Heart septal defects – ABC CARDIOL

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My Approach To

My Approach to Imaging the Atrial Septal Defect by Three-Dimensional Echocardiography

Pre-procedural assessment

At the end of a detailed 2D TEE with a full septal analysis from the four-chamber view to bicaval section and color mapping, we commence the 3D image acquisition. The en-face projection of the ASD and the defect’s positioning in the anatomic position provide valuable information from a single image: size, shape, location in the interatrial septum, characteristics of the defect’s borders, and the presence of additional fenestration.

I usually start the 3D evaluation from the perspective of the right atrium to facilitate the identification of anatomical markers. I acquire a medium angle block (3D or 4D zoom) or a large block (full-volume using the two-section tool) starting from an initial bicaval section and proceeding with approximate 90° rotation in the z-plane so that the superior and inferior vena cava are aligned in the vertical plane (i.e., superior vena cava at the 11 o’clock position) and the aorta in the anterior and superior region. I prefer not to use the narrow-angle mode for acquisition (live 3D or bird’s eye view) or very high magnification due to a loss of anatomical references adjacent to the defect, which can interfere with this fundamental initial analysis. From this reconstruction (), I can characterize the defect as unique, the OS type, having an oval shape, being central, being medium-sized, and having adequate borders. shows the same ASD and allows assessment of the occurrence of dynamic variation in its dimension with the cardiac cycle.

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Editorial

Coronary Arteries after Jatene Operation for Transposition of Great Arteries: The Role of CT Coronary Angiography on Follow-up

Antonio Joaquim Marinho-da-Silva

The correction of transposition of the great arteries (TGA) by the Jatene technique was one of the greatest achievements of cardiac surgery in congenital heart disease. By replacing the transposed arteries in their proper anatomical arrangement, this technique — atrial switch operation (ASO) – achieves a normal spatial arterial relationship. However, this new arrangement requires excision of the coronary artery buttons and their implantation in the new aorta. The difficulty of this step relates to the type of coronary origin and distance to the new insertion site.

Once this anatomical normalization step has been achieved, cardiac functional normalization is sought. The most common post-surgical complications are related to the complexity of associated anomalies (ventricular septal defect (VSD), coarctation of the aorta, valve stenosis, and others), suture sites of the neovessels, pulmonary ramification and dilation of the neoaorta, Not neglectable and object of concern, late complications of either congenital or acquired coronary circulation are well known. The actual incidence of such complications ranges from 0,8% to 27,5% according to reporting series and time of follow-up.^,

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Case Report

Pseudo-pulmonary Embolism – A Case of Hypoxemia Associated with Right-to-left Shunt

Mariana Faustino et al. Ana Oliveira Soares Fernando Rodrigues Rui Anjos … António Freitas Victor M. Gil

Introduction

Platypnea orthodeoxia is a rare syndrome characterized by dyspnea and decreased arterial oxygen saturation when passing from the dorsal decubitus position to the sitting or upright position. It usually results from an intracardiac right-to-left shunt; however, the pathophysiological mechanism responsible for the positional nature of the shunt has not been clarified^,. We report a case of dyspnea and orthostatic hypoxemia, which was attributed to a right-to-left shunt due to atrial septal defect (ASD).

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Correlação Clínico-Radiográfica

Case 1/2009: 21-month-old infant with partial atrioventricular septal defect, consisting of atrial septal defect and tricuspid insufficiency

Edmar Atik

CLINICORADIOLOGICAL SESSION

Case 1/2009 – 21-month-old infant with partial atrioventricular septal defect, consisting of atrial septal defect and tricuspid insufficiency

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Case Report

Anatomy of a dextrocardia case with situs solitus

Fabíola Sawaguchi Faig-Leite et al. Horácio Faig-Leite

We present a rare case of dextrocardia in the corpse of a female child, aged approximately one year old, presenting situs solitus. The cases of dextrocardia reported in the literature normally describe multiple associated cardiac malformations. In the present study, it is noteworthy the fact that a complete specular image of the heart and the vessels of the base of the heart was not found. There was no atrioventricular discordance or other intra and extracardiac malformations, which are commonly seen in cases of dextrocardia. A large ductus arteriosus was found, as well as the anomalous position of the right portion of the heart.

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My Approach to Imaging the Atrial Septal Defect by Three-Dimensional Echocardiography

Pre-procedural assessment

Coronary Arteries after Jatene Operation for Transposition of Great Arteries: The Role of CT Coronary Angiography on Follow-up

Pseudo-pulmonary Embolism – A Case of Hypoxemia Associated with Right-to-left Shunt

Introduction

Case 1/2009: 21-month-old infant with partial atrioventricular septal defect, consisting of atrial septal defect and tricuspid insufficiency

Anatomy of a dextrocardia case with situs solitus

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