Cardiomyopathies ; classification ; Heart Ventricles ; abnormalities ; Humans

Aorta ; abnormalities ; Child ; Heart Defects, Congenital ; diagnosis ; Heart Ventricles ; abnormalities ; Humans ; Male

Genetic Heterogeneity ; Heart Ventricles ; abnormalities ; Humans ; Lung ; abnormalities ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; genetics

Adolescent ; Cardiomyopathies ; complications ; diagnosis ; Echocardiography ; Heart Failure ; diagnosis ; etiology ; Heart Ventricles ; abnormalities ; Humans ; Male

Pectus excavatum exists as varying anatomic deformities and compression of the right heart by the chest wall can lead to patient symptoms including dyspnea and chest pain with exertion. Echocardiography can be difficult but is critical to the evaluation and diagnosis of this patient population. Modifying standard views such as biplane transthoracic and 3-D transesophageal views may be necessary in some patients due to limitations from the abnormal anatomy of the deformed anterior chest wall. Apical four-chamber views when seen clearly can usually visualize any extrinsic compression to the right ventricle of the heart.
Chest Pain ; Congenital Abnormalities ; Dyspnea ; Echocardiography ; Funnel Chest ; Heart ; Heart Ventricles ; Humans ; Thoracic Wall

OBJECTIVETo compare the postoperative outcomes of patients with the diagnostic univentricular heart undergoing lateral tunnel (LT) operation with extracardiac conduit (EC) operation.

METHODSFrom June 1996 to July 2007, 114 consecutive patients with a single ventricle underwent total cavopulmonary connection (TCPC) in Children's Heart Center, University Hospital Giessen and Marburg GmbH, Germany. A LT was performed in 19 (16.7%) patients, and an EC in 95 (83.3%) patients. The mean age of EC group was 50.8 +/- 31.6 (ranging from 22 to 212) months, and that of LT group was 61.5 +/- 41.2 (ranging from 30 to 168) months. Early and midterm outcomes of two groups were analyzed.

RESULTSOne died in LT group (5.3%) and three in EC group (3.2%). The overall mortality was 3.5%. There was no significant difference in mortality between EC and LT groups (P>0.05). The postoperative pulmonary arterial pressure, oxygen saturation, and effusion time of two groups had no significant difference (all P>0.05). No significant difference in the occurrences of complications (arrhythmias, enteropathy, and thrombosis) was found between two groups after operation (P>0.05).

CONCLUSIONSThere seems no difference between LT and EC in the clinical results in the early and middle postoperative stage. Glenn anastomosis followed by an EC seems to have some advantages.

Child ; Heart Bypass, Right ; methods ; Heart Ventricles ; abnormalities ; surgery ; Humans ; Treatment Outcome

BACKGROUNDRight dominant heart (RDH) in fetuses can occur with a number of cardiac as well as noncardiac anomalies. Analysis of the enlargement of the right cardiac chamber in the fetus remains a major challenge for sonographers and echocardiographers. The aim of this study was to report the experience with prenatal diagnosis of RDH in the fetuses over a 7-year period.

METHODSFetuses with prenatal diagnosis of RDH from July 2009 to July 2016 were evaluated in two different categories: according to the gestational age, Group I (n = 154, second trimester) and Group II (n = 298, third trimester); and according to the fetal echocardiography diagnosis, Group A (n = 452, abnormal cardiac structure) and Group B (n = 90, normal cardiac structure). Differences in categorical variables were assessed by Chi-square exact test and continuous variables were evaluated by independent Student's t-test or Mann-Whitney U-test depending on parametric or nonparametric nature of the data.

RESULTSOver a 7-year period, 452 fetuses were referred for the assessment of suspected RDH. Left-sided obstructive lesions were observed most frequently in the fetuses with RDH. When comparing Group I with Group II and Group A with Group B, the latter groups exhibited significant differences in the right/left ventricle (RV/LV) ratio (1.435 vs. 1.236, P = 0.002; 1.309 vs. 1.168, P = 0.047), RV width Z-score (1.626 vs. 1.104, P < 0.001; 1.553 vs. 0.814, P = 0.014), and above +2 cutoff percentages (14.3% vs. 22.5%; P = 0.038; 21.5% vs. 12.2%, P = 0.046). Multivariable logistic regression revealed no variables associated with perinatal survival.

CONCLUSIONSThe study demonstrates that RDH warrants careful attention to the possible presence of a structural cardiac anomaly, especially left-sided obstructive lesions. A diagnosis of RDH is best supported by a combination of the RV Z-score and RV/LV ratio. Most of the fetuses with RDH and structurally normal hearts had favorable outcomes.

Echocardiography ; Female ; Fetal Diseases ; diagnosis ; Fetal Heart ; abnormalities ; Heart Ventricles ; abnormalities ; Humans ; Pregnancy ; Prenatal Diagnosis ; methods ; Ultrasonography, Prenatal

Double-orifice mitral valve is a rare congenital anomaly. Most cases of double-orifice mitral valve are hemodynamically normal and remain symptomless, so that it is usually discovered incidentally in autopsy or during surgical correction of a cardiovascular abnormality. Recently, however, it is increasingly recognized as such, since the echocardiography has gained wide acceptance as a non-invasive diagnostic tool by the M-mode, two-dimensional and color Doppler echocardiogram. Two separate mitral valve apparatuses can be used on the M-mode echocardiogram. In the two-dimensional echocardiography, the parasternal and subcostal short-axis views can show two separate glass-like orifices in the left ventricle, and the parasternal long-axis view as well as the apical four-chamber view can show the anomaly. And the color Doppler echocardiogram can visualize two mosaic-pattern flows between the left atrium and ventricle. We present herewith two cases of double-orifice mitral valve, as diagnosed by means of echocardiography. The first case was an isolated one with mitral stenosis, showing two parachute mitral valves. The second was associated with perimembranous ventricular septal defect, and showed the accessory mitral valve directly attached to the ventricular septum, with the chordae crossing the ventricular outflow tract.
Autopsy ; Cardiovascular Abnormalities ; Echocardiography* ; Heart Atria ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Mitral Valve Stenosis ; Mitral Valve* ; Ventricular Septum

Ebstein's anomaly is a complex congenital defect of the tricuspid valve and right ventricle. Various surgical methods to repair the regurgitant tricuspid valve have been reported, and most of them depend on monocuspidalization with using the anterior leaflet. We report here on our first experience with Ebstein's anomaly in a 31-year-old female patient who underwent cone reconstruction of the tricuspid valve with using three leaflets.
Adult ; Congenital Abnormalities ; Ebstein Anomaly ; Female ; Heart Ventricles ; Humans ; Tricuspid Valve

Adolescent ; Cardiomyopathies ; complications ; genetics ; Female ; Heart Ventricles ; abnormalities ; Humans ; Pedigree ; Sick Sinus Syndrome ; complications ; genetics