Archives of Cardiovascular Diseases Supplements最新文献

{"title":"BeGraft aortic stents: A European multi-centre experience reporting acute safety and efficacy outcomes for the treatment of vessel stenosis in congenital heart diseases","authors":"G. Butera ,&nbsp;M. Remonato ,&nbsp;M. Pilati ,&nbsp;M. Jones ,&nbsp;M. Carminati ,&nbsp;S. Hascoet ,&nbsp;L. Giugno ,&nbsp;P. Betrian ,&nbsp;A.E. Baruteau ,&nbsp;E. Pascall ,&nbsp;H. Lucron ,&nbsp;G. Milani","doi":"10.1016/j.acvdsp.2023.07.024","DOIUrl":"10.1016/j.acvdsp.2023.07.024","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Stent implantation for the treatment of vessel stenosis in </span>congenital heart diseases has become the preferred method of treatment. Availability of new covered stents may decrease complications and may have an important role in the management of patients with complex </span>anatomy.</p></div><div><h3>Objective</h3><p>The aim of this study was to evaluate the feasibility and safety of the pre-mounted cobalt-chromium stent-graft covered ePTFE Aortic BeGraft in a broad spectrum of congenital vascular lesions.</p></div><div><h3>Methods</h3><p>A retrospective study of 112 implanted Be Graft Aortic stents between 2016 and 2022 in six different European centers was performed.</p></div><div><h3>Results/Expected results</h3><p><span><span><span>One hundred four patients with mean age 13 years (range 1–70 years; 56.5 kg, range 11–115 kg) underwent BeGraft stent implantation. Seventy three patients had aortic coarctation, seven BeGraft stents were implanted </span>in patients<span><span> with Fontan circulation for either restoration of Fontan conduit<span> patency in three patients and fenestration closure in four). Fourteen BeGraft aortic stents were implanted in 12 patients with dysfunctional RVOT. Eleven patients with complex CHD had miscellaneous indications for stent implantation: </span></span>superior vena cava stenosis in 3 patients, rehabilitation of percutaneous </span></span>Potts shunt<span> in two patients, exclusion of a porto-caval fistula<span> in one patient, relief of pulmonary arteries stenosis in 3 patients and percutaneous PA debanding in two patients with ccTGA. All the stents were implanted successfully. Median stent diameter was 16</span></span></span> <!-->mm (range 7–24<!--> <span>mm). Major complications were the following: one aortic dissection<span><span>, 2 stent balloon rupture, 1 patient experienced a cerebral embolization<span> without neurological consequences and 1 patient had a femoral artery occlusion requiring </span></span>vascular surgery.</span></span></p></div><div><h3>Conclusion/Perspectives</h3><p>BeGraft stent can be used safely and effectively in a wide spectrum of congenital heart diseases. Whether these good results will be stable in the long term follow up still needs to be investigated given its recent introduction into clinical practice.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 284"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46698719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of simulation-based communication training for cardio pediatricians in announcing congenital heart disease diagnosis in children: A randomized controlled trial (SIMUL - CHD)","authors":"P. Padovani ,&nbsp;Q. Hauet ,&nbsp;B. Lefort ,&nbsp;M. Letellier ,&nbsp;M. Bergé ,&nbsp;P. Amedro ,&nbsp;A.E. Baruteau","doi":"10.1016/j.acvdsp.2023.07.041","DOIUrl":"10.1016/j.acvdsp.2023.07.041","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Appropriate communication between physicians and parents is key when announcing a diagnosis of critical congenital heart disease (CHD) in the </span>perinatal period. However, young physicians often struggle with anxiety and self-confidence, hindering their ability to communicate adequately. Simulation-based learning has demonstrated efficacy in improving medical training, but its application in communication training is limited.</p></div><div><h3>Objective</h3><p>The aim of this study is to evaluate whether simulation-based training can improve the communication skills of paediatric cardiology fellows in announcing a diagnosis of critical CHD. The study will be implemented in collaboration with the associations of children's parents with CHD.</p></div><div><h3>Methods</h3><p>A randomized controlled trial<span> will be conducted to compare the effect of simulation-based training versus theoretical training alone. The simulation group will receive both theoretical and practical training, while the control group will only receive theoretical training. The primary endpoint is to evaluate the effect of simulation-based training on the announcement of CHD diagnosis paediatric cardiologists in training. The primary endpoint will be measured by the difference in proficiency score (BBN Skills) for announcing the diagnosis, video judged by a panel of experts, and blinded to group assignment. The study will also assess self-assessment scores of anxiety and self-confidence before making the announcement.</span></p></div><div><h3>Results/Expected results</h3><p>It is expected to show an improvement in communication skills among the simulation group, regardless of the level of young doctors, as well as likely showing a decrease in anxiety and an increase in confidence scores in the simulation group.</p></div><div><h3>Conclusion/Perspectives</h3><p>This nationwide study could provide a uniform curriculum for training, written in collaboration with patients’ associations involving expert parents that may be further integrated into the national graduate program. It could then easily be applied to other clinical situations, for example, when announcing poor surgical outcomes, a treatment limitation, etc.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 292"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49402380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The French Coccinelle study: Risk of lympho-hematopoietic malignancies after medical ionizing radiation exposure from cardiac catheterization during childhood","authors":"E. Rage ,&nbsp;S. Hascoët ,&nbsp;C. Dauphin ,&nbsp;S. Di Filippo ,&nbsp;S. Douchin ,&nbsp;F. Godart ,&nbsp;P. Guérin ,&nbsp;P. Helms ,&nbsp;C. Karsenty ,&nbsp;B. Lefort ,&nbsp;P. Mauran ,&nbsp;C. Ovaert ,&nbsp;J.F. Piéchaud ,&nbsp;J.B. Thambo ,&nbsp;D. Bonnet","doi":"10.1016/j.acvdsp.2023.07.016","DOIUrl":"10.1016/j.acvdsp.2023.07.016","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Cardiac catheterization<span><span> (CC) has largely improved the diagnosis and treatment of </span>congenital heart disease in children over the last decades, but it leads to exposure to low doses of X-rays. Children have a greater </span></span>radiation sensitivity, however, little is known about the long-term radiation associated cancer risks.</p></div><div><h3>Objective</h3><p>This study aims to assess the risk of lympho-hematopoietic malignancies among children diagnosed and/or treated with CC.</p></div><div><h3>Methods</h3><p><span>The COCCINELLE cohort includes children from 15 French paediatric cardiology<span> departments who underwent a first CC between 2000–2013, before 16 years old. The cohort was linked with national registries to identify cancer cases and collect information on predisposing factors to cancer (PF). Individual cumulative doses to active bone marrow (ABM) were calculated with the PCXMC software, based on detailed dosimetric information retrieved from reports of 1,139 CC procedures. Standardised incidence ratios (SIRs) and relative risks (RR) of </span></span>haematological malignancies associated with the 2-year lagged ABM dose were calculated.</p></div><div><h3>Results/Expected results</h3><p>The cohort included 17,104 children, followed 6.5 years on average. 22,227 CC procedures were collected, with a mean individual ABM cumulative dose of 3.0 mGy. 38 lympho-hematopoietic malignancies were counted (23 lymphoma and 15 leukemia). A significant excess of cancer incidence was observed (SIR<!--> <!-->=<!--> <!-->3.8 [95% confidence interval 2.9; 4.9]), which wasn’t anymore observed after excluding patients with PF (SIR<!--> <!-->=<!--> <!-->1.3 [0.6; 2.7]). The ABM dose wasn’t significantly associated with the risk of lympho-hematopoietic malignancies (RR/mGy<!--> <!-->=<!--> <!-->1.00 [0.88; 1.10]) or lymphoma (RR/mGy<!--> <!-->=<!--> <!-->1.03 [0.90; 1.14]) after adjustment for attained age, gender and PF.</p></div><div><h3>Conclusion/Perspectives</h3><p>No significant increase of cancer incidence was observed after excluding patients with PF and no dose-response relationship was observed between the risk of lympho-hematopoietic malignancies or lymphoma and cumulative ABM dose arising from CC procedure. The extension of the COCCINELLE study and the European Harmonic project will help to better assess health effects of CC exposure during childhood.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Pages 280-281"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48512640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of immune response after cardiac surgery with cardiopulmonary bypass in young infants","authors":"E. André,&nbsp;C. Bridonneau,&nbsp;C. Jacqueline,&nbsp;M. Davieau,&nbsp;V. Gourain,&nbsp;A. Roquilly,&nbsp;A. Chenouard","doi":"10.1016/j.acvdsp.2023.07.039","DOIUrl":"10.1016/j.acvdsp.2023.07.039","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Cardiac surgeries with cardiopulmonary bypass<span> (CPB) cause a complex systemic immuno-inflammatory response, which can lead to postoperative morbidity, particularly in young children. A better understanding of mechanisms involved is needed to improve the outcome. In a whole blood transcriptome study, we have recently identified 2,175 differentially expressed genes after CPB, mainly associated with the immune response. A group of 24 co-expressed immune-related genes correlated with </span></span>postoperative complications was also identified.</p></div><div><h3>Objective</h3><p>To validate the transcriptomic analysis data by flow cytometry.</p></div><div><h3>Methods</h3><p><span>Peripheral blood mononuclear cells (PBMC) have been isolated from whole blood (4 ml </span>EDTA<span> tube) before and immediately after CPB in children less than 3 months of age after obtaining parental consent. The extensive phenotype of myeloid and lymphoid cells and their ability to secrete cytokines after in vitro stimulation were assessed using flow cytometry. Surface expression of proteins encoded by 5 of 24 co-expressed immune-related genes (VSIG4, LILRB4, LTF, MSR1 and PGLYRP1) were also investigated.</span></p></div><div><h3>Results/Expected results</h3><p>Among 6 patients included (<span>Table 1</span><span>), we noted important phenotypic changes of immune cells after CPB. The expression of HLA-DR, CD11b, CD86 in CD14</span> <!-->+<!--> <!-->cells (monocytes) and CD3<!--> <!-->+<!--> <span>lymphocytes function (PD1, ICOS) are decreased on their surfaces after CPB (</span><span>Fig. 1</span><span>). After lipopolysaccharide<span> (LPS) in vitro stimulation, monocytes display an altered ability to produce IL1β after CPB (Median Fluorescence Intensity MFI : 2620 1610 - 3975 vs 3786 3200 - 7538, </span></span><em>p</em> <!-->=<!--> <!-->0.03). Finally, as suggested by transcriptomic analysis, monocytic expression of some immune-related proteins (MSR1 and VSIG4) is modified by CPB.</p></div><div><h3>Conclusion/Perspectives</h3><p>We reported an immediate immune dysfunction after CPB, concerning myeloid and lymphoid cells. The involvement of MSR1 and VSIG4 genes, previously unknown in the CPB-related inflammation, need to be further explored to improve post-operative outcome.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 291"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49466324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tetralogy of fallot in adulthood: Contribution of the right ventricle strain","authors":"M. Walha,&nbsp;R. Gargouri,&nbsp;M. Jarraya,&nbsp;H. Gargouri,&nbsp;L. Abid","doi":"10.1016/j.acvdsp.2023.07.035","DOIUrl":"10.1016/j.acvdsp.2023.07.035","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>The course after complete cure of tetralogy of Fallot is fraught with complications including </span>Right ventricle<span> (RV) systolic dysfunction<span>. MRI has long been considered the gold standard for the study of RV systolic function. However, it remains an expensive and not always available method. The new </span></span></span>ultrasound techniques such as the strain of the RV can be of an important contribution.</p></div><div><h3>Objective</h3><p>Calculate global and segmental RV strain.</p><p>Compare the RV strain with conventional measurements of RV systolic function.</p><p>Study the factors favoring the alteration of the longitudinal strain of the RV.</p></div><div><h3>Methods</h3><p>This is a prospective study of 30 patients older than 18 years followed for operated tetralogy of fallot. We measured the fractional area change, the TAPSE, the S’ wave of the RV and the longitudinal strain of RV. We then compared the strain with the other measurements and looked for echographic abnormalities associated with altered longitudinal strain of the RV.</p></div><div><h3>Results/Expected results</h3><p>The measurement of the longitudinal strain of the RV in its free wall has a mean of –18. The strain measurement showed a significant gradient between the base of the RV and the apex with a basal mean of –20.7 and an apical mean of –15.6. This can be explained by a widening of the apex and a bulging of the base.</p><p>Alteration in longitudinal strain of the VD showed a significant correlation with FAC, whereas there was no correlation with TAPSE and S’ wave.</p><p>Right atrium dilatation<span>, LV diastolic dysfunction, and residual pulmonary obstruction are the echocardiographic parameters associated with altered longitudinal strain of the LV.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>In conclusion, the follow-up of patients operated on for tetralogy of Fallot is fraught with complications, including RV systolic dysfunction. The measurement of the longitudinal strain of the RV is a promising tool for the study of the RV.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 289"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48798161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult complex aortic coarctation","authors":"A. Boutaleb ,&nbsp;Y. Mekouar ,&nbsp;A. Drighil ,&nbsp;A. Boutaleb","doi":"10.1016/j.acvdsp.2023.07.047","DOIUrl":"10.1016/j.acvdsp.2023.07.047","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Coarctation of the aorta<span> (CoA) is often associated with bicuspid aortic valve (BAV). Both count as the most frequent </span></span>congenital heart diseases and predispose to progressive valvular and aortic damage, leading to a higher morbimortality in undiagnosed patients. Rare cases of adult aortic coarctation lead to severely left ventricular impairment function so early diagnosis is crucial for prognosis improvement.</p></div><div><h3>Objective</h3><p>The objective of this case report is to highlight a rare form of late diagnosis of aortic coarctation discovered during heart failure with reduced ejection fraction (HFrEF) assessment.</p></div><div><h3>Results/Expected results</h3><p><span>A 60-year-old male presented to us with New York Heart Association functional class<span> III dyspnea and atypical chest pain<span>. On physical examination, he was found to have lower limbs pulse delay associated with asymmetrical blood pressure measurement<span><span> between the upper and lower limbs. The echocardiography revealed severe heart failure with reduced ejection fraction (HFrEF), a type 1 left right bicuspid aortic valve (BaV) with moderate </span>aortic stenosis (</span></span></span></span><span>Figure 1</span><span><span>), and severe coarctation of the aorta located in the aortic isthmus. The diagnosis was confirmed using computed tomography angiography, which allowed for a precise evaluation of the location and </span>anatomy<span> of the aorta. A pre-operative coronary angiography<span><span> revealed a smooth epicardial coronary artery tree. HFrEF secondary to long-term high afterload was diagnosed and treated with optimal medical therapy, and scheduled for percutaneous </span>balloon angioplasty of the aortic stenosis.</span></span></span></p></div><div><h3>Conclusion/Perspectives</h3><p><span>Despite the low prevalence of aortic coarctation among patients with adult congenital heart diseases, it should be screened </span>in patients presenting with refractory heart failure symptoms or persistent high blood pressure despite optimal medical treatment.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 294"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44727251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ours redaction","authors":"","doi":"10.1016/S1878-6480(23)00277-X","DOIUrl":"https://doi.org/10.1016/S1878-6480(23)00277-X","url":null,"abstract":"","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page i"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49752197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early spontaneous closure of large arterial ducts in two term neonates with ebstein anomaly after failed attempts of transcatheter closure","authors":"R. Haddad,&nbsp;D. Bonnet,&nbsp;S. Malekzadeh-Milani","doi":"10.1016/j.acvdsp.2023.07.045","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.07.045","url":null,"abstract":"<div><h3>Introduction</h3><p>The unique features of neonatal Ebstein's anomaly<span> (EA) are the presence of pulmonary atresia<span>, arterial duct (AD) patency, and the variability of pulmonary vascular resistance<span>. Promoting early ductal closure after ruling out or relieving anatomic pulmonary obstruction might improve neonatal survival. Transcatheter ductal closure is an interesting option but can be challenging in tiny neonates with large tortuous AD due to the limited available sizes of low-profile approved devices.</span></span></span></p></div><div><h3>Objective</h3><p>We report on 2 consecutive term newborns with EA and large AD in whom mechanical AD stimulus during failed attempts of transcatheter closure led after 2 days to definitive closure.</p></div><div><h3>Methods</h3><p><span>Two consecutive term neonates with EA were approached from the femoral vein for an attempted ductal closure. An 8</span> <!-->mm-AVPII was implanted in the AD (pulmonary end: 6.3<!--> <!-->mm, length 8.9<!--> <!-->mm) of the first 9-day-old patient (3<!--> <!-->kg) and was removed before release for important leak and device instability. Delivery of 10<!--> <!-->mm AVPII was laborious and procedure was aborted after important bleeding. A MVP-9Q was implanted in the AD (pulmonary end: 7.6<!--> <!-->mm, length 16.1<!--> <!-->mm) of the second 14-day-old patient (2.8<!--> <!-->kg) and was removed before release after immediate migration to the pulmonary artery trunk. The procedure was aborted in the absence of a larger low-profile occlusion device in the armamentarium.</p></div><div><h3>Results/Expected results</h3><p>Patients were sent back to the ICU for surveillance and a re-discussion of the management strategy. Follow-up ultrasound showed a spontaneous and progressive diminution in the AD size until complete closure two days postoperative with good follow-up outcomes.</p></div><div><h3>Conclusion/Perspectives</h3><p>Transcatheter closure should be attempted in similar cases requiring early ductal closure. Surgical ligation can be postponed a couple of days after failed interventions when clinically possible. Further studies seem interesting to evaluate whether mechanical stimulation of the ductal wall can be a useful alternative to initiate spontaneous ductal closure in pre-term and term neonates.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Pages 293-294"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49752461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No coronary artery in the aorta: Severe congenital malformation under-diagnosed","authors":"J. Karila,&nbsp;L. Houyel","doi":"10.1016/j.acvdsp.2023.07.032","DOIUrl":"10.1016/j.acvdsp.2023.07.032","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Absence of connection of both coronary arteries<span> to the aorta is an extremely rare congenital malformation. Most cases reported are anatomic variants of anomalous </span></span>left coronary artery to pulmonary artery.</p></div><div><h3>Objective</h3><p>We describe here four cases of patients born without any coronary artery connecting connected to the aorta (<span>Figure 1</span>).</p></div><div><h3>Results/Expected results</h3><p><span><span>Case 1: a male infant was diagnosed with aortic coarctation and perimembranous </span>ventricular septal defect<span><span> (VSD). Left ventricular dysfunction appeared four months after coarctation repair and </span>pulmonary artery banding<span>. Heart catheterization showed no coronary artery in the aorta and a single coronary artery connected to the </span></span></span>right pulmonary artery.</p><p><span>Case 2: a female neonate born with multiples VSD and aortic coarctation died during coarctation repair. At autopsy, there were no </span>epicardial coronary arteries<span> except a short segment in the posterior atrioventricular sulcus. Two small dimples were seen in aortic root. No proximal coronary artery connected to the aorta or the pulmonary arteries. Several intramyocardial arterial vessels of different sizes were detected, without any communication with the ventricles.</span></p><p><span><span>Case 3: a male neonate was born with pulmonary atresia<span> with intact ventricular septum. Cardiac </span></span>angiography revealed multiple coronary-ventricular </span>fistulae and no coronary arteries from the aorta. Autopsy confirmed 1) absence of epicardial coronary arteries except a very short segment of left anterior descending and small fistulous apical segments 2) two large coronary-ventricular fistulas. There were no coronary ostia within the aorta or the pulmonary tree.</p><p>Case 4: a coronarography<span><span> revealed a single coronary artery originating from the left ventricle just below the </span>aortic valve<span> in a 64-year old with syncope at exercise. Surgical reimplantation was performed with success.</span></span></p></div><div><h3>Conclusion/Perspectives</h3><p>Those exceptional coronary malformations have a poor prognosis and are often diagnosed at autopsy. Total absence of epicardial coronary arteries, described only once in the literature, leads us to reconsider current knowledge of human coronary artery development.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 288"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42220318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strain in cardiac magnetic resonance imaging: Utility in the description of the global mechanical left ventricle function","authors":"O. Werner,&nbsp;F. Raimondi","doi":"10.1016/j.acvdsp.2023.07.026","DOIUrl":"10.1016/j.acvdsp.2023.07.026","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Nowadays, the fraction of ejection (FE) is no longer considered as the unique way of expression of the efficiency of cardiac labor. The development of strain imaging (SI), in </span>echocardiography and in MRI, has led to a better understanding of </span>ventricular contraction<span>, especially in cases of cardiac dysfunction with preserved FE. But SI still under-exploited in clinical practice despite the fact that it is a proved prognostic factor<span> in many cardiomyopathies. Recently, a new framework was developed to associate the FE and the deformation parameters, the global longitudinal (GLS) and circular strain (GCS), to give the opportunity of a global assessment of the cardiac function. This mathematical relationship was validated on the adult population. This work intends to determine the more accurate evaluation of the GCS and GLS values in pediatric population and its use in order to validate the mathematic model described.</span></span></p></div><div><h3>Methods</h3><p><span>Retrospective monocentric study carried out in the cardiopediatric unit of Florence University Hospital. Inclusion of all pediatric patients who completed cardiac MRI between November 2021 and December 2022. An assessment of the </span>left ventricle FE, GCS and GLS and a double reading was made by two specialized cardiologists.</p></div><div><h3>Results/Expected results</h3><p>In total, 134 CMR were studied. A good reproducibility between readers was observed (GCS: r<!--> <!-->=<!--> <!-->0,94, GLS: r<!--> <!-->=<!--> <!-->0,83). The correlation between isolated strain parameters and FE (GCS: r<!--> <!-->=<!--> <!-->0,84 and GLS: r<!--> <!-->=<!--> <!-->0,68) and between theorical FE (GCS<!--> <!-->+<!--> <!-->GLS) and FE was high (FE/FE(th): r<!--> <!-->=<!--> <span>0,88). The use of endocardial strain and the assessment of GCS with short axis slice assured the best correlation with the FE.</span></p></div><div><h3>Conclusion/Perspectives</h3><p>The evaluation of GCS and GLS with CMR are a safe way to evaluate the mechanical contraction of the left ventricle in pediatric population. The use of an integrated mathematical formula gives a summarized information of SI with a very good correlation to the FE.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 285"},"PeriodicalIF":18.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47835994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}