is that of managing the biliary duct during liver lobe resection and reimplantation. Olos biliary anatomy variants are associated with an increased risk of postoperative complications, including biliary leaks and strictures, in both the donor and recipient [3, 4]. One cause of complications is unrecognized anomalous biliary anatomy (24%–57% of individuals have variant biliary patterns) [5–8]. Although anomalous anatomy is not always a contraindication for liver donation, knowledge of variant anatomy is critical to ensuring the safety of donors and aids selection of suitable candidates [9, 10]. The authors as Varotti et al., Heloury et al., Soares et al., and Cheng et
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