A congenital anomaly caused by the failed development of TRUNCUS ARTERIOSUS into separate AORTA and PULMONARY ARTERY. It is characterized by a single arterial trunk that forms the outlet for both HEART VENTRICLES and gives rise to the systemic, pulmonary, and coronary arteries. It is always accompanied by a ventricular septal defect.
The arterial trunk arising from the fetal heart. During development, it divides into AORTA and the PULMONARY ARTERY.
A congenital heart defect characterized by the persistent opening of fetal DUCTUS ARTERIOSUS that connects the PULMONARY ARTERY to the descending aorta (AORTA, DESCENDING) allowing unoxygenated blood to bypass the lung and flow to the PLACENTA. Normally, the ductus is closed shortly after birth.
A fetal blood vessel connecting the pulmonary artery with the descending aorta.
Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.
Radiography of the heart and great vessels after injection of a contrast medium.
Congenital syndrome characterized by a wide spectrum of characteristics including the absence of the THYMUS and PARATHYROID GLANDS resulting in T-cell immunodeficiency, HYPOCALCEMIA, defects in the outflow tract of the heart, and craniofacial anomalies.
Congenital, inherited, or acquired anomalies of the CARDIOVASCULAR SYSTEM, including the HEART and BLOOD VESSELS.
Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.
'Abnormalities, Multiple' is a broad term referring to the presence of two or more structural or functional anomalies in an individual, which may be genetic or environmental in origin, and can affect various systems and organs of the body.
Flaps of tissue that prevent regurgitation of BLOOD from the HEART VENTRICLES to the HEART ATRIA or from the PULMONARY ARTERIES or AORTA to the ventricles.
A specific pair of GROUP G CHROMOSOMES of the human chromosome classification.
The pathologic narrowing of the orifice of the PULMONARY VALVE. This lesion restricts blood outflow from the RIGHT VENTRICLE to the PULMONARY ARTERY. When the trileaflet valve is fused into an imperforate membrane, the blockage is complete.
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
An infant during the first month after birth.
The two longitudinal ridges along the PRIMITIVE STREAK appearing near the end of GASTRULATION during development of nervous system (NEURULATION). The ridges are formed by folding of NEURAL PLATE. Between the ridges is a neural groove which deepens as the fold become elevated. When the folds meet at midline, the groove becomes a closed tube, the NEURAL TUBE.
The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA.
The hollow, muscular organ that maintains the circulation of the blood.

Structural abnormalities of great arterial walls in congenital heart disease: light and electron microscopic analyses. (1/16)

BACKGROUND: Great arteries in congenital heart disease (CHD) may dilate, become aneurysmal, or rupture. Little is known about medial abnormalities in these arterial walls. Accordingly, we studied 18 types of CHD in patients from neonates to older adults. METHODS AND RESULTS: Intraoperative biopsies from ascending aorta, paracoarctation aorta, truncus arteriosus, and pulmonary trunk in 86 patients were supplemented by 16 necropsy specimens. The 102 patients were 3 weeks to 81 years old (average, 32+/-6 years). Biopsies were examined by light (LM) and electron (EM) microscopy; necropsy specimens by LM. Positive aortic controls were from 15 Marfan patients. Negative aortic controls were from 11 coronary artery disease patients and 1 transplant donor. Nine biopsies from acquired trileaflet aortic stenosis were compared with biopsies from bicuspid aortic stenosis. Negative pulmonary trunk controls were from 7 coronary artery disease patients. A grading system consisted of negative controls and grades 1, 2, and 3 (positive controls) based on LM and EM examination of medial constituents. CONCLUSIONS: Medial abnormalities in ascending aorta, paracoarctation aorta, truncus arteriosus, and pulmonary trunk were prevalent in patients with a variety of forms of CHD encompassing a wide age range. Aortic abnormalities may predispose to dilatation, aneurysm, and rupture. Pulmonary trunk abnormalities may predispose to dilatation and aneurysm; hypertensive aneurysms may rupture. Pivotal questions are whether these abnormalities are inherent or acquired, whether CHD plays a causal or facilitating role, and whether genetic determinants are operative.  (+info)

Targeted disruption of semaphorin 3C leads to persistent truncus arteriosus and aortic arch interruption. (2/16)

Semaphorin 3C is a secreted member of the semaphorin gene family. To investigate its function in vivo, we have disrupted the semaphorin 3C locus in mice by targeted mutagenesis. semaphorin 3C mutant mice die within hours after birth from congenital cardiovascular defects consisting of interruption of the aortic arch and improper septation of the cardiac outflow tract. This phenotype is similar to that reported following ablation of the cardiac neural crest in chick embryos and resembles congenital heart defects seen in humans. Semaphorin 3C is expressed in the cardiac outflow tract as neural crest cells migrate into it. Their entry is disrupted in semaphorin 3C mutant mice. These data suggest that semaphorin 3C promotes crest cell migration into the proximal cardiac outflow tract.  (+info)

Structure of the conus arteriosus of the sturgeon (Acipenser naccarii) heart. I: the conus valves and the subendocardium. (3/16)

Sturgeons are bony fish that retain structural traits typical of the more primitive Chondrostei. From an evolutionary viewpoint, sturgeons are considered relic fish. However, they show remarkable ecological plasticity and are well adapted to contemporary environmental conditions. Although development of the cardiovascular system is critical for all organs and systems, and is affected by evolutionary changes, the structure of the sturgeon heart has been mostly overlooked. This is also true for the conus arteriosus, which, as in Chondrostei, is endowed with several rows of valves and a layer of contractile myocardium. This work reports on the structure of the valves, the endocardium, and the subendocardium of the conus arteriosus of the sturgeon (Acipenser naccarii) heart. It is part of a broader study that aims to cover the entire structure of the sturgeon heart. The conus arteriosus of 15 A. naccarii hearts, ranging in age from juveniles to sexually-differentiated adults, has been studied by conventional light, transmission (TEM), and scanning electron microscopy (SEM). In addition, maceration of the soft tissues with NaOH, and actin localization by fluorescent phalloidin has been used. The conus is a tubular chamber that arises from the right ventricular side and presents two constrictions at the conus-ventricle and conus-aorta junctions. The conus is endowed with three rows of valves: one distal and two proximal. The segment of the conus located between the distal and the two proximal rows is devoid of valvular structures. The distal row has four leaflets, while the two proximal rows show the greatest variation in leaflet number, size, and shape. All leaflets have collagenous chordae tendineae arising from the free border and from the parietal side of the leaflets. The endocardium is a flat endothelium which shows a thick, irregular basement membrane. The leaflet body is formed by a loose connective tissue which blends with the subendocardium. The subendocardium is a connective tissue consisting of myofibroblasts, collagen, and elastin. It is divided into two distinct areas: one proximal, which shows little elastin and poorly organized collagen; and one distal, which is rich in elastin, with cells and extracellular fibers organized into layers that are oriented in alternative circumferential and longitudinal directions. The present report is the first systematic analysis of the structure of the sturgeon conus. Descriptions of the conus valves should recognize the existence of three valve rows only. The variability in valve morphology, and the loose structure of the leaflet tissue make it unlikely that the valves play an effective role in preventing blood backflow. In this regard, the ventricle-conus constriction may act as a sphincter. The subendocardium is an elastic coat capable of actively sustaining the tissue deformation that accompanies the heart contractile cycle. Further comparative studies are needed to provide deeper insight into the structural changes that accompany phyletic diversification.  (+info)

The structure of the conus arteriosus of the sturgeon (Acipenser naccarii) heart: II. The myocardium, the subepicardium, and the conus-aorta transition. (4/16)

Sturgeons constitute a family of living "fossil" fish whose heart is related to that of other ancient fish and the elasmobranches. We have undertaken a systematic study of the structure of the sturgeon heart aimed at unraveling the relationship between the heart structure and the adaptive evolutionary changes. In a related paper, data were presented on the conus valves and the subendocardium. Here, the structure of the conus myocardium, the subepicardial tissue, and the conus-aorta transition were studied by conventional light, transmission, and scanning electron microscopy. In addition, actin localization by fluorescent phalloidin was used. The conus myocardium is organized into bundles whose spatial organization changes along the conus length. The variable orientation of the myocardial cell bundles may be effective in emptying the conus lumen during contraction and in preventing reflux of blood. Myocardial cell bundles are separated by loose connective tissue that contains collagen and elastin fibers, vessels, and extremely flat cells separating the cell bundles and enclosing blood vessels and collagen fibers. The ultrastructure of the myocardial cells was found to be very similar to that of other fish groups, suggesting that it is largely conservative. The subepicardium is characterized by the presence of nodular structures that contain lympho-hemopoietic (thymus-like) tissue in the young sturgeons and a large number of lymphocytes after the sturgeons reach sexual maturity. This tissue is likely implicated in the establishment and maintenance of the immune responses. The intrapericardial ventral aorta shows a middle layer of circumferentially oriented cells and internal and external layers with cells oriented longitudinally. Elastin fibers completely surround each smooth muscle cell, and the spaces between the different layers are occupied by randomly arranged collagen bundles. The intrapericardial segment of the ventral aorta is a true transitional segment whose structural characteristics are different from those of both the conus subendocardium and the rest of the ventral aorta.  (+info)

Septation and separation within the outflow tract of the developing heart. (5/16)

The developmental anatomy of the ventricular outlets and intrapericardial arterial trunks is a source of considerable confusion. First, major problems exist because of the multiple names and definitions used to describe this region of the heart as it develops. Second, there is no agreement on the boundaries of the described components, nor on the number of ridges or cushions to be found dividing the outflow tract, and the pattern of their fusion. Evidence is also lacking concerning the role of the fused cushions relative to that of the so-called aortopulmonary septum in separating the intrapericardial components of the great arterial trunks. In this review, we discuss the existing problems, as we see them, in the context of developmental and postnatal morphology. We concentrate, in particular, on the changes in the nature of the wall of the outflow tract, which is initially myocardial throughout its length. Key features that, thus far, do not seem to have received appropriate attention are the origin, and mode of separation, of the intrapericardial portions of the arterial trunks, and the formation of the walls of the aortic and pulmonary valvar sinuses. Also as yet undetermined is the formation of the free-standing muscular subpulmonary infundibulum, the mechanism of its separation from the aortic valvar sinuses, and its differentiation, if any, from the muscular ventricular outlet septum.  (+info)

Histological study of the proximal and distal segments of the embryonic outflow tract and great arteries. (6/16)

The normal development of the ventricular outlets and proximal region of the great arteries is a controversial subject. It is known that the conus, truncus arteriosus (truncus), and aortic sac participate; however, there are some doubts as to the actual prospective fate of the truncus. Some authors propose that it gives origin to the proximal region of the great arteries and that the myocardial cells of its wall become smooth muscle. Nevertheless, others think that the truncus only forms the arterial valve apparatus and that therefore the myocardial cells transform into fibroblasts. As a first approach to beginning to elucidate which process occurs, the aim of this article was to study the histological changes in the wall of these components of the developing heart in chick embryos whose hearts had been labeled at the truncoconal boundary at stage 22HH, tracing the changes up to stage 36HH. Also, the histological constitution of the wall of the pulmonary arterial trunk and its valve apparatus were studied in the posthatching and adult hearts of chickens and rats. The conus and truncus walls were always encircled by a myocardial sleeve from the outset of their development. Between stages 26HH to 28HH, the truncal myocardial cells adjacent to the mesenchymal tissue of the ridges began to lose cell-to-cell contacts and invaded the extracellular matrix. At stage 24HH, the aortic sac began to project into the pericardial cavity and became divided into two channels by the aortic-pulmonary septum at stage 26HH. The wall of the aortic sac is mostly constituted by a compact mesenchymal tissue. Initially, it does not have smooth muscle but this starts to appear at stage 30HH. The insertion ring of the valves, a broad structure, was formed by mesenchymal tissue. Both structures were always covered by a myocardial sleeve. The leaflets developed from the truncal ridges, the segment immediately proximal to the aortic sac. Our results indicate that the proximal region of the pulmonary and aortic arteries do not originate from the truncus arteriosus; rather, we found that they take origin from the aortic sac. Thus, our findings agree with the proposal that the myocardial cells of the external sleeve of the truncus become fibroblastic and suggest that the insertion ring of the arterial valves has a dual origin: fibroblasts produced by truncal myocardial transdiferentiation and the mesenchymal tissue of the proximal region of the truncal ridges, while the leaflets have their origin from the truncal ridges. We discuss the fact that, because the truncus arteriosus does not give origin to the trunks of the aortic and pulmonary arteries, it may be necessary to modify terminology. Based on our results, together with the new findings obtained by in vivo labeling, immunostaining, a chimeric approach, and ultrastructural studies, we propose a developmental model that correlates the fate of the conus, truncus, and aortic sac with the normal morphogenesis of the ventricular outlet tracts and the trunks of the great arteries. (c) 2005 Wiley-Liss, Inc.  (+info)

Repair of conotruncal abnormalities with the use of the valved conduit: improved early and midterm results with the cryopreserved homograft. (7/16)

Repair of complex cardiac lesions has been facilitated by the availability of valved conduits to reestablish right ventricular to pulmonary artery continuity. From 1977 to June 1991, 148 patients underwent repair with insertion of a conduit. Their mean age was 6.6 years (11 days to 45 years). The diagnosis was transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction in 51, truncus arteriosus in 36, pulmonary atresia with ventricular septal defect in 25, tetralogy of Fallot in 19, double-outlet right ventricle in 10, pulmonary atresia with intact ventricular septum in 6 and atrioventricular canal with pulmonary atresia in 1. A Dacron porcine-valved conduit was used in 37, a homograft conduit in 106 and a nonvalved conduit in 5. There were 13 early deaths overall (8.8%); 8 (22%) of the early deaths occurred in the 37 patients who received a Dacron graft, 4 (3.8%) occurred in the 106 patients who received a homograft and 1 occurred in a patient with a nonvalved Gore-Tex conduit. An additional patient underwent orthotopic heart transplantation in the early postoperative period. In 117 patients operated on from January 1985 to June 1991 the early mortality rate was 2.6% (3 of 117). Among 28 patients receiving a Dacron porcine-valved graft there were two late deaths (7.1%) after a mean follow-up interval of 93 months, and 8 patients required reoperation for conduit obstruction. Among 102 homograft recipients there were two late deaths (1.9%).(ABSTRACT TRUNCATED AT 250 WORDS)  (+info)

Cardiac outflow tract: a review of some embryogenetic aspects of the conotruncal region of the heart. (8/16)

A review concerning some embryogenetic aspects of the cardiac outflow tract is presented. Two main topics are discussed: the truncal septation and the secondary heart field. In the context of the septation of the truncus arteriosus, the development of the arterial valves is largely discussed, particularly in reference to the sinuses of Valsalva. Emphasis is also given to the fate of the external myocardial wall of the truncus arteriosus, as this primordial myocardial surface disappears later in the development. Molecular genetics data concerning Sox4 and NF-Atc transcription factors are correlated in the present review with rare forms of truncus malformations encountered in human pathology. The roles exerted by the secondary heart field and the neural crest on the development and growth of the conotruncal musculature are largely discussed. Reported experimental ablations of both secondary heart field and neural crest, showed conotruncal defects such as persistent truncus arteriosus, tetralogy of Fallot, and double-outlet right ventricle, which were considered as the result of a short outflow tract causing, ultimately, a lack of conotruncal rotation. In this regard, some morphologic correlations are carried out, in the present review, between these experimental animal models and human malformations, and it is thought that this sort of conotruncal defects cannot be explained always in terms of conotruncal hypoplasia. Finally, influence of Pitx2c, a left-right laterality signaling gene, on the modulation of the conotruncal rotation, as most recently reported, is emphasized in terms of very likely multifactorial contributions in the embryogenesis of the conotruncal region of the heart.  (+info)

Persistent Truncus Arteriosus is a rare congenital heart defect that is characterized by the failure of the truncus arteriosus to divide into the separate pulmonary artery and aorta during fetal development. This results in a single large vessel, the truncus arteriosus, which gives rise to both the systemic and pulmonary circulations.

The truncus arteriosus contains a single semilunar valve, instead of the two separate semilunar valves (pulmonary and aortic) found in a normal heart. Additionally, there is often a ventricular septal defect (VSD), a hole in the wall between the two lower chambers of the heart, present.

This condition leads to mixing of oxygenated and deoxygenated blood within the truncus arteriosus, resulting in cyanosis (bluish discoloration of the skin and mucous membranes) and decreased oxygen delivery to the body. Symptoms typically appear soon after birth and may include difficulty breathing, poor feeding, rapid heart rate, and failure to thrive.

Persistent truncus arteriosus is usually treated with surgical repair in infancy or early childhood to separate the pulmonary and systemic circulations, close the VSD, and reconstruct the great vessels as needed.

Truncus Arteriosus is a congenital heart defect where a single large vessel arises from the heart, instead of separate pulmonary and aortic trunks. This results in the mixing of oxygenated and deoxygenated blood within the truncus. The truncus then divides into systemic, coronary, and pulmonary arteries. It's usually associated with a ventricular septal defect. This condition is often diagnosed early in life due to cyanosis (bluish discoloration of the skin) and heart murmurs. Surgical correction is required for survival.

Patent Ductus Arteriosus (PDA) is a congenital heart defect in which the ductus arteriosus, a normal fetal blood vessel that connects the pulmonary artery and the aorta, fails to close after birth. The ductus arteriosus allows blood to bypass the lungs while the fetus is still in the womb, but it should close shortly after birth as the newborn begins to breathe and oxygenate their own blood.

If the ductus arteriosus remains open or "patent," it can result in abnormal blood flow between the pulmonary artery and aorta. This can lead to various cardiovascular complications, such as:

1. Pulmonary hypertension (high blood pressure in the lungs)
2. Congestive heart failure
3. Increased risk of respiratory infections

The severity of the symptoms and the need for treatment depend on the size of the PDA and the amount of blood flow that is shunted from the aorta to the pulmonary artery. Small PDAs may close on their own over time, while larger PDAs typically require medical intervention, such as medication or surgical closure.

The Ductus Arteriosus is a fetal blood vessel that connects the pulmonary trunk (the artery that carries blood from the heart to the lungs) and the aorta (the largest artery in the body, which carries oxygenated blood from the heart to the rest of the body). This vessel allows most of the blood from the right ventricle of the fetal heart to bypass the lungs, as the fetus receives oxygen through the placenta rather than breathing air.

After birth, with the first breaths, the blood oxygen level increases and the pressure in the lungs rises. As a result, the circulation in the newborn's body changes, and the Ductus Arteriosus is no longer needed. Within the first few days or weeks of life, this vessel usually closes spontaneously, turning into a fibrous cord called the Ligamentum Arteriosum.

Persistent Patency of the Ductus Arteriosus (PDA) occurs when the Ductus Arteriosus does not close after birth, which can lead to various complications such as heart failure and pulmonary hypertension. This condition is often seen in premature infants and may require medical intervention or surgical closure of the vessel.

Congenital heart defects (CHDs) are structural abnormalities in the heart that are present at birth. They can affect any part of the heart's structure, including the walls of the heart, the valves inside the heart, and the major blood vessels that lead to and from the heart.

Congenital heart defects can range from mild to severe and can cause various symptoms depending on the type and severity of the defect. Some common symptoms of CHDs include cyanosis (a bluish tint to the skin, lips, and fingernails), shortness of breath, fatigue, poor feeding, and slow growth in infants and children.

There are many different types of congenital heart defects, including:

1. Septal defects: These are holes in the walls that separate the four chambers of the heart. The two most common septal defects are atrial septal defect (ASD) and ventricular septal defect (VSD).
2. Valve abnormalities: These include narrowed or leaky valves, which can affect blood flow through the heart.
3. Obstruction defects: These occur when blood flow is blocked or restricted due to narrowing or absence of a part of the heart's structure. Examples include pulmonary stenosis and coarctation of the aorta.
4. Cyanotic heart defects: These cause a lack of oxygen in the blood, leading to cyanosis. Examples include tetralogy of Fallot and transposition of the great arteries.

The causes of congenital heart defects are not fully understood, but genetic factors and environmental influences during pregnancy may play a role. Some CHDs can be detected before birth through prenatal testing, while others may not be diagnosed until after birth or later in childhood. Treatment for CHDs may include medication, surgery, or other interventions to improve blood flow and oxygenation of the body's tissues.

Angiocardiography is a medical procedure used to examine the heart and blood vessels, particularly the chambers of the heart and the valves between them. It involves injecting a contrast agent into the bloodstream and taking X-ray images as the agent flows through the heart. This allows doctors to visualize any abnormalities such as blockages, narrowing, or leakage in the heart valves or blood vessels.

There are different types of angiocardiography, including:

* Left heart catheterization (LHC): A thin tube called a catheter is inserted into a vein in the arm or groin and threaded through to the left side of the heart to measure pressure and oxygen levels.
* Right heart catheterization (RHC): Similar to LHC, but the catheter is threaded through to the right side of the heart to measure pressure and oxygen levels there.
* Selective angiocardiography: A catheter is used to inject the contrast agent into specific blood vessels or chambers of the heart to get a more detailed view.

Angiocardiography can help diagnose and evaluate various heart conditions, including congenital heart defects, coronary artery disease, cardiomyopathy, and valvular heart disease. It is an invasive procedure that carries some risks, such as bleeding, infection, and damage to blood vessels or heart tissue. However, it can provide valuable information for diagnosing and treating heart conditions.

DiGeorge syndrome is a genetic disorder caused by the deletion of a small piece of chromosome 22. It is also known as 22q11.2 deletion syndrome. The symptoms and severity can vary widely among affected individuals, but often include birth defects such as congenital heart disease, poor immune system function, and palatal abnormalities. Characteristic facial features, learning disabilities, and behavioral problems are also common. Some people with DiGeorge syndrome may have mild symptoms while others may be more severely affected. The condition is typically diagnosed through genetic testing. Treatment is focused on managing the specific symptoms and may include surgery, medications, and therapy.

Cardiovascular abnormalities refer to structural or functional anomalies in the heart or blood vessels. These abnormalities can be present at birth (congenital) or acquired later in life. They can affect the heart's chambers, valves, walls, or blood vessels, leading to various complications such as heart failure, stroke, or even death if left untreated.

Examples of congenital cardiovascular abnormalities include:

1. Septal defects - holes in the walls separating the heart's chambers (atrial septal defect, ventricular septal defect)
2. Valvular stenosis or insufficiency - narrowing or leakage of the heart valves
3. Patent ductus arteriosus - a persistent opening between the aorta and pulmonary artery
4. Coarctation of the aorta - narrowing of the aorta
5. Tetralogy of Fallot - a combination of four heart defects, including ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy

Examples of acquired cardiovascular abnormalities include:

1. Atherosclerosis - the buildup of plaque in the arteries, leading to narrowing or blockage
2. Cardiomyopathy - disease of the heart muscle, causing it to become enlarged, thickened, or stiffened
3. Hypertension - high blood pressure, which can damage the heart and blood vessels over time
4. Myocardial infarction (heart attack) - damage to the heart muscle due to blocked blood supply
5. Infective endocarditis - infection of the inner lining of the heart chambers and valves

These abnormalities can be diagnosed through various tests, such as echocardiography, electrocardiogram (ECG), stress testing, cardiac catheterization, or magnetic resonance imaging (MRI). Treatment options depend on the type and severity of the abnormality and may include medications, medical procedures, or surgery.

A ventricular septal defect (VSD) is a type of congenital heart defect that involves a hole in the wall separating the two lower chambers of the heart, the ventricles. This defect allows oxygenated blood from the left ventricle to mix with deoxygenated blood in the right ventricle, leading to inefficient oxygenation of the body's tissues. The size and location of the hole can vary, and symptoms may range from none to severe, depending on the size of the defect and the amount of blood that is able to shunt between the ventricles. Small VSDs may close on their own over time, while larger defects usually require medical intervention, such as medication or surgery, to prevent complications like pulmonary hypertension and heart failure.

'Abnormalities, Multiple' is a broad term that refers to the presence of two or more structural or functional anomalies in an individual. These abnormalities can be present at birth (congenital) or can develop later in life (acquired). They can affect various organs and systems of the body and can vary greatly in severity and impact on a person's health and well-being.

Multiple abnormalities can occur due to genetic factors, environmental influences, or a combination of both. Chromosomal abnormalities, gene mutations, exposure to teratogens (substances that cause birth defects), and maternal infections during pregnancy are some of the common causes of multiple congenital abnormalities.

Examples of multiple congenital abnormalities include Down syndrome, Turner syndrome, and VATER/VACTERL association. Acquired multiple abnormalities can result from conditions such as trauma, infection, degenerative diseases, or cancer.

The medical evaluation and management of individuals with multiple abnormalities depend on the specific abnormalities present and their impact on the individual's health and functioning. A multidisciplinary team of healthcare professionals is often involved in the care of these individuals to address their complex needs.

Heart valves are specialized structures in the heart that ensure unidirectional flow of blood through its chambers during the cardiac cycle. There are four heart valves: the tricuspid valve and the mitral (bicuspid) valve, located between the atria and ventricles, and the pulmonic (pulmonary) valve and aortic valve, located between the ventricles and the major blood vessels leaving the heart.

The heart valves are composed of thin flaps of tissue called leaflets or cusps, which are supported by a fibrous ring. The aortic and pulmonic valves have three cusps each, while the tricuspid and mitral valves have three and two cusps, respectively.

The heart valves open and close in response to pressure differences across them, allowing blood to flow forward into the ventricles during diastole (filling phase) and preventing backflow of blood into the atria during systole (contraction phase). A properly functioning heart valve ensures efficient pumping of blood by the heart and maintains normal blood circulation throughout the body.

Human chromosome pair 22 consists of two rod-shaped structures present in the nucleus of each cell in the human body. Each chromosome is made up of DNA tightly coiled around histone proteins, forming a complex structure called a chromatin.

Chromosome pair 22 is one of the 22 autosomal pairs of human chromosomes, meaning they are not sex chromosomes (X or Y). Chromosome 22 is the second smallest human chromosome, with each arm of the chromosome designated as p and q. The short arm is labeled "p," and the long arm is labeled "q."

Chromosome 22 contains several genes that are associated with various genetic disorders, including DiGeorge syndrome, velocardiofacial syndrome, and cat-eye syndrome, which result from deletions or duplications of specific regions on the chromosome. Additionally, chromosome 22 is the location of the NRXN1 gene, which has been associated with an increased risk for autism spectrum disorder (ASD) and schizophrenia when deleted or disrupted.

Understanding the genetic makeup of human chromosome pair 22 can provide valuable insights into human genetics, evolution, and disease susceptibility, as well as inform medical diagnoses, treatments, and research.

Pulmonary Valve Stenosis is a cardiac condition where the pulmonary valve, located between the right ventricle and the pulmonary artery, has a narrowed opening. This stenosis (narrowing) can cause obstruction of blood flow from the right ventricle to the lungs. The narrowing can be caused by a fusion of the valve leaflets, thickened or calcified valve leaflets, or rarely, a dysplastic valve.

The severity of Pulmonary Valve Stenosis is classified based on the gradient pressure across the valve, which is measured during an echocardiogram. A mild stenosis has a gradient of less than 30 mmHg, moderate stenosis has a gradient between 30-59 mmHg, and severe stenosis has a gradient of 60 mmHg or higher.

Mild Pulmonary Valve Stenosis may not require treatment, while more severe cases may need to be treated with balloon valvuloplasty or surgical valve replacement. If left untreated, Pulmonary Valve Stenosis can lead to right ventricular hypertrophy, heart failure, and other complications.

The pulmonary artery is a large blood vessel that carries deoxygenated blood from the right ventricle of the heart to the lungs for oxygenation. It divides into two main branches, the right and left pulmonary arteries, which further divide into smaller vessels called arterioles, and then into a vast network of capillaries in the lungs where gas exchange occurs. The thin walls of these capillaries allow oxygen to diffuse into the blood and carbon dioxide to diffuse out, making the blood oxygen-rich before it is pumped back to the left side of the heart through the pulmonary veins. This process is crucial for maintaining proper oxygenation of the body's tissues and organs.

A newborn infant is a baby who is within the first 28 days of life. This period is also referred to as the neonatal period. Newborns require specialized care and attention due to their immature bodily systems and increased vulnerability to various health issues. They are closely monitored for signs of well-being, growth, and development during this critical time.

The neural crest is a transient, multipotent embryonic cell population that originates from the ectoderm (outermost layer) of the developing neural tube (precursor to the central nervous system). These cells undergo an epithelial-to-mesenchymal transition and migrate throughout the embryo, giving rise to a diverse array of cell types and structures.

Neural crest cells differentiate into various tissues, including:

1. Peripheral nervous system (PNS) components: sensory neurons, sympathetic and parasympathetic ganglia, and glial cells (e.g., Schwann cells).
2. Facial bones and cartilage, as well as connective tissue of the skull.
3. Melanocytes, which are pigment-producing cells in the skin.
4. Smooth muscle cells in major blood vessels, heart, gastrointestinal tract, and other organs.
5. Secretory cells in endocrine glands (e.g., chromaffin cells of the adrenal medulla).
6. Parts of the eye, such as the cornea and iris stroma.
7. Dental tissues, including dentin, cementum, and dental pulp.

Due to their wide-ranging contributions to various tissues and organs, neural crest cells play a crucial role in embryonic development and organogenesis. Abnormalities in neural crest cell migration or differentiation can lead to several congenital disorders, such as neurocristopathies.

The thoracic aorta is the segment of the largest artery in the human body (the aorta) that runs through the chest region (thorax). The thoracic aorta begins at the aortic arch, where it branches off from the ascending aorta, and extends down to the diaphragm, where it becomes the abdominal aorta.

The thoracic aorta is divided into three parts: the ascending aorta, the aortic arch, and the descending aorta. The ascending aorta rises from the left ventricle of the heart and is about 2 inches (5 centimeters) long. The aortic arch curves backward and to the left, giving rise to the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. The descending thoracic aorta runs downward through the chest, passing through the diaphragm to become the abdominal aorta.

The thoracic aorta supplies oxygenated blood to the upper body, including the head, neck, arms, and chest. It plays a critical role in maintaining blood flow and pressure throughout the body.

In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.

Illustration of truncus arteriosus in a fully formed heart Failure of the truncus arteriosus to close results in the condition ... The truncus arteriosus and bulbus cordis are divided by the aorticopulmonary septum. The truncus arteriosus gives rise to the ... ISBN 978-0-07-163340-6. "Truncus Arteriosus , Pediatric Echocardiography". "Truncus Arteriosus Imaging: Overview, Radiography, ... known as persistent truncus arteriosus, a rare congenital heart defect. This is often just referred to as truncus arteriosus. ...
... (PTA), often referred to simply as truncus arteriosus, is a rare form of congenital heart disease ... Truncus arteriosus (embryology) Patent ductus arteriosus Ruan, Wen; Loh, Yee Jim; Guo, Kenneth Wei Qiang; Tan, Ju Le (2016). " ... Persistent truncus arteriosus is a rare cardiac abnormality that has a prevalence of less than 1%. Diagrams to illustrate the ... "eMedicine - Truncus Arteriosus : Article by Doff McElhinney, MD". Retrieved 2007-11-04. Van Praagh R, Van Praagh S (September ...
Persistent truncus arteriosus is when the truncus arteriosus fails to split into the aorta and pulmonary trunk. This occurs in ... "Persistent Truncus Arteriosus - Pediatrics". MSD Manual Professional Edition. Retrieved 2022-06-19. Cleveland Clinic (September ... persistent truncus arteriosus, and Ebstein's anomaly are various congenital cyanotic heart diseases, in which the blood of the ... "Truncus Arteriosus". Cleveland Clinic. Archived from the original on 2020-08-04. Bhat, Venkatraman (2016). "Illustrated Imaging ...
"Orphanet: Truncus arteriosus". www.orpha.net. Retrieved 20 November 2019. CDC (15 November 2019). "Congenital Heart Defects - ... CDC (22 January 2019). "Congenital Heart Defects - Facts about Truncus Arteriosus , CDC". Centers for Disease Control and ... Some babies born with cyanotic heart disease are treated with prostaglandin E1 after birth to keep the ductus arteriosus open ... Taussig had recognized that children with Tetralogy of Fallot who also had a patent ductus arteriosus (PDA) typically lived ...
Golberg, M.; Heitzman, G.; Kass, I.; Grow, J. B.; Hoffman, M. S. (1957-12-01). "Persistent truncus arteriosus; an unusual type ...
AMHR2 Persistent truncus arteriosus; 217095; NKX2-6 Peters anomaly; 604229; CYP1B1 Peters anomaly; 604229; PAX6 Peters anomaly ...
Burakovsky, V. I., Falkovsky, G. E., & Ivanitsky, A. V. (1984). Surgical repair of truncus arteriosus. Pediatric cardiology, 5( ... ductus arteriosus, atrial septal defect). Complex defects are those that occur with other anatomical anomalies or require non- ...
The truncus arteriosus is derived from it later. The adjacent walls of the bulbus cordis and ventricle approximate, fuse, and ... It receives blood from the primitive ventricle, and passes it to the truncus arteriosus. After heart looping, it is located ... while the junction of the bulbus with the truncus arteriosus is brought directly ventral to and applied to the atrial canal. By ...
The truncus arteriosus is a type of congenital heart disease which was object of study by Rastelli. It is characterized by a ... D.C. McGoon, G.C. Rastelli, P.A. Ongley, An Operation for the Correction of Truncus Arteriosus, JAMA 1968 Lo Russo, Lucertini, ... McGoon, Dwight C. (8 July 1968). "An Operation for the Correction of Truncus Arteriosus". JAMA: The Journal of the American ... His two surgical techniques, Rastelli 1 and Rastelli 2, have been fundamental in the classification of both truncus arteriosus ...
Mavroudis, C; Jonas, RA; Bove, EL (April 2015). "Personal glimpses into the evolution of truncus arteriosus repair". World ...
... associated with truncus arteriosus: a case report. Turk J Pediatr 2007;49:444e7 Jena AK, Kharbanda OP ... atrial septal defects or persistent truncus arteriosus. Other alterations described are craniofacial anomalies associated with ...
Less common defects in the association are truncus arteriosus and transposition of the great arteries.[citation needed] The ... If the separation is incomplete, the result is a "persistent truncus arteriosus". The vessels may be reversed ("transposition ... Such defects include persistent truncus arteriosus, total anomalous pulmonary venous connection, tetralogy of Fallot, ... A small vessel, the ductus arteriosus allows blood from the pulmonary artery to pass to the aorta. The ductus arteriosus stays ...
... or from the sinus venosus to the truncus arteriosus. The truncus arteriosus will divide to form the aorta and pulmonary artery ... The truncus arteriosus splits into the ascending aorta and the pulmonary trunk. The bulbus cordis forms part of the ventricles ... From head to tail, these are the truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium, and the sinus ... The tubular heart quickly differentiates into the truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium, and ...
Less common defects are truncus arteriosus and transposition of the great arteries. It is subsequently thought that cardiac ...
Persistent truncus arteriosus - Defect in that the truncus arteriosus fails to divide. Pulmonary valve stenosis (PVS) - ... Patent ductus arteriosus (PDA) - Failure of the ductus arteriosus to close on birth. Patent foramen ovale (PFO) - An atrial ...
The pulmonary arteries originate from the truncus arteriosus and the sixth pharyngeal arch. The truncus arteriosus is a ... As a septum develops between the two ventricles of the heart, two bulges form on either side of the truncus arteriosus. These ... The swelling is known as the bulbus cordis and the upper part of this swelling develops into the truncus arteriosus.: 159-160 ... and the truncus arteriosus is exposed to what will eventually be both the left and right ventricles. ...
Truncus arteriosus Samuel David Gross, John Hunter and his Pupils (1881), p. 92; archive.org. Albert Chauncey Eycleshymer, ...
Specific examples include Truncus Arteriosus, sinus venosus atrial septal defect, and heterotaxy syndrome. Society for ... Van Praagh, Richard; Van Praagh, Stella (1965). "The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and ...
Fetal circulation does not include the lungs, which are bypassed via the truncus arteriosus. Before birth the fetus obtains ... The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its ...
Description of a New Case with Truncus Arteriosus Type 2 and Review". Mol Syndromol. 2 (1): 35-44. doi:10.1159/000334262. PMC ...
... which takes a spiral course toward the proximal end of the truncus arteriosus. It divides the distal part of the truncus into ... In the developing heart, the truncus arteriosus and bulbus cordis are divided by the aortic septum. This makes its appearance ... Four endocardial cushions appear in the proximal part of the truncus arteriosus in the region of the future semilunar valves; ... Misalignment of the septum can cause the congenital heart conditions tetralogy of Fallot, persistent truncus arteriosus, dextro ...
A failure of the aorticopulmonary septum to divide the great vessels results in persistent truncus arteriosus. The aorta is an ... 188 In patent ductus arteriosus, a congenital disorder, the fetal ductus arteriosus fails to close, leaving an open vessel ... MedlinePlus > Patent ductus arteriosus Update Date: 21 December 2009 Seeley, Rod; Stephens, Trent; Philip Tate (1992). "20". In ... which loops under the aortic arch just lateral to the ligamentum arteriosum. It then runs back to the neck. The aortic arch has ...
... and causes persistent truncus arteriosus, unequal division of the truncus arteriosus, transposition of the great arteries, ... The truncus arteriosus and the adjacent bulbus cordis partition by means of cells from the neural crest. Once the cells from ... the first one and closest to the arterial end is the truncus arteriosus, then follow the bulbus cordis, the primitive ventricle ...
Porter I, Vacek J (May 2008). "Single ventricle with persistent truncus arteriosus as two rare entities in an adult patient: a ...
There is no visible difference in the pulmonary veins of chick embryos that developed persistent truncus arteriosus and embryos ... Complete removal of cardiac neural crests results in persistent truncus arteriosus characterised in most cases by the presence ... One of the main cardiac outflow anomalies present during cardiac neural crest complex ablation is persistent truncus arteriosus ... Into the pharyngeal arches and Truncus arteriosus (embryology), forming the aorticopulmonary septum and the smooth muscle of ...
With regards to the heart, increased likelihood of truncus arteriosus, atrioventricular septal defect, and single ventricle ...
The appearance of aortopulmonary window has similarities to that of truncus arteriosus, ventricular septal defect, and large ... a small aortopulmonary defect may produce a murmur similar to a patent ductus arteriosus. When a large defect is left ... patent ductus arteriosus. A two-dimensional echocardiogram can detect and distinguish between these problems. Corrective heart ...
... and truncus arteriosus. There are three types of interrupted aortic arch, with type B being the most common. Interrupted aortic ... and eventual closing of the ductus arteriosus. For an infant with an interrupted aortic arch, a patent (open) ductus arteriosus ... If the diagnosis is made prenatally, prostaglandin E1 (PGE1) is started after birth to avoid closure of the ductus arteriosus. ... While PGE1 is the standard of care for maintaining the ductus arteriosus, there is insufficient data on the proper dose, ...
Initially, all venous blood flows into the sinus venosus, and is propelled from tail to head to the truncus arteriosus. This ...
When post-mortem examination was performed in the brother, he was found to have truncus arteriosus and a ventricular septal ...

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