Pulmonary and systemic arteriovenous fistulas in patients with left isomerism

1998 ◽  
Vol 8 (3) ◽  
pp. 290-294 ◽  
Author(s):  
Hiroaki Kawata ◽  
Hidefumi Kishimoto ◽  
Seiichiro Ikawa ◽  
Takayoshi Ueno ◽  
Tohru Nakajima ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Congenital Heart ◽  
Surgical Intervention ◽  
Venous Blood ◽  
Vasoactive Agent ◽  
Arteriovenous Fistulas ◽  
Left Isomerism ◽  
Hepatic Venous Blood ◽  
Right Isomerism ◽  
Pulmonary Arteriovenous Fistulas

AbstractAbstract Hepatic venous blood has been thought to play some role as a vasoactive agent in the development of pulmonary arteriovenous fistulas in patients with congenital heart disease. During the last 15 years, we have observed pulmonary arteriovenous fistulas in 3, and systemic arteriovenous fistulas in 2, patients from our 16 cases of left isomerism. During the same period, neither pulmonary nor systemic arteriovenous fistulas were detected among 50 patients with right isomerism. Pulmonary arteriovenous fistulas had developed in the absence of surgery in 1 of the patients. Both pulmonary and systemic fistulas were detected in an another patient, in whom the hepatic venous blood bypassed the pulmonary circulation. The level of somatostatin, which is known to reduce splanchnic blood flow, was high in the systemic venous blood of this patient. Although the mechanism of development of the fistulas has yet to be clarified, we should be aware that not only pulmonary, but also systemic arteriovenous fistulas can be found in patients with left isomerism, even prior to any surgical intervention.

Hepatic Venous Blood and the Development of Pulmonary Arteriovenous Malformations in Congenital Heart Disease

Circulation ◽  
1995 ◽  
Vol 92 (5) ◽  
pp. 1217-1222 ◽  
Author(s):  
Deepak Srivastava ◽  
Tamar Preminger ◽  
James E. Lock ◽  
Valerie Mandell ◽  
John F. Keane ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Arteriovenous Malformations ◽  
Congenital Heart ◽  
Venous Blood ◽  
Pulmonary Arteriovenous Malformations ◽  
Hepatic Venous Blood

Normal and abnormal pulmonary arteriovenous shunting: occurrence and mechanisms

2013 ◽  
Vol 23 (5) ◽  
pp. 629-641 ◽  
Author(s):  
Julien I.E. Hoffman
Keyword(s):  
Liver Disease ◽  
Venous Blood ◽  
Hepatopulmonary Syndrome ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
First Passage ◽  
Arteriovenous Shunting ◽  
Arteriovenous Fistulas ◽  
Cavopulmonary Anastomosis ◽  
Hepatic Venous Blood ◽  
Pulmonary Arteriovenous Fistulas

AbstractSevere cyanosis due to pulmonary arteriovenous fistulas occurs often after a bidirectional superior cavopulmonary anastomosis (Glenn operation) and also in some congenital anomalies in which hepatic venous blood bypasses the lungs in the first passage. Relocation of hepatic flow into the lungs usually causes these fistulas to disappear. Similar pulmonary arteriovenous fistulas are observed in hereditary haemorrhagic telangiectasia, and in liver disease (hepatopulmonary syndrome). There is no convincing identification yet of a responsible hepatic factor that produces these lesions. Candidates for such a factor are reviewed, and the possibility of angiotensin or bradykinin contributing to the fistulas is discussed.

scholarly journals Managing Congenital Lobar Overinflation Associated with Congenital Heart Disease

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 113
Author(s):  
Ranjit I. Kylat
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Surgical Intervention ◽  
Combined Approach ◽  
Resonance Imaging ◽  
Cardiac Defect ◽  
Surgical Decision ◽  
Magnetic Resonance Imaging Mri ◽  
The Ideal

The incidence of congenital lobar overinflation (CLO) is reported at 1 in 20,000–30,000 live births and represents 10% of all congenital lung malformations. The occurrence of concomitant congenital heart disease (CHD) and CLO ranges from 12% to 20%. There are diverging views in the management as to whether early lobectomy or repair of the cardiac defect, with the assumption that respiratory symptomatology would gradually resolve, or a combined lung and cardiac repair would be the ideal first step in the management. In concomitant CLO and CHD, the surgical decision has to be individualized. Prior to surgical intervention a thorough evaluation may be needed with contrast computed tomography (CT) or magnetic resonance imaging (MRI), bronchoscopy, and if needed cardiac catheterization. CLO improves with management of many left to right shunts and in those with anomalous vessels, but early lobectomy or combined approach may be considered in those symptomatic patients with more complex CHD.

Transcatheter Treatment of Aortopulmonary Window with a Symmetrical Membranous Ventricular Septal Occluder

Cardiology ◽  
2017 ◽  
Vol 138 (2) ◽  
pp. 76-79 ◽  
Author(s):  
Hai-Xia Xu ◽  
Dong-Dong Zheng ◽  
Min Pan ◽  
Xiao-Fei Li
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Surgical Intervention ◽  
Transcatheter Closure ◽  
Aortopulmonary Window ◽  
Transcatheter Device

Aortopulmonary window (APW), the presence of a communication between aorta and pulmonary artery, is a rare congenital heart disease, and surgical intervention is the standard for closure. Recently, several cases have been treated with transcatheter device occluders. Here, we report an APW patient treated successfully using a transcatheter closure with a symmetrical membranous ventricular septal occluder. We are the first to report on a case treated with this type of occluder for APW.

Dissecting aneurysm of the pulmonary arteries—an unusual complication of congenital heart disease

1994 ◽  
Vol 4 (2) ◽  
pp. 131-135
Author(s):  
Thomas M. Farrell ◽  
Carol M. Cottrill ◽  
William N. O'Connor ◽  
Dede Boucher ◽  
Jacqueline A. Noonan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Pulmonary Arteries ◽  
Dissecting Aneurysm ◽  
Unusual Complication ◽  
Arterial Aneurysm ◽  
Pulmonary Arterial

SummaryDissection of a pulmonary arterial aneurysm due to underlying pulmonary hypertension from congenital heart disease is uniformly fatal, but fortunately rare. Two such cases are presented, along with review of 24 other known cases published in the literature. Clinical presentation, guidelines tomanagement, and possible surgical intervention in the acutely dissecting patient are discussed.

Does milk fortification increase the risk of necrotising enterocolitis in preterm infants with congenital heart disease?

2012 ◽  
Vol 23 (3) ◽  
pp. 450-453 ◽  
Author(s):  
Atul Malhotra ◽  
Alex Veldman ◽  
Samuel Menahem
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Premature Infants ◽  
Congenital Heart ◽  
Surgical Intervention ◽  
Necrotising Enterocolitis ◽  
Lethal Outcome ◽  
Adequate Oxygenation ◽  
Infant’S Growth

AbstractPrematurity and low birth weight adds to the risk of serious congenital heart disease in infants. It may also delay surgical intervention, especially when cardiopulmonary bypass is required, or where an aortopulmonary shunt is necessary to maintain adequate oxygenation. In this setting, neonatologists are faced with the challenge of accelerating the infant's growth to allow for early surgery. We describe the cases of two infants in whom an attempt to fortify the feeds was associated with necrotising enterocolitis, with a lethal outcome in one. The outcome suggests caution in fortifying feeds in premature infants with serious congenital heart disease.

77Infective endocarditis in patients with congenital heart disease: Results of a nationwide study including 1494 endocarditis cases

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G P Diller ◽  
E Freisinger ◽  
L Bronstein ◽  
J Koeppe ◽  
J Gerss ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Relative Risk ◽  
Infective Endocarditis ◽  
Adverse Events ◽  
Congenital Heart ◽  
Surgical Intervention ◽  
High Morbidity ◽  
Heart Defect ◽  
Major Adverse Events

Abstract Background Infective endocarditis (IE) represents a major complication in patients with congenital heart disease (CHD) and is associated with high morbidity and mortality. The aim of this study was to analyse the frequency and outcome of IE in contemporary CHD patients based on all IE hospital admissions in Germany between 2011 and 2016. Methods Based on the German diagnosis related groups data of patients treated between 2011 and 2016, we identified all CHD patients with a diagnosis of IE. The data contains information on patient demographics, primary and secondary diagnoses, interventional or surgical procedures, duration of stay and outcome including mortality. The primary endpoint of the study was endocarditis-associated mortality as well as major adverse events (defined as death or myocardial infarction, stroke, pulmonary embolism, sepsis, resuscitation or intubation). Results Overall, 181,924 CHD patients were included in the analysis (55% male; 73% children, mean age 2.3 years; 27% adults, mean age 58.4 years; underlying heart defect of simple complexity 55%, moderate complexity 23% and complex heart defect 22%, respectively). During the study period 1494 cases were treated for IE corresponding to 0.82% of all inpatient treatment cases in CHD patients. Mortality rate was 6.6% (95% CI: 5.0–7.6%) with a major adverse events rate of 44.6% (95% CI: 41.3–48.2%). In total, 682 IE patients (45.7% CI: 42.3%-49–2%) required a surgical intervention. The relative risk of dying due to endocarditis in CHD patients was significantly lower compared to older IE patients without CHD (relative risk 0.39; 95% CI: 0.32–0.47). Conclusions Infective endocarditis accounts for a minority of CHD related hospitalizations but remains a deadly disease with a high proportion of patients requiring surgical intervention. In addition, major adverse events are common in this setting, with almost half of the IE population presenting with a major adverse event. Due to different demographic and comorbidity spectrum encountered in CHD patients, these younger patients tend to have significantly better survival prospects compared to non-CHD IE patients in the current era.

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