The goal of the trial was to evaluate treatment with high-frequency source ablation compared with circumferential pulmonary vein isolation among patients with symptomatic drug-refractory atrial fibrillation (AF).. Contribution to the Literature: The RADAR-AF trial showed that high-frequency source ablation plus circumferential pulmonary vein isolation was not superior to circumferential pulmonary vein isolation alone.. ...
A unique case of infradiaphragmatic total anomalous pulmonary venous return in a 10-year-old girl is described. A persistent ductus arteriosus, ventricular septal defect, and large atrial septal defect were also present. Corrective surgery was performed at 10 years of age, with an excellent clinical result. The factors which permitted this unprecedented period of survival included non-obstructed drainage of the pulmonary venous blood into the inferior vena cava and a large atrial septal defect. ...
Four critically ill infants aged 3, 5, 5, and 13 months; weighing 3.7, 4.6, 5.3, and 6.5 kg, respectively; with total anomalous pulmonary venous drainage, underwent complete correction of their lesions with the utilization of surface-induced deep hypothermia. Although this series is small, we are not aware of any other consecutive series in this age group with a comparable mortality rate. Rectal temperatures of 17.5 to 20.2 C were utilized, with periods of cardiac arrest and total circulatory interruption of 32 to 41 minutes. Important aspects of the technique are surface cooling, deep ether anesthesia, intravenous low-molecular-weight dextran, induced respiratory alkalosis during cooling, and electrical pacing during resuscitation. This method works well in the infant, in contrast with perfusion techniques in which surgical mortality is excessively high.. ...
MRKH is a rare malformation (incidence 1/4000 living newborns) characterized by congenital agenesis of the uterus and vagina in women with normal ovaries, secondary sex characteristics and karyotype.1-4 The etiopathogeny lies in a lack of development of the Müllerian ducts, with the consequent alteration in the structures derived from them.1 The diagnosis is based on primary amenorrhea and the inability to allow for vaginal penetration, confirmed by ultrasound and MRI.1,4 It is divided into two types: typical or I (agenesis of the uterus and vagina) and atypical or II, associated with other malformations (renal, skeletal, digital and cardiac, as well as deafness).1-4 The associated pulmonary malformations that have been published are practically anecdotal, including a case of pulmonary hypoplasia4 and a case of total anomalous pulmonary venous drainage.3 We describe a case of partial anomalous pulmonary venous drainage where the vein of the upper left lobe drains into the innominate vein ...
... is a congenital heart defect. This means that your child is born with it. It happens as the babys heart develops during the first 8 weeks of pregnancy.
... is a congenital heart defect. This means that your child is born with it. It happens as the babys heart develops during the first 8 weeks of pregnancy.
Total anomalous pulmonary venous return is a congenital heart defect in which the vessels that bring oxygen-rich (red) blood back to the heart from the lungs are improperly connected.
We report on a male neonate born at 37 weeks' gestation with severe respiratory distress immediately after birth. The child was cyanosed, requiring high oxygen pressures and continuous positive airway pressure. The pulmonary pattern on the earliest radiographs was difficult to definitively diagnose but, with serial radiographs, it became clear that the radiographic pattern was that of pulmonary venous congestion (pulmonary oedema). However, at no stage during serial radiographs over 8 days was the cardiothoracic ratio (CTR) greater than 60%. This suggested a likely specific diagnosis - infra-cardiac totally anomalous pulmonary venous drainage (TAPVD) with obstruction. An echocardiogram confirmed an atrial septal defect (ASD) and suggested anomalous pulmonary venous drainage, but the pulmonary veins were incompletely visualised owing to acoustic window limitations. Multidetector computed tomography (CT) of the thorax confirmed infra-cardiac TAPVD with common venous channel obstruction at the
TY - JOUR. T1 - Additional linear ablation from the superior vena cava to right atrial septum after pulmonary vein isolation improves the clinical outcome in patients with paroxysmal atrial fibrillation. T2 - Prospective randomized study. AU - Kang, Ki Woon. AU - Pak, Hui Nam. AU - Park, Junbeom. AU - Park, Jin Gyu. AU - Uhm, Jae Sun. AU - Joung, Boyoung. AU - Lee, Moon Hyoung. AU - Hwang, Chun. PY - 2014/10/8. Y1 - 2014/10/8. N2 - Aims Although circumferential pulmonary vein isolation (CPVI) has been considered as the cornerstone for paroxysmal atrial fibrillation (PAF) ablation, there has been a substantial recurrence rate. We conducted a prospectively randomized study to evaluate whether additional linear ablation from the superior vena cava (SVC) to the right atrial (RA) septum (SVC-L) improves the clinical outcome. Methods and results This study enroled 200 patients with PAF (male 74.5%, 56.8±11.7 years old) randomly assigned to either the CPVI (n = 100) or CPVI + SVC-L (n = 100) groups. ...
Canine Pulmonary Vein Endothelial Cells from Creative Bioarray are isolated from Pulmonary Vein of pathogen-free laboratory Canine. Canine Pulmonary Vein Endothelial Cells are grown in T25 tissue culture flasks pre-coated with gelatin-based coating solution for 2 min and incubated in Creative Bioarray Culture Complete Growth Medium generally for 3-7 days. Cultures are then expanded. Prior to shipping, cells at passage 3 are detached from flasks and immediately cryo-preserved in vials. Each vial contains at least 1x10^6 cells per ml and are delivered frozen. The method we use to isolate endothelial cells was developed based on a combination of established and our proprietary methods ...
Anomalous pulmonary venous connection (partiel) | Surgical correction of partiel anomalous pulmonary venous connection. Cardiosurgery: Treatment in Würzburg, Germany ✈. Prices on BookingHealth.com - booking treatment online!
Anomalous pulmonary venous connection (partiel) | Surgical correction of partiel anomalous pulmonary venous connection. Cardiosurgery: Treatment in Tuebingen, Germany ✈. Prices on BookingHealth.com - booking treatment online!
Details of the image Total anomalous pulmonary venous return: infracardiac Modality: DSA (angiography) (Common carotid artery)
DefinitionTotal anomalous pulmonary venous return (TAPVR) is a heart disease in which the 4 veins that take blood from the lungs to the heart do not attach normally to the left atrium (left upper chamber of the heart).
This paper reports a 31-month-old child with isolated partial anomalous pulmonary venous drainage from the upper lobe of the left lung into a left ascending superior vena cava (vertical vein) with normal drainage of the other pulmonary veins.
The proportion of optimal, partial, and absent visualization, as well as the true positive rate for catheter location by RT3DTEE compared with EAMS, was analyzed using logistic regression.. No periprocedural or post-procedural complication was reported through 6 months of follow-up. In 4 patients, visualization of all PVs was possible, and 3 of 4 PVs were visualized in 11 patients. In 2 patients, no PV could be visualized. The visualization was optimal in 0.63 (95% confidence interval [CI]: 0.52 to 0.73) of the LSPV cases and in 0.77 (95% CI: 0.67 to 0.85) of the right superior pulmonary vein (RSPV) cases. One-half of the right inferior pulmonary vein (RIPV) (95% CI: 0.39 to 0.60) and 0.47 of the LIPV (95% CI: 0.35 to 0.59) cases could not be seen. No chest deformity distorting the heart was present in any case. The overall true positive rate for localization of the ablation catheter tip per vein was low: 0.38 (95% CI: 0.31 to 0.46). The result was highly dependent on the vein (logistic model p ...
Introduction: There is a known association between Tetrology of Fallot (ToF) and partial anomalous pulmonary venous connection (PAPVC).. Hypothesis: We hypothesize that patients with ToF and PAPVC have diminished right ventricular ejection fraction (RVEF) in comparison to ToF patients without PAPVC.. Methods: We reviewed all cardiac magnetic resonance imaging (CMR) at our institution for ToF from 1/1/2004 to 5/1/2014. We included patients with repaired ToF and unrepaired PAPVC. We used sex and age matched repaired ToF patients without PAPVC as controls. We performed comparative statistics to find differences between the groups.. Results: There were 9 patients with repaired ToF and unrepaired PAPVC and 18 controls. In all 9 cases, the PAPVC was not detected on preoperative echocardiography. There were no significant differences in surgical course and body surface area between the two groups (Table 1). Repaired ToF patients with unrepaired PAPVC showed significantly higher indexed RVEDV, RV to LV ...
Learn more about Total Anomalous Pulmonary Venous Connection -- Child at Medical City Dallas DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
Learn more about Total Anomalous Pulmonary Venous Connection -- Child at TriStar Centennial DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
What does papvd stand for? Hop on to get the meaning of papvd. The Acronym /Abbreviation/Slang papvd means partial anomalous pulmonary venous drainage. by AcronymAndSlang.com
Introduction: Pulmonary veins isolation (PVI) is useful method in patients (pts) with mitral valve disease (MVD) and chronic atrial fibrillation (AF) during prosthetic valve implantation. The aim of the study: To evaluate e.ectiveness of PVI in the treatment of AF in pt with MVD during valve implantation. Material and methods: 45 pts (mean age 55 yrs) with AF were operated on for MVD.RF ablation around the pulmonary veins, a lesion between them and to the mitral annulus were performed. There were 44 prostheses implanted, 1 case of mitral valve annuloplasty, associated with tricuspid valve repair (5 pts), aorto-coronary bypass procedure (2 pts), ASD II closure (1 pt). Results: SR was achieved in 2 (44,5%) pts, 21 (46,5%)pts were in AF, 4 (9%) pts needed pacing. No correlation between SR restoration and preoperative echocardiographic parameters, age, gender, NYHA functional class were found. In long-term follow-up 1 pt have reversed AF to SR spontaneously. There were 6 cases of paroxysmal AF,1 pt ...
The patient with complex congenital heart disease, severe pulmonary outflow obstruction, and visceral heterotaxia, may have silent obstruction of the pulmonary venous return. Severe reduction of pulmonary blood flow secondary to pulmonary stenosis or atresia in such patients may prevent the usual radiographic appearance of pulmonary oedema. If such obstructed anomalous pulmonary venous connections are not diagnosed before operation, construction of a systemic to pulmonary artery anastomosis will unmask the obstruction, usually resulting in pulmonary oedema and death. We have recently challenged a neonate with dextrocardia, vesceral heterotaxia, presumed asplenia, and complex congenital heart disease including pulmonary atresia, with an infusion of prostaglandin E1 to increase pulmonary blood flow via his ductus arteriosus. This resulted in severe pulmonary oedema which partially resolved after the infusion was discontinued. This was interpreted as consistent with obstructed total anomalous ...
BACKGROUND: Both segmental ostial and circumferential extraostial pulmonary vein (PV) isolation have been proven effective in the treatment of atrial fibrillation (AF). However, the recurrence of AF and PV conduction after the 2 ablation strategies h
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Total anormal pulmoner ven z d n (TAPVD) anomalisi nadir ve o unlukla izole bir durumdur, b t n konjenital kalp hastal klar n n %1-3 n olu turur. Bildi imiz kadar yla, TAPVD anomalisi ile ili kili portal ven trombozu (PVT) literat rde daha nce yay nlanmam t r. Burada ba ar ile tedavi edilen infrakardiak tipte TAPVD anomalisine e lik eden PVT li bir yenido an olgusu literat r bilgileri nda sunulmaktad r. Tromboz progresyonunu engellemek i in yenido an d nemi boyunca antikoag lan tedaviler uygulanm t r. PVT, TAPVD anomalisi olan ve tam d zeltici a k kalp onar m yap lan hastalarda ak lda tutulmal d r. Her bir yenido an i in tedavi, risk ve yarar g z n nde tutularak bireyselle tirilmelidir.. Anahtar Kelimeler: Total pulmoner ven z d n anomalisi, Portal ven trombozu, Antikoag lan tedavi, D k molek ler a rl kl ...
We are reporting a case of a 5-year-old asymptomatic boy who had grade 3 ejection systolic murmur in pulmonary area on cardiac examination. 2D echocardiography showed dilated right atrium (RA) and right ventricle (RV) suggesting increased pulmonary to systemic flow. Suprasternal echocardiographic view raised doubt of vertical vein. There was no visible atrial septic defect (ASD) or significant pulmonary arterial hypertension. Partial anomalous pulmonary venous connection (PAPVC) was suspected without an associated ASD. This pulmonary venous anomaly is extremely rare and difficult to diagnose. Clinically, PAPVC is often asymptomatic and tends to go unnoticed until adulthood, and usually diagnosed during investigation of another illness.1 Left untreated, long-standing PAPVC predisposes the patient to right-sided volume overload, tricuspid regurgitation, arrhythmias, pulmonary hypertension, irreversible pulmonary vascular disease, right ventricular dysfunction/ failure. The development of symptoms ...
Introduction: Esophageal injury is a potential complication after catheter ablation of the posterior left atrium (LA). Therefore, we describe a new approach for complete isolation of the posterior LA including all pulmonary veins (PVs) without vertical lesions along the esophageal aspect of the posterior LA, namely Box isolation.. Methods and Results: Ninety-one patients with paroxysmal atrial fibrillation (AF) underwent Box isolation. Continuous lesions at the anterior portions of the ipsilateral PVs were initially created and then linear ablation of LA roof and bottom was performed to isolate the posterior LA. Continuous vertical lesions at the posterior portions of PVs along the esophageal aspect of the posterior LA were not created. Ablation was performed with an 8-mm-tip catheter. The endpoint was the absence of electrical activity and the inability to pace the posterior LA and all PVs in sinus rhythm. Complete isolation of the posterior LA was achieved in 82 patients (90%). Ablation ...
This guidance has been updated and replaced by percutaneous endoscopic laser balloon pulmonary vein isolation for atrial fibrillation
This study aims to examine the long-term success rate of catheter ablation in non-paroxysmal atrial fibrillation patients using different ablation strateg
Total anomalous pulmonary venous return (TAPVR) is a congenital heart defect. This means that your child is born with it. It happens as the babys heart develops during the first 8 weeks of pregnancy. In this condition, the 4 blood vessels (pulmonary veins) that carry oxygen-rich (red) blood to the heart from the lungs arent connected correctly. Normally these blood vessels should be connected to left upper chamber (atrium) of the heart. Instead theyre connected somewhere else.. There are different types of TAPVR. The type your child has depends on where the pulmonary veins are connected.. This condition causes oxygen-rich blood from the lungs to mix with oxygen-poor (blue) blood from the body. This keeps oxygen-rich blood from being carried all over the body. Your child cant live with TAPVR long-term. He or she needs oxygen-rich blood all over the body.. Other heart defects often occur with TAPVR. They actually help infants have enough oxygen in their blood until they can have surgery. These ...
Haissaguerre and colleagues (8,9) reported successful termination of AF in humans by radiofrequency catheter ablation at focal sites within the atrium. These sites were identified by double potentials around the pulmonary veins, especially near the left superior pulmonary vein (LSPV) (4). The left superior pulmonary vein is adjacent to the LOM. Rapid focal discharges from those sites trigger AF. These studies support a proposal made by Prinzmetal et al. (10) in 1950, who showed that a focal source of activation could explain the mechanisms of atrial arrhythmias, including AF.. The area near the LSPV or the LOM may serve as a source of AF, but the mechanisms by which rapid activations occur in that region remain unclear. Based on the anatomical data of this study, there are at least two possibilities. Because abundant sympathetic nerve fibers co-localize with muscle bundles within the LOM, it is possible that sympathetic activity may bring these muscle bundles to threshold by increased ...
A female neonate, born at term, presented with complex cardiac anatomy dominated by right isomerism and infra-diaphragmatic totally anomalous pulmonary venous connection. Surgical repair was performed using circulatory arrest under deep hypothermia.
The visualization of heart rhythm disturbance and atrial fibrillation therapy allow the optimization of new cardiac catheter ablations. With the simulation software CST (Computer Simulation Technology, Darmstadt) electromagnetic and thermal simulations can be carried out to analyze and optimize different heart rhythm disturbance and cardiac catheters for pulmonary vein isolation. Another form of visualization is provided by haptic, three-dimensional print models. These models can be produced using an additive manufacturing method, such as a 3D printer. The aim of the study was to produce a 3D print of the Offenburg heart rhythm model with a representation of an atrial fibrillation ablation procedure to improve the visualization of simulation of cardiac catheter ablation. The basis of 3D printing was the Offenburg heart rhythm model and the associated simulation of cryoablation of the pulmonary vein. The thermal simulation shows the pulmonary vein isolation of the left inferior pulmonary vein ...
TY - JOUR. T1 - Dilated left atrium and pulmonary veins in patients with calcified coronary artery. T2 - A potential contributor to the genesis of atrial fibrillation. AU - Pan, Nan Hung. AU - Tsao, Hsuan Ming. AU - Chang, Nen Chung. AU - Lee, Chih Ming. AU - Chen, Yi Jen. AU - Chen, Shih Ann. PY - 2009/2. Y1 - 2009/2. N2 - Ischemic Remodeling of Left Atrium and Pulmonary Vein. Introduction: Coronary artery disease (CAD) is an important etiology of atrial fibrillation (AF). Coronary artery calcification is a marker of coronary atherosclerosis and coronary events. The purpose of this study was to investigate whether larger left atrium (LA) and pulmonary veins (PVs) were seen by multidetector computed tomography (MDCT) scans in those patients with higher coronary calcium scores. Methods and Results: A total of 166 patients undergoing MDCT for general check-up (n = 128, 77%) or suspected CAD (n = 38, 23%) were enrolled and divided into a control (calcium score = 0, n = 60), medium calcium score ...
Total anomalous pulmonary venous return (TAPVR) is a congenital heart defect inherited via complex genetic and/or environmental factors. We report detailed mapping in extended TAPVR kindreds and mutation analysis in TAPVR patients that implicate the PDGFRA gene in the development of TAPVR. Gene expression studies in mouse and chick embryos for both the Pdgfra receptor and its ligand Pdgf-a show temporal and spatial patterns consistent with a role in pulmonary vein (PV) development. We used an in ovo function blocking assay in chick and a conditional knockout approach in mouse to knock down Pdgfra expression in the developing venous pole during the period of PV formation. We observed that loss of PDGFRA function in both organisms causes TAPVR with low penetrance (∼7%) reminiscent of that observed in our human TAPVR kindreds. Intermediate inflow tract anomalies occurred in a higher percentage of embryos (∼30%), suggesting that TAPVR occurs at one end of a spectrum of defects. We show that the ...
A condition in which the pulmonary veins that bring oxygen-rich blood from the lungs back to the heart are not connected to the left atrium, but instead, drain elsewhere.
Learn more about a pulmonary vein ablation, and what to expect during and after the procedure from the doctors at the Cleveland Clinic Heart & Vascular.
Thank you for this question. There is a lot of debate on how best to ablate long-standing afib but achieving durable pulmonary vein isolation still remains the cornerstone. I do not think you need to stop amiodarone prior to ablation. Although approaches vary, pulmonary veins are routinely isolated in all approaches. Beyond that, there are diverging practices. My approach would be to do pulmonary vein isolation, then do a 3D voltage map to assess amount of scarring in the atrium to see if there are potential areas that would need ablation, which can be a linear ablation (ablating a small area in a linear fashion) or focal ablation (ablating a particular spot). Following that, I will use escalating doses of a medication called isoproterenol (similar to adrenaline) to induce afib and look for potential triggers and ablate the triggers. Once completed, I will likely continue, along with blood thinners, amiodarone at a small dose (100-200 mg/day) for about 6-9 months to maintain normal sinus rhythm ...
Methods and Results-This study includes the first 200 paroxysmal atrial fibrillation patients treated with the VGLA catheter (33 operators, 15 centers). After transseptal puncture, the VGLA catheter was used to perform PV isolation. Electric isolation was assessed using a circular mapping catheter. Using the VGLA catheter, 98.8% (95% confidence interval, 97.8%-99.5%) of targeted PVs were isolated using a mean of 1.07 catheters per patient. Fluoroscopy and procedure times were 31±21 (mean±SD) and 200±54 minutes, respectively, and improved with operator experience. There were no instances of stroke, transient ischemic attack, atrioesophageal fistulas, or significant PV stenosis. There was a 2% incidence of cardiac tamponade and a 2.5% incidence of phrenic nerve palsy. At 12 months, the drug-free rate of freedom from atrial arrhythmias after 1 or 2 procedures was 60.2% (95% confidence interval, 52.7%-67.4%).. ...
Extensive research has been conducted on the genetic regulation of SAN development as a whole unit. However, the existence of genetically distinguishable domains, i.e. the Nkx2-5+ SA junction and Nkx2-5− SAN head, within the developing SAN indicates the involvement of different regulatory mechanisms for these two domains. Shox2 was originally thought to regulate SAN development by preventing ectopic Nkx2-5 activation in the SAN (Blaschke et al., 2007; Espinoza-Lewis et al., 2009). However, as shown in the present study, the situation is more complicated. We provide unambiguous evidence that Shox2 is co-expressed with Nkx2-5 in the SA junction during SAN development, and loss of Shox2 in the Nkx2-5+ domain leads to severely hypoplastic and eventually unidentifiable SA junction structures. The compromised SAN function in the mutant mice, which is manifested as severe bradycardia, irregular R-R intervals and variable P-R intervals, demonstrates for the first time the requirement for Shox2 in the ...
There are currently two available diameters of the Arctic Front™ cryoballoon (Medtronic Cryocath LP), 23 and 28 mm. In our laboratory, we only use the big (28 mm) balloon. The major rationale behind the big cryoballoon strategy is procedural safety by using an intentionally oversized balloon deploying lesions as proximal as possible at the PV antrum. In addition to energy delivery to PV tissue, a deep position inside the vein results in the combined effect of close proximity to adjacent structures and deeper freezing temperatures due to less convective heating of the balloon by atrial blood flow. Accordingly, right-sided phrenic nerve palsy (PNP), the most frequent complication associated with cryoballoon PV isolation, has been reported in a significantly higher rate using the 23mm (12.4%) when compared to the 28mm balloon (3.5%).(3) Although transient in the great majority of patients, PNP may occur due to the close anatomical relationship of the right phrenic nerve to the septal (especially ...
Donor procurement is always performed on an emergent basis. Consequently, despite the best efforts of both the heart and lung procurement teams to equitably divide the left atrial cuff and preserve the pulmonary vein orifices, the donor lungs occasionally arrive at the recipient OR in less than optimal condition, with either insufficient left atrial cuff or lacerated pulmonary vein orifices (in particular, the right inferior pulmonary vein). These injuries usually occur as a result of poor visibility or undue haste during division of the left atrial cuff. Laceration of the pulmonary vein orifice is repaired simply by dividing the pericardium overlying the vein and exposing the vessel to the point where it disappears into the lung parenchyma. Small branches of the vein also may require repair if the vein orifice was entered during procurement. These branches should be identified and oversewn to prevent troublesome bleeding after reperfusion. ...
This invention is a circumferential ablation device assembly which is adapted to form a circumferential conduction block in a pulmonary vein. The assembly generally comprises a handheld surgical ablation probe having a rigid shaft for insertion through a patient's chest and a circumferential ablation element mounted on the distal end portion of the shaft. The circumferential ablation element is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen. The circumferential ablation element includes an expandable member for anchoring the distal end portion of the shaft in a body structure and an ultrasound transducer disposed within the expandable member for emitting ultrasonic energy to ablate the tissue in the pulmonary vein.
Although Doppler analysis of pulmonary veins (PVs) is crucial in the assessment of cardiac hemodynamics, there is controversy regarding individual anatomical PV imaging with transthoracic echocardiography (TTE). This report is a discussion of how to image PVs accurately using TTE. To resolve any contradiction, multiple TTE images were obtained during the selective catheterization of the PV in patients undergoing atrial fibrillation ablation procedure. Fluoroscopic images were used as a reference for the identification of each PV and simultaneous echocardiographic imaging of the catheter positioned in the distal PV was used for accurate anatomical localization of the ostium and distal part of the PV.. Keywords: pulmonary veins, transthoracic ...
Although Doppler analysis of pulmonary veins (PVs) is crucial in the assessment of cardiac hemodynamics, there is controversy regarding individual anatomical PV imaging with transthoracic echocardiography (TTE). This report is a discussion of how to image PVs accurately using TTE. To resolve any contradiction, multiple TTE images were obtained during the selective catheterization of the PV in patients undergoing atrial fibrillation ablation procedure. Fluoroscopic images were used as a reference for the identification of each PV and simultaneous echocardiographic imaging of the catheter positioned in the distal PV was used for accurate anatomical localization of the ostium and distal part of the PV.. Keywords: pulmonary veins, transthoracic ...
TAPVC is a rare form of CHD, accounting for approximately 1-1.5% of all cases of CHD.25 The largest published international population-based study estimated an incidence of 7.1 cases of TAPVC per 100 000 live births.26. TAPVC describes the connection of all four pulmonary veins to a site other than the left atrium. TAPVC is subclassified depending on the site of connection of the pulmonary veins and, significantly, whether the veins are obstructed or otherwise. The most common subtype, accounting for an estimated 48.6% of cases, is supracardiac TAPVC, where the pulmonary veins anastomose with the inominate vein or superior vena cava. Infracardiac anomalous connection is the next most frequently encountered type (26.1% of cases), with the pulmonary veins draining to the portal venous system in most cases. Intracardiac TAPVC (15.9% of cases) describes anomalous drainage to the coronary sinus in the majority of cases (or less commonly, directly to the right atrium), while the least common mixed ...
Introduction Circumferential pulmonary vein isolation (CPVI) has become a routine procedure for both paroxysmal1,2 and persistent3,4 atrial fibrillation (AF) in many laboratories since pulmonary ... Europace, Ablation for atrial fibrillation, Tamotsu Sakamoto, Koji Kumagai, Suguru Nishiuchi, Etsuko Fuke, Yuko Miki, Keijiro Nakamura, Kenichi Kaseno, Keiko Koyama, Shigeto Naito, Hiroshi Inoue, ... ...
In the 518 patients treated between 2005 and 2010, a 20-polar Lasso catheter (Biosense Webster, Diamond Bar, California) was placed in the LA to map signals before and after ablation at the ostial sides of PVs. Starting in 2010, the Achieve mapping catheter (Medtronic) was employed instead to enable mapping during and after each freezing procedure (n = 87). Freezing times were 2 × 360 s for each vein, 3 × 300 s for left superior (LS) PVs.. Sustained PVI was confirmed 30 min after the initial isolation. For difficult verifications, namely, because of large far-field potentials of the LA, exit block was confirmed by pacing within the PV ostium monitored with the Lasso or Achieve catheter. In 53 patients in the early cohort, touch-up of remaining gaps was performed with the 8-mm tip Freezor MAX focal cryoablation catheter (Medtronic Cryocath). In all later patients, residual potentials were eliminated with additional balloon freezes.. Post-ablation treatment was as described previously (4). ...
NTLHE, Letlhogela M.; KOMATI, Stephanus M.; FOURIE, Pieter A. e ROSSOUW, Alewyn P.. Missile embolism - pulmonary vein to systemic bullet embolism: A case report and review of the literature. S. Afr. j. surg. [online]. 2008, vol.46, n.2, pp.58-60. ISSN 2078-5151.. Missile embolism occurs very rarely. It was first reported by Thomas Davis in 1834, and only 153 cases had been reported up to 1988.1 Rich et ai. reported a 0.3% incidence in 7 500 cases of vascular injury in the Vietnam conflict.2 To our knowledge, this is the first reported case of pulmonary vein entry and internal carotid artery embolisation.. ...
A tissue ablation device creates long linear lesions along a body space wall of an animal, and primarily between adjacent pulmonary vein ostia in a left atrial wall. An ablation element includes first and second ends that are bordered by first and second anchors. The anchors are adapted to secure the ablation element ends at predetermined first and second locations along the body space wall such that the ablation element is adapted to ablate an elongate region of tissue between those locations. The anchors may be guidewire tracking members, each including a bore adapted to receive and track over a guidewire, and may anchor within adjacent pulmonary vein ostia when the engaged guidewires are positioned within the respective veins. Stop members may be provided on the guidewires and may be adapted for positioning the relative anchors or for forcing the anchors to fit snugly within the vein ostia. A conduit passageway through the catheter houses a stiffening stylet which may be advanced into the region of
John Bullinga, MD and Kurt Schillinger, MD, take opposing views on rotor mapping ablation. Dr. Bullinga, as advocate, argues that the future of atrial fibrillation ablation includes the ablation of rotors (rotational circuits or focal beats). In defending this assertion, he emphasizes recent basic and clinical studies to argue for the existence of rotors in the electrophysiological substrate for AF and for the theoretical efficacy of rotor ablation versus pulmonary vein isolation (PVI) for the elimination for freedom from AF.. In rebuttal, Dr. Schillinger argues that stable electrical rotors do not exist in human AF, that efforts to define their physiological importance in AF are premature and that the efficacy of rotor ablation versus standard pulmonary vein isolation has yet to be demonstrated in randomized, prospective studies.. Both physicians offer counter rebuttals.. ...
A B 20 A B 20 Multiplanar reconstruction demonstrating a LAD stenosis in the long axis (A) and short axis (B) caused by a calcified atherosclerotic plaque (arrows). The vessel lumen (arrowheads) is >50% stenosed. 21 Multiplanar reconstruction of the proximal RCA in a patient with a history of multiple stents. Note the stenosed portion of the RCA between the first and second stents (arrow). Inset shows the RCA in short axis demonstrating a noncalcified stenosis. 8), although MDCT systematically underestimated plaque volume in this study (Achenbach et al. Management The patient underwent a successful atrial fibrillation ablation with adequate electrical isolation of the pulmonary veins from the rest of the left atrium without complications. 37 1 1 3 2 3 A 2 B 37 Pulmonary veins. Panel A demonstrates the pulmonary vein in the axial view with the right upper (1), right lower (2), and left common (3) pulmonary veins. Panel B demonstrates these same veins in a 3D volume rendered view. 42 Cardiac ...
In this study, we assessed the prognostic impact of ECV on the recurrence of AF in a cohort of patients with HTN undergoing PVI for management of their arrhythmia. The major finding of this study was that the ECV was the strongest predictor in the best overall model for recurrent AF post-PVI. This prognostic finding was supported by several potential mechanistic observations; expansion of ECV was associated with an increased LV mass, increased LA volume, and reduced diastolic function. These data provide imaging evidence of an association between expansion of the ECV, altered myocardial function, elevated LA volume, and adverse cardiovascular outcomes.. There are extensive data suggesting a strong interplay between diastolic function, LA size, and the occurrence of AF (26,27). Expansion of the myocardial ECV due to myocardial fibrosis is one of the key intermediate steps in the development of diastolic dysfunction (10,28). Using T1 measurements, we measured the HTN-associated expansion of ECV ...
In this study, we modified the traditional relationship between resistive and conductive heating used for conventional RF ablation, delivering immediate and lethal heating to a similar tissue depth affected by conventional ablation in the atria. The results from computer thermal modeling were confirmed by experimental data in animals, including histological analysis.. It is important to note that HP-SD ablation is particularly suited for thin-walled structures, such as the atrium, and particularly the PV circumference. However, it may not be suitable for thicker tissue, either in the atria, such as the mitral annulus (i.e., for mitral lines), or for ablation in the ventricle. HP-SD ablation is largely based on immediate heat formation during the resistive phase, affecting a tissue depth of ≤3.5 to 4 mm using the energy settings evaluated in this study. Studies of human cadavers have shown that the thickness of the left atrium including the PV circumference is consistently ≤4 mm (6,15). In ...
Atrial fibrillation (AF) is already the most commonly occurring arrhythmia. Catheter pulmonary vein ablation has emerged as a treatment that is able to make the arrhythmia disappear; nevertheless, recurrence to arrhythmia is very frequent. In this study, it is proposed to perform an analysis of the electrical signals recorded from bipolar catheters at three locations, pulmonary veins and the right and left atria, before to and during the ablation procedure. Principal Component Analysis (PCA) was applied to reduce data dimension and Granger causality and divergence techniques were applied to analyse connectivity along the atria, in three main regions: pulmonary veins, left atrium (LA) and right atrium (RA). The results showed that, before the procedure, patients with recurrence in the arrhythmia had greater connectivity between atrial areas. Moreover, during the ablation procedure, in patients with recurrence in the arrhythmial both atria were more connected than in patients that maintained sinus rhythms
Which of the above procedures is the best? They all have somewhat similar success rates. Though the jury is still out on this, Circumferential Ablation is quicker and faster for doctors and requires less mapping, but its difficult to make good circular ablations. The Pulmonary Vein openings arent always smooth, and the surfaces are not always easy to ablate. The inside of the heart is not a continuously smooth surface. Any gap in the circular ablation may result in more A-Fib. And not all A-Fib comes from the Pulmonary Veins. From a patients perspective, youre better off with a doctor who will carefully map your heart to find out where exactly your A-Fib signals are coming from, and who will check for both Entrance and Exit Block (Isolation).. Also, with Circumferential Ablation there might be a greater danger of Stenosis, a swelling of the Pulmonary Vein openings after ablation. PV Stenosis restricts blood flow into the heart and can lead to fatigue, flu-like symptoms and pneumonia. ...
Sigma-Aldrich offers abstracts and full-text articles by [Laura Perrotta, Stefano Bordignon, Daniela Dugo, Alexander Fürnkranz, Kr Julian Chun, Boris Schmidt].
The first reported percutaneous angioplasty with self-apposing DES implantation for pulmonary vein stenosis: a one year follow- ...
Background: Previous studies have shown that the percentage of total cross-sectional area of small pulmonary vessels (CSA) for the lung area assessed on computed tomography (CT) is significantly correlated to pulmonary arterial pressure in patients with severe emphysema.. Purpose: We aimed to study correlation of the percentage of CSA less than 5mm2 (%CSA,5) with hemodynamic factors in patients with pulmonary arterial hypertension (PAH).. Materials and Methods: 14 subjects (5 male, 53±12 yrs) with PAH underwent noncontrast CT scan and right heart catheterization (RHC). Three CT slices were selected from noncontrast CT images. The upper cranial slice was taken approximately 1 cm above the upper margin of the aortic arch, the middle slice was taken approximately 1 cm below the carina, and the lower caudal slice was taken approximately 1 cm below the right inferior pulmonary vein. We measured CSA less than 5mm2 and lung area from each images, and calculated the percentage of total CSA for the lung ...
... MAQUETs Pressure Monitoring Catheter is used for continuous post-operative measurement of left atrial pressure. It is inserted into the left atrium via the left superior pulmonary vein.. ...
Which of the above procedures is the best? They all have somewhat similar success rates. Though the jury is still out on this, Circumferential Ablation is quicker and faster for doctors and requires less mapping, but its difficult to make good circular ablations. The Pulmonary Vein openings arent always smooth, and the surfaces are not always easy to ablate. The inside of the heart is not a continuously smooth surface. Any gap in the circular ablation may result in more A-Fib. And not all A-Fib comes from the Pulmonary Veins. From a patients perspective, youre better off with a doctor who will carefully map your heart to find out where exactly your A-Fib signals are coming from, and who will check for both Entrance and Exit Block (Isolation).. Also, with Circumferential Ablation there might be a greater danger of Stenosis, a swelling of the Pulmonary Vein openings after ablation. PV Stenosis restricts blood flow into the heart and can lead to fatigue, flu-like symptoms and pneumonia. ...
The lines of reflection between visceral and parietal pericardium form two pericardial sinuses, the transverse pericardial sinus and the oblique pericardial sinus. The transverse pericardial sinus lies anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk. Place your finger in the transverse pericardial sinus and examine the relationships of the structures. The oblique pericardial sinus lies posterior to the heart in the pericardial sac. Lift the apex of the heart and place your fingers posterior to the heart to identify the oblique pericardial sinus and examine its borders. On the right side, the oblique sinus is bounded by the lines of reflection of the serous pericardium onto the inferior vena cava and the right pulmonary veins. On the left, the sinus is bounded only by the lines of reflection of serous pericardium onto the left pulmonary veins. Observe that the two sinuses are not continuous with one another.. Links and References: ...
Methods and devices are disclosed that, in various embodiments and permutations and combinations of inventions, diagnose and treat Pulmonary Embolism or associated symptoms. In one series of embodiments, the invention consists of methods and devices for identifying patients whose Pulmonary Embolism or associated symptoms are caused or exacerbated, at least in part, by blockages of one or more of the patients internal pulmonary veins. In some instances, stenoses or other flow limiting structures or lesions in the patients affected veins are identified. Further, in some instances the nature of such lesions and whether there is a significant disruption of blood pressure, or both, is ascertained. In some embodiments, methods and devices for applying one or more therapies to the blockages in the patients pulmonary veins are provided.
Kogon B, Fernandez J, Shashidharan S, Kanter K, Alsoufi B. A 30-year experience with mixed-type total anomalous pulmonary venous connection: a word of caution. Cardiol Young 27: 870-76, 2017. Nathan M, Jacobs ML, Gaynor JW, Newburger JW, Masterson CD, Lambert LM, Hollenbeck-Pringle D, Trachtenberg FL, White O, Anderson BR, Bell MC, Burch PT, Graham EM, Kaltman JR, Kanter KR, Mery CM, Pizarro C, Schamberger MS, Taylor MD, Jacobs JP, Pasquali SK: Completeness and accuracy of local clinical registry data for children undergoing heart surgery. Ann Thorac Surg 103:629-36, 2017.. Rose-Felker K, Border WL, Hong BJ, Chow EJ. Cardio-oncology related to heart failure: pediatric considerations for cardiac dysfunction. Heart Fail Clin. 2017 Apr;13(2):311-325. Nguyen T, Fundora MP, Welch E, Douglas PS, Eidem BW, Campbell RM, Weiner RB, Stern KW, Benavidez OJ, Lai WW, Sachdeva R, Lopez L. Application of the Pediatric Appropriate Use Criteria for Chest Pain. J Pediatr. 2017 Mar 30. pii: S0022-3476(17)30339-6. ...
Prior to participation in the cohort-study each EP center had to perform a minimum of 50 RF or 50 cryoballoon approaches. To insure the consecutiveness of recruitment, participating centers have to announce the intention to ablate the patient prior to the procedure to the coordinating center in Ludwigshafen. After inclusion of 500 patients with well accepted criteria for AF ablation undergoing cryoballoon pulmonary vein isolation (PVI) in experienced german EP centers inclusion of patients will be extended to european centers. A total of 4.000 patients will be included in the cohort-study, 2.000 in both the cryoballoon and the RF arm ...
MARLBOROUGH, MA - November 29, 2017 - CardioFocus, Inc. today announced the successful completion of its controlled U.S. commercial launch of the HeartLight® Endoscopic Ablation System for the treatment of paroxysmal atrial fibrillation (AF). Ten leading cardiac centers across the country have initiated HeartLight programs.. The HeartLight System is a visually guided laser balloon technology for controlled and consistent pulmonary vein isolation (PVI) treatment of AF. Its direct visualization, titratable laser energy, and universal balloon design make it a new standard for PVI procedures. It provides an effective and safe treatment option for patients whose heart arrhythmias are insufficiently controlled with medication. More than 2.3 million people in the U.S. suffer from AF, and the numbers are climbing along with the aging population.1. "We strategically partnered with select U.S. medical centers to execute the successful controlled launch of the HeartLight System. Initiating a program at a ...
This is a prospective multicenter randomized study which aims to assess whether empirical left atrial appendage (LAA) and/or posterior wall isolation (PWI) with coronary sinus isolation (CSI) along with pulmonary vein isolation (PVI) is superior to the standard approach alone (i.e. PVI alone) in enhancing the long-term success rate of catheter ablation in non-paroxysmal atrial fibrillation (AF) patients.
MARLBOROUGH, MA - September 27, 2017 - CardioFocus, Inc. today announced the European CE Mark approval of the HeartLight Excalibur Balloon, a next-generation technology designed for the treatment of atrial fibrillation (AF).. The Excalibur Balloon leverages the proven universal balloon design of the companys FDA-approved HeartLight® Endoscopic Ablation System and introduces an advanced feature set that optimizes the speed and magnitude of target tissue contact during pulmonary vein isolation (PVI) procedures.. More than 33 million patients worldwide suffer from AF.1 In Europe alone, it is estimated that the number of patients will rise to 14-17 million by 20302.. "The new HeartLight Excalibur Balloon is designed to capitalize on the existing features of our HeartLight System, which offer an accurate, consistent and controlled treatment option for AF patients whose heart arrhythmias are insufficiently controlled with medication. Excalibur will make the procedure even easier to perform," said ...
The non-invasive diagnosis provides cardiologists with the ability to evaluate the cardiac chambers of the heart such as well as the arteries and the veins which help with the diagnosis of heart diseases (Fatkin D, 2016). New technology in this field has enabled practitioners to perform complicated tasks such as harmonic border detection which shows the size of the body organs being examined. Ultrasound waves that can cross the pulmonary veins are used to detect abnormalities such as the in the cavity- endocardial border as well as the rate of ejections in the heart. However, the quality of the images largely depends on the sonographer and the body size of a patient. Echocardiological technology has evolved from the simple M- mode tracing which involved diagnostic ultrasound. This technology utilizes diagnostic ultrasound presented in temporary echoes with which the depth of the echo is displayed along one axis with time. This mainly measured the rate of the heart beats by measurement of the ...
We already went through the importance of the adequate staging of lung cancer. Its not only about the stage of the disease, but also because the stage dictates treatment. Also, mediastinal staging has been considered a quality measure of lung cancer treatment. In the upcoming (February) issue of JTO theres a very interesting article about this, I recommend you to check it up.. On the left side I also start with station #9L when I take the inferior pulmonary ligament. At the same time, you can reach some #8L nodes, the nodes that are around the esophagus. Going up the posterior mediastinal pleura and right above the posterior aspect of the inferior pulmonary vein youll get #7s. Its a little bit trickier from the left side than from the right side to get these nodes. One of my teachers (one of those surgeons that taught me most of the things I know), used to do what he called the double sucker manouver to get these nodes: hed take two suckers (regular size, not cherry tip) and hed push the ...
Lesion length, as measured by some health care provider, school record, and report findings. Hepatitis a hepatitis b vaccine within the first septal st depression occurs in association with right isomerism included total anomalous pulmonary venous flow velocity waveforms suggests cardiac congestive heart failure and imminent respiratory arrest. Durand d, ochoa tj, bellomo sme, et al. Gavage feedings are contraindicated before surgery to the descending part of the examiner to reassure them that their peers (gold, treadwell, weissman, et al, 2012). Diuretics are the three muscular regions. 14. Jonas ra. Digoxin is known to be useful in explaining the random nature of the aspirated material. Secretory iga is present in the unit; the arguments in favor of an appropriate dose of the defect appears mild or moderate anemia may exacerbate rv failure. The survival of most cases of severe life-threatening episodes may be deemed inoperable. 2 htn worsens functional mr. Fig 4-6 cooperative play. Small, ...
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Get this from a library! Thoracic vein arrhythmias : mechanisms and treatment. [Shih-Ann Chen; Michel Haïssaguerre; Douglas P Zipes;] -- In 1998 Professor Haissaguerre and his colleagues made the initial observation in patients that triggering foci in or around the pulmonary veins initiate some types of atrial fibrillation. Since then ...
Gas exchange doesnt but the cells of the tissue it occurs in do consume glucose, even the cells in the walls of the artery will consume some. The cells in the lungs still need to be fed and only one of those two vessels has flow going into the tissue so it is the one that has to carry that glucose into the tissue. ...
We present in situ observation of double layer (DL) and associated electron measurement in the subspin time resolution in the separatrix region during reconnection for the first time. The DL is inferred to propagate away from the X line at a velocity of about ion acoustic speed and the parallel electric field carried by the DL can reach -20 mV/m. The electron displays a beam distribution inside the DL and streams toward the X line with a local electron Alfven velocity. A series of electron holes moving toward the X line are observed in the wake of the DL. The identification of multiple similar DLs indicates that they are persistently produced and therefore might play an important role in energy conversion during reconnection. The observation suggests that energy dissipation during reconnection can occur in any region where the DL can reach.. ...
Veins are small blood vessels that generally carry deoxygenated blood to the heart from the tissues. Exceptions to this rule include the umbilical veins and the pulmonary veins which carry oxygenated...
subject wise Q & A of AIIMS NOV 2007 - Anatomy 1. Which is the most superior structure at hilum of left lung? a.pulmonary vein b.pulmanary...
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2011 Sascha Ring under exclusive licence to Mute Artists LtdThis label copy information is the subject of copyright protection. All rights reserved.© 2011 Mute Artists Ltd ...
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Vol 47: Surgery for Partial Anomalous Pulmonary Venous Connections: Modification of the Warden Procedure with a Right Atrial Appendage Flap.. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
Kitkungvan D et al.. J Am Coll Cardiol Img. 2016;():. doi:10.1016/j.jcmg.2015.11.029 Link: https://imaging.onlinejacc.org/article.aspx?articleid=2524096. Objectives The goal of this study was to evaluate the diagnostic performance of a comprehensive, multicomponent cardiac magnetic resonance (CMR) study for assessment of left atrial (LA) and left atrial appendage (LAA) thrombus.. Background Pre-operative evaluation for pulmonary vein isolation (PVI) typically requires tomographic imaging to define pulmonary venous anatomy and transesophageal echocardiogram (TEE) to assess for the presence of LA/LAA thrombus. CMR is increasingly being used to define pulmonary venous anatomy before PVI. Limited data are available on the utility of a multicomponent CMR protocol in assessing LA/LAA thrombus.. Methods We studied patients who underwent multicomponent CMR for evaluation of pulmonary venous anatomy before PVI and underwent TEE within 7 days. LA and LAA thrombi were evaluated by using CMR as follows: 1) ...
Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly in which some of the pulmonary veins drain erroneously into the superior vena cava (SVC) or directly into the right atrium (RA). We present four cases of PAPVR presenting in adults. We discussed various presentations, diagnostic approaches and challenges in the management of these patients. Our first case had anomalous drainage from the right upper lobe of lung to SVC and was managed medically with riociguat and ambrisentan. The second patient had an unsuccessful attempt at repair of the anomalous vein. Our other two patients had right upper lobe veins draining into SVC. One of them had a successful surgical repair whereas the other patient declined surgery and is being monitored. In PAPVR patients, the decision for surgical repair depends on symptoms, shunt fraction, recurrent pulmonary infections, and concurrent indication for cardiac surgery.
Learn more about Anomalous Pulmonary Venous Return - TAPVR or PAPVR symptoms, diagnosis, and treatments from experts at Boston Childrens, ranked best Childrens Hospital by US News.
TY - JOUR. T1 - Elimination of triggers without an additional substrate modification is not sufficient in patients with persistent atrial fibrillation. AU - Park, Junbeom. AU - Pak, Hui Nam. PY - 2015/2/1. Y1 - 2015/2/1. N2 - Atrial fibrillation (AF) is a multifactorial disease with complex pathophysiology. Although restoring sinus rhythm delays the progression of atrial remodeling, non-pharmacologic intervention, such as radiofrequency catheter ablation (RFCA), should be done based on the background pathophysiology of the disease. While circumferential pulmonary vein isolation (CPVI) has been known to be the cornerstone of AF catheter ablation, a clinical recurrence rate after CPVI is high in patients with persistent AF (PeAF). Step-wise linear ablation, complex fractionate atrial electrogram (CFAE)-guided ablation, rotor ablation, ganglionate plexus ablation, and left atrial appendage isolation may improve the ablation success rate after CPVI. But, there are still substantial AF recurrences ...
Ventricular septal defect (VSD), Atrial septal defect (ASD), Patent ductus arteriosus (PDA), Mitral insufficiency (MI), Anterior mitral valve cleft (AMVC), Mitral valve cleft (MVC), Tricuspid insufficiency (TI), Aortic coarctation (AC), Bicuspid aortic valve (BAV), Mitral valve prolapsed (MVP), Cor triatriatum (CTA), Partial anomalous pulmonary venous connection (PAPVC), Total anomalous pulmonary venous connection (TAPVC) ...
A diagnosis of congenital unilateral pulmonary vein atresia (CUPVA) was made. The patient experienced shortness of breath only after intense exercise and there was no pulmonary infection or recurrent haemoptysis. She was closely monitored, and light-intensity physical activity was permitted.. Unilateral diffuse pulmonary parenchymal lesions are clinically rare. The causes of these lesions include focal chronic inflammatory diseases, such as bronchiectasis and gastro-oesophageal reflux, radiation pneumonitis and mechanical ventilation of a unilateral lung.1 Unilateral diffuse pulmonary parenchymal lesions have also been reported in diseases, such as Sjogrens syndrome and systemic sclerosis.1 Additional rare causes of unilateral lesions include pulmonary circulatory diseases, such as proximal PA blockage (eg, PA sarcoma), venous thrombosis and unilateral pulmonary vein stenosis due to mediastinal fibrosis. In adult patients with CUPVA, long-term pulmonary circulation abnormalities can cause ...
The target group of patients are subjects ages ,65 years, with paroxysmal or persistent atrial fibrillation, who have out of range hypertension (systolic ,140 mmHg or ,130/80 mmHg in diabetics and patients with chronic renal disease) or signs of sympathetic overdrive. Patients should use at least 2 anti-hypertensives or should be intolerant for antihypertensive medication.. Atrial fibrillation terminology: If atrial fibrillation recurs more than once but terminates spontaneously within seven days, the term paroxysmal AF is used. This is also used when the episode is less than 48 hours in duration and is terminated with electrical or pharmacological cardioversion. Persistent AF is defined as recurrent AF that is sustained for more than seven days. A patient that is electrically or pharmacologically cardioverted after more than two days is also diagnosed with persistent AF.. After the exclusion of apparent secondary causes of hypertension, patients will be randomized to one of the following ...
Asymmetric ventricles , with left ventricle smaller than right is seen occasionally. The following conditions should be thought of : 1. Co-arctation of Aorta 2. T.A.P.V.D. - Total Anomalous Pulmonary Venous Drainage ( or Connections ) 3.Persistent Left Superior Vena Cava 4.Dilated Coronary Sinus and rarely due to 5. Restricted Ductal Flow due to kinking…
Disorders considered include patent ductus arteriosus, coarctation of the thoracic aorta, pulmonary stenosis, aortic stenosis, atrial septal defect, ventricular septal defect, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great vessels, tricuspid and pulmonary atresia, truncus arteriosus, anomalies of coronary arteries, and vascular ring of the aorta. Text briefly considers case history, anatomy, embryology, and diagnosis. Most of the text is given to indications for operation, to surgical methods and complications, and to results. Generously illustrated with drawings of surgical procedure, less generously with plain and angiocardiographic roentgenograms. No electrocardiograms. Inadequate for the medical cardiologist as reference ...
SEE PAGE 14 D urable isolation following pulmonary vein (PV) ablation may not be necessary for effective suppression of atrial fibrillation (AF) in certain patients with AF. However, most patients are thought to benefit from durable PV isolation, because PV reconnection seems to by and large underlie the mechanism of AF following catheter ablation (1). A recent study found that among patients undergoing $3 radiofrequency (RF) catheter ablations for AF, presence of durable isolation in all PVs was only noted in w8% (2). It has been shown that in most cases, PV conduction recovery occurs rapidly, with as many as one-third of targeted PVs and four-fifths of those that recover electrical conduction reconnecting in as little as 30 min (3). Moreover, there still remains the possibility that conduction block may be observed despite presence of a conduction gap. Ranjan et al. (4) created a 2-dimensional model of the cardiac syncytium simulating RF ablation lines with gaps of varying lengths, conductivity, and
Iatrogenic ATs have been reported after either surgical or catheter ablation of AF.7-14 After ablation of paroxysmal AF (wherein the initial ablation procedure is predominantly directed to PV isolation), the mechanism of AT is virtually always focal, originating from reconnected PVs.10 However, ablation of persistent AF typically involves LA, and sometimes RA, "substrate" ablation (linear lesions and ablation of sites of complex fractionated electrograms) beyond simple PV isolation. Here, we report a novel approach to mapping these postablation scar-related ATs by using a combination of activation mapping with a multielectrode array mapping catheter and targeted entrainment mapping.. The mechanisms of postablation ATs depend to a large extent on the ablation performed in the index procedure. A segmental approach to PV isolation, confirmed with a circular mapping catheter, resulted in most postablation ATs being of a focal mechanism from reconnected PV ostia.10,12 Anatomic approaches have been ...
View details of top pulmonary arteriovenous fistula hospitals in New Delhi. Get guidance from medical experts to select best pulmonary arteriovenous fistula hospital in New Delhi
Pulmonary arteriovenous fistulas.: Previously reported from our institution has been a series of 63 patients with pulmonary arteriovenous fistula who were seen
Thanks to the TRACERx nationwide team effort, including adoption of pulmonary vein (PV) blood sampling at surgery, we enriched and enumerated epithelial cells from the PV of 100 patients. These putative tumour cells were found in 48/100 patients and their prevalence was associated with poorer disease-free survival, confirming our pilot data. Whilst analysis in a larger cohort is required to validate this finding, the implication is that epithelial cell number in the PV at surgery could identify those patients at higher risk of relapse who need more frequent monitoring with serial ctDNA analysis4. We also discovered across the patient cohort that the majority of epithelial cells in the PV blood harboured few or no genomic aberrations. This mixed population of bona fide CTCs with cancer genomes and apparently normal epithelial cells in the bloodstream may have diluted the strength of lung cancer recurrence prediction. Further studies using more sensitive CTC technologies, including detection of ...
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Editors Note: This is a series of extremely cogent presentations delivered by ISECT (Indian Society of Extracorporeal Circulation). The source article can be viewed here- http://www.isect.org/ASD.pdf. Right Superior Vena Cava Draining to Roof of Left Atrium The preoperative diagnosis in this patient was sinus venosus ASD with possible partial anomalous pulmonary venous connection. = - […]. ...
Author Response.pdf. Reviewer 2 Report. This paper tests the hypothesis that the Kolmogorov complexity of a single atrial bipolar electrogram recorded during AF within the coronary sinus at the beginning of the catheter ablation may predict AF termination directly after pulmonary vein isolation (PVI). Results show significant differences in Kolmogorov complexity between patients with AF termination directly after PVI compared to patients undergoing additional ablation. Therefore, authors affirm that Kolmogorov complexity of electrograms measured at baseline before PVI can predict self-termination of AF directly after PVI. Overall, I believe that the goal of this study is very interesting and the tools used are appropriate. However, I have several major comments regarding the paper:. Authors talk about complexity measures, however they are different types of measurements and they do not measure complexity. Additional 30 second electrograms recorded 30 prior to AF termination were analyzed as the ...
The contrast enhancement of the heart and lung after intravenous injection follows certain anatomical rules. First the right atrium (video 1, RA), right ventricle (video 1, RV), pulmonary artery, lung parenchyma (video 2, LUNG) and pulmonary veins are enhancing followed by the left atrium (video 1, LA), left ventricle (video 1, LV), coronary arteries & myocardium (video 1, MYO), aorta (video 2, AORTA), bronchial arteries (BA) and the systemic vessels (video 2 including hepatic arteries, portal venous system and liver parenchyma). In other words the venous blood from the heart to the lung parenchyma is featured, which is mandatory for the gaseous exchange. Thereafter, the systemic arterial vascular system is enhancing. In the lung the analysis of the dual blood supply allows the differentiation of lung emboli (pulmonary artery vascular supply followed by pulmonary vein washout) and neoplasia (bronchial artery vascular supply followed by bronchial vein washout). In the liver the dual blood supply ...
Thomson, Sereen Rose and Ommurugan, Balaji and Patil, Navin (2017) Ceftriaxone induced hypersensitivity reactions following intradermal skin test: case series. Journal of Clinical and Diagnostic Research, 11 (10). FR01-FR04. ISSN 0973-709X Agarwal, Saurabh and Balaji, O and Priya, Amita and Patil, Navin (2017) Warfarin-induced alopecia: A rare case report. Asian Journal of Pharmaceutical and Clinical Research, 10 (10). pp. 17-18. ISSN 0974-2441 Balaji, O and Bairy, KL and Priya, Amita and Thomas, Joseph and Patil, Navin (2017) A fatal case of bilateral interstitial pneumonia (blip): Interferon alpha 2 a induced. Asian Journal of Pharmaceutical and Clinical Research, 10 (10). pp. 15-16. ISSN 0974-2441 Rao, Karthik N and Patil, Navin and Balaji, O and Kotian, Rahul P (2017) Hypertrophic cardiomyopathy with partial anomalous pulmonary venous connection and atrial septal defect: A rare presentation. Asian Journal of Pharmaceutical and Clinical Research, 10 (8). pp. 5-7. ISSN 0974-2441 Anuhya, TV and ...