Cardiology in the young
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Cardiology in the young · Apr 2015
Crossed pulmonary arteries with hypoplasia of the transverse aortic arch.
The entity of crossed pulmonary arteries was first described by Jue, Lockman, and Edwards in 1966, in a patient with trisomy 18. Since then, several series have been described, both in terms of the isolated anatomic variant, or its association with other intracardiac or extracardiac anomalies. We describe a rare association that has previously not been reported. Methods and results Institutional Review Board approval for a retrospective chart review was obtained. Over the period 2011 through 2013, we have encountered six patients in whom the crossed origins of the pulmonary arteries from the pulmonary trunk were associated with hypoplasia of the transverse aortic arch, an association that, to the best of our knowledge, has previously not been reported. In all of the patients, the isthmic component of the aortic arch was inserted in an end-to-side manner into the ductal arch, with additional discrete coarctation in half of the patients. ⋯ To the best of our knowledge, no cases of crossed pulmonary arteries have been described in association with hypoplasia of the transverse aortic arch. We draw comparisons between the cases with exclusively tubular hypoplasia, and those with the added problem of the more typical isthmic variant of aortic coarctation. In all cases, the ability to reconstruct cross-sectional images added significantly to the diagnosis and understanding of these complex lesions. These findings have specific surgical implications, which are discussed.
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Cardiology in the young · Mar 2015
Near-infrared spectroscopy after high-risk congenital heart surgery in the paediatric intensive care unit.
To establish whether the use of near-infrared spectroscopy is potentially beneficial in high-risk cardiac infants in United Kingdom paediatric intensive care units. ⋯ We found that cerebral near-infrared spectroscopy is potentially beneficial as a non-invasive, continuously displayed value and is feasible to use on cost-constrained (National Health Service) cardiac intensive care units in children following heart surgery.
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Cardiology in the young · Mar 2015
Case ReportsInverted left atrial appendage in an infant during cardiac surgery.
Inverted left atrial appendage is an unusual complication associated with congenital cardiac surgery. Inversion of the left atrial appendage may occur during the surgical procedure or afterwards. The left atrial appendage may invert iatrogenically or as a result of the negative pressure during placement or removal of the left atrial vent or during deairing manoeuvres. This event can be life-threatening because of the mass effect of the atrial appendage within the left atrial cavity.
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Cardiology in the young · Mar 2015
Case ReportsScimitar syndrome in a case with VACTERL association.
VACTERL association and Scimitar syndrome are rare congenital diseases. In this study, we report on a neonate with prenatal suspicion of VACTERL association and small left-sided cardiac structures, which, only on postnatal angiography, could be revealed to be part of a Scimitar syndrome. As this is the second reported case of VACTERL association and Scimitar syndrome, the presence of Scimitar syndrome should be considered in the prenatal and postnatal evaluation of VACTERL association.