scholarly journals Missed Traumatic Conoventricular Septal Defect: A Case Report

2021 ◽  
Vol 24 (4) ◽  
pp. E680-E683
Author(s):  
Mingjin Cheng ◽  
Niuliu Huang ◽  
Chengdong Ning ◽  
Qianlun Huo
Keyword(s):  
Septal Defect ◽  
Cardiac Injury ◽  
Penetrating Trauma ◽  
Emergency Operation ◽  
Ventricular Septum ◽  
Right Ventricular Free Wall ◽  
Left Chest ◽  
Septal Defects ◽  
The Right ◽  
Penetrating Cardiac Injury

Traumatic ventricular septal defects (VSDs) after penetrating trauma to the left chest are rare. Most of the traumatic VSDs are located in the muscular ventricular septum, and a few reports place them in the membranous ventricular septum. There has been no report of traumatic conoventricular VSD by penetrating trauma. We present a case of penetrating cardiac injury (PCI). The rupture of the right ventricular free wall was found and repaired in emergency operation. This is the first report of the use of auricular forceps to control cardiac rupture bleeding. After operation, we found traumatic conoventricular VSD, which was repaired under cardiopulmonary bypass.

Operative Management Considerations in a Patient With Multiple Occult Penetrating Cardiac Injuries

2022 ◽  
pp. 000313482110540
Author(s):  
Jaclyn N Portelli Tremont ◽  
Andrea Ward ◽  
Amirreza Motameni
Keyword(s):  
Cardiac Injury ◽  
Median Sternotomy ◽  
Exploratory Laparotomy ◽  
Operative Management ◽  
Traumatic Injuries ◽  
Left Chest ◽  
Urban Level ◽  
The Right ◽  
High Index Of Suspicion ◽  
Penetrating Cardiac Injury

Penetrating cardiac injury remains one of the deadliest traumatic injuries. Early identification and definitive operative management are critical tenets for patient survival; however, variable clinical presentations can obscure the diagnosis. Here, we present the case of a 58-year-old obese man who presented to an urban level 1 trauma center with multiple stab wounds to the epigastrium and lateral left chest in the axillary line with an unknown weapon. The patient was taken emergently to the operating room for exploratory laparotomy, median sternotomy, and attempted repair of multiple full-thickness lacerations of the right ventricle and left and right atrium. This case demonstrates several instructive points. First, a high index of suspicion for penetrating cardiac injury is needed, especially during triage of multiple injuries. Second, careful release of cardiac tamponade is critical. Finally, there are several indications for cardiopulmonary bypass, which include multichambered injuries, uncontrollable hemorrhage, and concern for intracardiac injury.

Delayed Closure of Multiple Muscular Ventricular Septal Defects in an Infant after Coarctation Repair and a Hybrid Procedure�A Case Report

2011 ◽  
Vol 14 (1) ◽  
pp. 67 ◽  
Author(s):  
Ireneusz Haponiuk ◽  
Maciej Chojnicki ◽  
Radosaw Jaworski ◽  
Jacek Juciski ◽  
Mariusz Steffek ◽  
...  
Keyword(s):  
Septal Defect ◽  
Color Doppler ◽  
Hybrid Approach ◽  
Ventricular Septal Defects ◽  
Color Doppler Echocardiography ◽  
Septal Defects ◽  
Coarctation Repair ◽  
Step Procedure ◽  
The Right ◽  
Delayed Closure

There are several strategies of surgical approach for the repair of multiple muscular ventricular septal defects (mVSDs), but none leads to a fully predictable, satisfactory therapeutic outcome in infants. We followed a concept of treating multiple mVSDs consisting of a hybrid approach based on intraoperative perventricular implantation of occluding devices. In this report, we describe a 2-step procedure consisting of a final hybrid approach for multiple mVSDs in the infant following initial coarctation repair with pulmonary artery banding in the newborn. At 7 months, sternotomy and debanding were performed, the right ventricle was punctured under transesophageal echocardiographic guidance, and the 8-mm device was implanted into the septal defect. Color Doppler echocardiography results showed complete closure of all VSDs by 11 months after surgery, probably via a mechanism of a localized inflammatory response reaction, ventricular septum growth, and implant endothelization.

scholarly journals Double-Outlet Right Ventricle in a Chianina Calf

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 318
Author(s):  
Domenico Caivano ◽  
Maria Chiara Marchesi ◽  
Piero Boni ◽  
Noemi Venanzi ◽  
Giovanni Angeli ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Septal Defect ◽  
Heart Defects ◽  
Double Outlet Right Ventricle ◽  
Cardiac Malformation ◽  
Septal Defects ◽  
Congenital Cardiac Malformation ◽  
The Right ◽  
Similar Complex ◽  
Echocardiographic Findings

Congenital heart defects have been occasionally reported in cattle and ventricular septal defect represents the most frequently encountered anomaly. The double-outlet right ventricle is a rare congenital ventriculoarterial malformation reported only in certain cattle breeds. We describe this rare and complex congenital cardiac malformation observed in a 10-day-old male Chianina calf. Clinical examination showed tachycardia, tachypnea, jugular pulses, cyanotic mucous membranes and a right apical systolic murmur. Transthoracic echocardiography revealed severe dilation of the right-sided cardiac chambers with a markedly hypoplastic left ventricle. Both aorta and pulmonary artery leaving the right ventricle in parallel alignment with the tricuspid valve were suggestive of a dual-outlet right ventricle. Interventricular and interatrial septal defects were also visualized. Post-mortem examination confirmed the echocardiographic findings. To the authors’ knowledge, a similar complex congenital cardiac malformation has not been reported in calves of the Chianina breed to date.

Delayed presentation of cardiac injury four weeks after stabbing

2019 ◽  
Vol 28 (1) ◽  
pp. 62-64
Author(s):  
Ayame Ochi ◽  
Ashutosh A Hardikar
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Cardiac Tamponade ◽  
Cardiac Injury ◽  
Penetrating Trauma ◽  
Delayed Presentation ◽  
Stab Injury ◽  
Artery Injury ◽  
Coronary Artery Injury ◽  
The Right

Penetrating trauma to the heart has a high associated mortality due to significant hemorrhage, coronary artery injury, and cardiac tamponade. Such sequelae progress rapidly, often leading to death before reaching hospital. We report a case of delayed presentation following a stab injury to the right ventricle. This case highlights the mechanisms that may facilitate a delayed presentation and the importance of appropriate investigation when suspicion of cardiac injury is high.

scholarly journals Penetrating cardiac stab wounds: A case report with management algorithm and review of the literature

2018 ◽  
Vol 14 (2) ◽  
Author(s):  
Antonino M. Grande ◽  
Filippo Antonacci ◽  
Paolo Aseni
Keyword(s):  
Cardiac Injury ◽  
Penetrating Trauma ◽  
Pericardial Fluid ◽  
Stab Wounds ◽  
Emergency Department Thoracotomy ◽  
Management Algorithm ◽  
Left Pleural Effusion ◽  
Immediate Surgery ◽  
The Right ◽  
Midline Sternotomy

A 57-year-old man attempted a suicide self-inflicting multiple scissors stab wounds in the chest. At the scene, Focused Assessment with Sonography in Trauma (FAST) showed an important left pleural effusion and pericardial fluid. Computed Tomography Angiography confirmed the pericardial effusion. The patient underwent immediate surgery. Three epicardial wounds of the anterior surface of the right ventricle were identified, one of which was actively bleeding. The lesion was sutured, the patient recovered uneventfully, and on the sixth postoperative day was transferred to a psychiatric unit. At 6-month follow-up, he is doing well and has returned to work. We discuss the importance of FAST for an early diagnosis of chest penetrating trauma leading to a rapid life-saving cardiac procedure and propose a clinical-based protocol for the management of patients with suspected penetrating cardiac injury which we have applied in our service for last six years. Midline sternotomy should be considered the incision of choice in patients with penetrating trauma in the cardiac box with evidence of injury to the heart and great vessels. Emergency Department Thoracotomy can be a possible option for those patients with impending cardiac arrest despite adequate resuscitation.

Persistent electrical and morphological atrial abnormalities after early closure of atrial septal defect

2004 ◽  
Vol 14 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Clifford L. Cua ◽  
Elizabeth E. Sparks ◽  
David P. Chan ◽  
Curt J. Daniels
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Pearson Correlation ◽  
P Wave ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Pr Interval ◽  
Early Closure ◽  
The Right

Atrial arrhythmias are associated with enlarged atrial chambers and an increased duration of the P wave. Repair of atrial defects within the oval fossa is expected to normalize atrial size. Few studies, however, have evaluated electrical and morphological atrial features after repair. Our study was performed to determine if atrial abnormalities exist after surgical closure of such atrial septal defects, and whether early closure improves outcome. We recruited patients who had undergone surgical closure of a defect within the oval fossa, so-called “secundum” atrial septal defects. Electrocardiograms, signal averaged electrocardiograms, and echocardiograms were performed. Two-tailed test and Pearson correlation was utilized for statistical analysis. The population consisted of 20 patients and 27 controls, with the mean age of the patient being 11.25 ± 5.10 years, their age at surgery 6.55 ± 5.10 years, and the time since surgery 4.70 ± 2.61 years. The size of the right (23.88 ± 6.35 ml/m2 versus 18.84 ± 4.43 ml/m2) and left (21.91 ± 12.47 ml/m2 versus 17.72 ± 4.83 ml/m2) atrium were significantly larger in the patients. The duration of the P wave (108 ± 16 ms versus 96 ± 8 ms) and the duration of the PR interval (155 ± 18 ms versus 138 ± 23 ms) were longer. No correlation existed between age or interval since surgery with atrial sizes or measurements of the signal averaged electrocardiogram. We conclude that, despite surgical repair, abnormalities exist in patients with an atrial septal defect. Early surgery does not appear to prevent the atrial abnormalities.

scholarly journals The Fate of the Outflow Tract Septal Complex in Relation to the Classification of Ventricular Septal Defects

2019 ◽  
Vol 6 (1) ◽  
pp. 9 ◽  
Author(s):  
Robert Anderson ◽  
Justin Tretter ◽  
Diane Spicer ◽  
Shumpei Mori
Keyword(s):  
Outflow Tract ◽  
Ventricular Septum ◽  
Ventricular Septal Defects ◽  
Atrioventricular Canal ◽  
Dorsal Wall ◽  
Septal Defects ◽  
Major Significance ◽  
Ongoing Development ◽  
The Right

It is now established that the entity often described as an “aortopulmonary septal complex” is better considered as an “outflow tract septal complex”. This change is crucial for appropriate understanding of not only malformations of the outflow tract, but also ventricular septal defects. Thus, the embryonic outflow tract, as it develops, is separated into its two components by fusion of a protrusion from the dorsal wall of the aortic sac with the distal end of the outflow cushions. The key point with regard to morphogenesis is that, with ongoing development, these structures lose their septal integrity, although they can still be identified as septal structures when the ventricular septum itself is deficient. In the normal postnatal heart, however, the aortic and pulmonary components have their own walls throughout the length of the outflow tracts. All of this is of clinical significance, since some current concepts of categorisation of the ventricular septal defects are based on the existence in the normal heart of a “conal septum”, along with a “septum of the atrioventricular canal”. In this review, we show how analysis of postnatal hearts reveals the definitive ventricular septum to possess only muscular and fibrous components in the absence of either discrete outflow or inlet components. We also show that this information regarding development, in turn, is of major significance in determining whether categorisation of ventricular septal defects is best approached, in the first instance, on the basis of the borders of the defects or the fashion in which they open to the right ventricle.

Absent Pulmonary Valve with Tricuspid Atresia or Severe Tricuspid Stenosis: Report of Three Cases and Review of the Literature

2000 ◽  
Vol 3 (4) ◽  
pp. 353-366 ◽  
Author(s):  
Silvio Litovsky ◽  
Michael Choy ◽  
Jeanny Park ◽  
Mark Parrish ◽  
Brenda Waters ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pulmonary Valve ◽  
Left Ventricular ◽  
Tricuspid Atresia ◽  
Ventricular Free Wall ◽  
Ventricular Septum ◽  
Free Wall ◽  
Absent Pulmonary Valve ◽  
Right Ventricular Free Wall ◽  
The Right

Absence of the pulmonary valve occurs usually in association with tetralogy of Fallot and occasionally with an atrial septal defect or as an isolated lesion. Very rarely it occurs with tricuspid atresia, intact ventricular septum, and dysplasia of the right ventricular free wall and of the ventricular septum. We present the clinical, anatomic, and histologic findings of a new case, and for the first time, the data from two patients with absent pulmonary valve and severe tricuspid stenosis, who exhibited similar histologic findings. We also reviewed the clinical and anatomic data of 24 previously published cases and compared them with the new cases. In all three new cases, the myocardium of the right ventricle was very abnormal. In the two cases with tricuspid stenosis, large segments of myocardium were replaced with sinusoids and fibrous tissue. In the case with tricuspid atresia, the right ventricular free wall contained only fibroelastic tissue. The ventricular septum in all three patients showed asymmetric hypertrophy and in two of the three patients, multiple sinusoids had replaced large segments of myocardial cells. The left ventricular free wall myocardium and the walls of the great arteries were unremarkable. Our data indicate that myocardial depletion involving the right ventricular free wall and the ventricular septum and its replacement by sinusoids and fibroelastic tissue occur not only in cases of absent pulmonary valve with tricuspid atresia but also in cases of absent pulmonary valve with tricuspid stenosis. The degree of myocardial depletion varies and is more severe when the tricuspid valve is atretic.

Transcatheter closure of a membranous ventricular septal defect in a 1.8-kg infant using Amplatzer Duct Occluder II additional size device

2017 ◽  
Vol 27 (7) ◽  
pp. 1437-1440
Author(s):  
Bhavik Champaneri ◽  
Mahesh Kappanayil ◽  
Raman K. Kumar
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Artery Occlusion ◽  
Amplatzer Duct Occluder ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Femoral Artery Occlusion ◽  
Catheter Closure ◽  
The Right

AbstractCatheter closure of membranous ventricular septal defects is generally not considered feasible in small infants. We report the successful closure of a membranous ventricular septal defect in a 1.8-kg infant with bilateral femoral artery occlusion using Amplatzer Duct Occluder II additional size device. The ventricular septal defect was crossed from the right ventricle, and the device was deployed using transthoracic echocardiographic guidance.

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