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[PMID]:29384934
[Au] Autor:Ninomiya K; Fukasawa M; Kawakami Y; Fuke C; Miyazaki T
[Ti] Título:Investigation of an anatomically variant isolated bicuspid pulmonary valve: A case report.
[So] Source:Medicine (Baltimore);96(52):e9464, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: We provide a discussion of the anatomical characteristics of the bicuspid pulmonary valve (BPV) in this paper. We performed an autopsy of an isolated BPV found in the heart of a deceased individual. The deceased was a man in his 60s and had no previous history of cardiovascular disease. The heart weighed 260 g and had mild right ventricular hypertrophy. The pulmonary valve had a fish-mouth-like shape that was convex to the pulmonary trunk and both cusps were thickened and hardened. The anterior and left semilunar cusps of the pulmonary valve were fused. Post-stenotic dilatation was noted. CONCLUSIONS: In comparing the present case with previous reports, we found that, in human BPVs, cusps are fused in at least 2 patterns.
[Mh] Termos MeSH primário: Valva Pulmonar/anormalidades
[Mh] Termos MeSH secundário: Autopsia
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009464


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[PMID]:28742780
[Au] Autor:Gharde P; Aggarwal N; Sharma KP; Gadhinglajkar S; Babu S; Chauhan S; Rajashekar P
[Ad] Endereço:From the *Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India; †Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India; and ‡Department of Cardiac Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
[Ti] Título:Absent Pulmonary Valve in a Case of Tetralogy of Fallot: An Incidental Discovery on Intraoperative Transesophageal Echocardiography.
[So] Source:Anesth Analg;125(4):1149-1152, 2017 Oct.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ecocardiografia Transesofagiana/métodos
Achados Incidentais
Monitorização Intraoperatória/métodos
Valva Pulmonar/anormalidades
Valva Pulmonar/diagnóstico por imagem
Tetralogia de Fallot/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Seres Humanos
Masculino
Valva Pulmonar/cirurgia
Tetralogia de Fallot/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180117
[Lr] Data última revisão:
180117
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002317


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[PMID]:29173614
[Au] Autor:Kozicka U; Weronski K; Ruzyllo W; Demkow M; Kowalski M; Spiewak M; Piotrowicz E; Siudalska H; Hoffman P; Biernacka EK
[Ad] Endereço:Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland. Electronic address: ukozicka@ikard.pl.
[Ti] Título:Pregnancy After Transcatheter Pulmonary Valve Implantation.
[So] Source:Can J Cardiol;33(12):1737.e5-1737.e7, 2017 Dec.
[Is] ISSN:1916-7075
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Transcatheter pulmonary valve implantation (TPVI) is a relatively new method of treating patients with significant pulmonary regurgitation or pulmonary stenosis, or both, after reconstruction of the right ventricular outflow tract. It is an attractive alternative to conduit replacement in this group of patients, who are typically young and active. This report includes 4 young women who after successful TPVI became pregnant and gave birth. Transthoracic echocardiography, cardiopulmonary exercise testing, and cardiac magnetic resonance imaging were performed in all patients. The results suggest that pregnancy and delivery after successful TPVI is safe when the appropriate precautions have been taken.
[Mh] Termos MeSH primário: Insuficiência da Valva Pulmonar/cirurgia
Estenose da Valva Pulmonar/cirurgia
Valva Pulmonar/cirurgia
[Mh] Termos MeSH secundário: Adulto
Cateterismo Cardíaco/métodos
Ecocardiografia
Teste de Esforço
Feminino
Seguimentos
Seres Humanos
Imagem Cinética por Ressonância Magnética
Período Pós-Operatório
Gravidez
Resultado da Gravidez
Valva Pulmonar/diagnóstico por imagem
Insuficiência da Valva Pulmonar/diagnóstico
Estenose da Valva Pulmonar/diagnóstico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28465119
[Au] Autor:Ing RJ
[Ad] Endereço:Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
[Ti] Título:Anesthetic Outcomes in Tetralogy of Fallot With Absent Pulmonary Valve.
[So] Source:J Cardiothorac Vasc Anesth;31(3):922-923, 2017 06.
[Is] ISSN:1532-8422
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Valva Pulmonar/cirurgia
Tetralogia de Fallot/cirurgia
[Mh] Termos MeSH secundário: Anestésicos
Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Anesthetics)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:29084778
[Au] Autor:Heng EL; Gatzoulis MA; Uebing A; Sethia B; Uemura H; Smith GC; Diller GP; McCarthy KP; Ho SY; Li W; Wright P; Spadotto V; Kilner PJ; Oldershaw P; Pennell DJ; Shore DF; Babu-Narayan SV
[Ad] Endereço:From Adult Congenital Heart Disease Centre, (E.L.H., M.A.G., A.U.., B.S., H.U., W.L., V.S., P.O., D.F.S., S.V.B.-N.), Cardiac Morphology Unit (K.P.M., S.Y.H.), and Non-Invasive Cardiology Department (P.W.), Royal Brompton Hospital, London, United Kingdom; National Institute for Health Research Cardi
[Ti] Título:Immediate and Midterm Cardiac Remodeling After Surgical Pulmonary Valve Replacement in Adults With Repaired Tetralogy of Fallot: A Prospective Cardiovascular Magnetic Resonance and Clinical Study.
[So] Source:Circulation;136(18):1703-1713, 2017 Oct 31.
[Is] ISSN:1524-4539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot provides symptomatic benefit and right ventricular (RV) volume reduction. However, data on the rate of ventricular structural and functional adaptation are scarce. We aimed to assess immediate and midterm post-PVR changes and predictors of reverse remoeling. METHODS: Fifty-seven patients with repaired tetralogy of Fallot (age ≥16 y; mean age, 35.8±10.1 y; 38 male) undergoing PVR were prospectively recruited for cardiovascular magnetic resonance performed before PVR (pPVR), immediately after PVR (median, 6 d), and midterm after PVR (mPVR; median, 3 y). RESULTS: There were immediate and midterm reductions in indexed RV end-diastolic volumes and RV end-systolic volumes (RVESVi) (indexed RV end-diastolic volume pPVR versus immediately after PVR versus mPVR, 156.1±41.9 versus 104.9±28.4 versus 104.2±34.4 mL/m ; RVESVi pPVR versus immediately after PVR versus mPVR, 74.9±26.2 versus 57.4±22.7 versus 50.5±21.7 mL/m ; <0.01). Normal postoperative diastolic and systolic RV volumes (the primary end point) achieved in 70% of patients were predicted by a preoperative indexed RV end-diastolic volume ≤158 mL/m and RVESVi ≤82 mL/m . RVESVi showed a progressive decrease from baseline to immediate to midterm follow-up, indicating ongoing intrinsic RV functional improvement after PVR. Left ventricular ejection fraction improved (pPVR versus mPVR, 59.4±7.6% versus 61.9±6.8%; <0.01), and right atrial reverse remodeling occurred (pPVR versus mPVR, 15.2±3.4 versus 13.8±3.6 cm /m ; <0.01). Larger preoperative RV outflow tract scar was associated with a smaller improvement in post-PVR RV/left ventricular ejection fraction. RV ejection fraction and peak oxygen uptake predicted mortality ( =0.03) over a median of 9.5 years of follow-up. CONCLUSIONS: Significant right heart structural reverse remodeling takes place immediately after PVR, followed by a continuing process of further biological remodeling manifested by further reduction in RVESVi. PVR before RVESVi reaches 82 mL/m confers optimal chances of normalization of RV function.
[Mh] Termos MeSH primário: Implante de Prótese de Valva Cardíaca
Próteses Valvulares Cardíacas
Imagem por Ressonância Magnética
Valva Pulmonar/cirurgia
Volume Sistólico
Tetralogia de Fallot
Remodelação Ventricular
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Masculino
Tetralogia de Fallot/diagnóstico por imagem
Tetralogia de Fallot/fisiopatologia
Tetralogia de Fallot/cirurgia
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171101
[St] Status:MEDLINE
[do] DOI:10.1161/CIRCULATIONAHA.117.027402


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[PMID]:28982503
[Au] Autor:Martin E; Mohammadi S; Jacques F; Kalavrouziotis D; Voisine P; Doyle D; Perron J
[Ad] Endereço:Division of Cardiac Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Université Laval, Quebec City, Quebec, Canada.
[Ti] Título:Clinical Outcomes Following the Ross Procedure in Adults: A 25-Year Longitudinal Study.
[So] Source:J Am Coll Cardiol;70(15):1890-1899, 2017 Oct 10.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Very few reports of long-term outcomes of patients who underwent the Ross procedure have been published. OBJECTIVES: The authors reviewed their 25-year experience with the Ross procedure with the aim of defining very-long-term survival and factors associated with Ross-related failure. METHODS: Between January 1990 and December 2014, the Ross procedure was performed in 310 adults (mean age 40.8 years) at a single institution. All patients were prospectively added to a dedicated cardiac surgery registry. Complete post-operative clinical examination and history were obtained, and transthoracic echocardiography was performed according to a standardized protocol. There was no loss to follow-up. Median follow-up was 15.1 years and up to 25 years. RESULTS: Bicuspid aortic valve was diagnosed in 227 patients (73.2%), and the most common indication for surgery was aortic stenosis (n = 225 [72.6%]). Freedom from any Ross-related reintervention was 92.9% and 70.1% at 10 and 20 years, respectively. Independent risk factors for pulmonary autograft degeneration were pre-operative large aortic annulus (hazard ratio: 1.1; p = 0.01), pre-operative aortic insufficiency (hazard ratio: 2.7; p = 0.002), and concomitant replacement of the ascending aorta (hazard ratio: 7.7; p = 0.0003). There were 4 hospital deaths (1.3%), and overall survival at 10 and 20 years was 94.1% and 83.6%, respectively. Long-term survival was not significantly different in patients who required Ross-related reintervention (log-rank p = 0.70). However, compared with the general population, survival was significantly lower in patients following the Ross procedure when matched on age and sex (p < 0.0001). CONCLUSIONS: The Ross procedure was associated with excellent long-term valvular outcomes and survival, regardless of the need for reintervention. Adults presenting with aortic insufficiency or a dilated aortic annulus or ascending aorta were at greater risk for reintervention. Unlike previous reports, long-term survival was lower in Ross patients compared with matched subjects.
[Mh] Termos MeSH primário: Insuficiência da Valva Aórtica
Estenose da Valva Aórtica
Valva Aórtica/anormalidades
Anuloplastia da Valva Cardíaca
Vasos Coronários
Doenças das Valvas Cardíacas
Efeitos Adversos de Longa Duração
Valva Pulmonar
Reimplante
[Mh] Termos MeSH secundário: Adulto
Valva Aórtica/diagnóstico por imagem
Valva Aórtica/cirurgia
Insuficiência da Valva Aórtica/etiologia
Insuficiência da Valva Aórtica/cirurgia
Estenose da Valva Aórtica/etiologia
Estenose da Valva Aórtica/cirurgia
Canadá/epidemiologia
Anuloplastia da Valva Cardíaca/efeitos adversos
Anuloplastia da Valva Cardíaca/métodos
Vasos Coronários/diagnóstico por imagem
Vasos Coronários/cirurgia
Feminino
Doenças das Valvas Cardíacas/complicações
Doenças das Valvas Cardíacas/diagnóstico
Doenças das Valvas Cardíacas/epidemiologia
Doenças das Valvas Cardíacas/cirurgia
Seres Humanos
Efeitos Adversos de Longa Duração/diagnóstico
Efeitos Adversos de Longa Duração/etiologia
Efeitos Adversos de Longa Duração/fisiopatologia
Efeitos Adversos de Longa Duração/terapia
Masculino
Avaliação de Processos e Resultados (Cuidados de Saúde)
Inibidores da Agregação de Plaquetas/uso terapêutico
Período Pós-Operatório
Valva Pulmonar/diagnóstico por imagem
Valva Pulmonar/cirurgia
Sistema de Registros
Reimplante/efeitos adversos
Reimplante/métodos
Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE


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[PMID]:28954831
[Au] Autor:Carlson SD; Steinberg ZL; Krieger EV
[Ad] Endereço:Department of Medicine, Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA.
[Ti] Título:Exertional dyspnoea in a 28-year-old woman.
[So] Source:Heart;103(22):1779-1829, 2017 Nov.
[Is] ISSN:1468-201X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CLINICAL INTRODUCTION: A 28-year-old woman with a history of critical pulmonic stenosis, status postsurgical valvotomy and subsequent pulmonary valve replacement, presented to the cardiology clinic with 1 year of progressive exertional dyspnoea. She has a heart rate of 75 bpm and blood pressure of 110/55 mm Hg. Cardiac auscultation reveals a 1/6 systolic ejection murmur along the left sternum and an early 3/6 diastolic decrescendo murmur. A transthoracic echocardiogram is obtained (figure 1). QUESTIONS: Which of the following would be most likely found during right heart catheterisation?Ratio of pulmonary to systemic blood flow (Qp:Qs) >1.5Pulmonary vascular resistance >3 Wood unitsRight atrial pressure >10mm HgPulmonary artery systolic pressure >45mm Hg E. Pulmonary artery diastolic pressure <10mm Hg.
[Mh] Termos MeSH primário: Dispneia/etiologia
Implante de Prótese de Valva Cardíaca/efeitos adversos
Esforço Físico
Insuficiência da Valva Pulmonar/diagnóstico
Estenose da Valva Pulmonar/cirurgia
Valva Pulmonar/cirurgia
[Mh] Termos MeSH secundário: Adulto
Função do Átrio Direito
Pressão Atrial
Pressão Sanguínea
Cateterismo Cardíaco
Ecocardiografia Doppler de Pulso
Feminino
Frequência Cardíaca
Seres Humanos
Valor Preditivo dos Testes
Valva Pulmonar/fisiopatologia
Insuficiência da Valva Pulmonar/etiologia
Insuficiência da Valva Pulmonar/fisiopatologia
Estenose da Valva Pulmonar/diagnóstico
Estenose da Valva Pulmonar/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1136/heartjnl-2017-312174


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[PMID]:28901232
[Au] Autor:da Costa FDA; Etnel JRG; Torres R; Balbi Filho EM; Torres R; Calixto A; Mulinari LA
[Ad] Endereço:1 Department of Cardiac Surgery, Santa Casa de Curitiba-PUCPR and Hospital Infantil Pequeno Príncipe, Curitiba, Brazil.
[Ti] Título:Decellularized Allografts for Right Ventricular Outflow Tract Reconstruction in Children.
[So] Source:World J Pediatr Congenit Heart Surg;8(5):605-612, 2017 Sep.
[Is] ISSN:2150-136X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Determine the midterm outcomes of decellularized allografts for right ventricular outflow tract (RVOT) reconstruction in children less than 12 years of age. METHODS: The study included all consecutive patients submitted to RVOT reconstruction with decellularized allografts between June 2006 and June 2016. Besides clinical and echocardiographic control, 20 patients with more than five years of follow-up were evaluated with computed tomography (CT) scans to determine allograft diameters and calcium scores. Structural valve deterioration was defined as any peak gradient above 40 mm Hg and/or insufficiency of moderate or severe degree. Conduit failure was defined as the need for allograft reintervention. RESULTS: There were 59 patients with a median age of six years (range = 0.01-12 years). The most common operation was the Ross procedure (34%). Mean clinical follow-up was 5.4 (2.8) years and was 94% complete. At eight years, only two patients needed a reintervention, with a 90.9% freedom from this event. Structural valve deterioration occurred in 13 patients, 5 due to stenosis and 8 due to insufficiency, with a freedom from structural valve deterioration due to any cause of 64.9% at eight years. Late CT scans demonstrated the absence or minimal calcification of the conduits. CONCLUSIONS: Decellularized allografts for RVOT reconstruction in children were associated with a low incidence of structural valve deterioration and conduit failure. Although these results still need to be confirmed in larger series and with longer follow-up, our data suggest favorable outcomes, at least in the first decade after the operation.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/métodos
Ventrículos do Coração/cirurgia
Valva Pulmonar/transplante
Obstrução do Fluxo Ventricular Externo/cirurgia
[Mh] Termos MeSH secundário: Aloenxertos
Brasil/epidemiologia
Criança
Pré-Escolar
Ecocardiografia
Feminino
Ventrículos do Coração/diagnóstico por imagem
Seres Humanos
Incidência
Lactente
Recém-Nascido
Masculino
Complicações Pós-Operatórias/epidemiologia
Desenho de Prótese
Engenharia Tecidual
Tomografia Computadorizada por Raios X
Obstrução do Fluxo Ventricular Externo/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1177/2150135117723916


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[PMID]:28858090
[Au] Autor:Zhang WJ; Zhang ZL; Chang JJ; Song XY
[Ad] Endereço:Department of Medical Ultrasound, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
[Ti] Título:Prenatal ultrasonic diagnosis of absent pulmonary valve syndrome: A case report.
[So] Source:Medicine (Baltimore);96(35):e7747, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease that is often associated with tetralogy of Fallot (TOF). Here, we report 2 cases of APVS associated with TOF diagnosed via fetal echocardiography and discuss their specific ultrasonographic characteristics. PATIENT CONCERNS: Two pregnant women with suspicion of fetal heart anomaly were referred from their local hospitals to our hospital for fetal malformation screening and detailed fetal echocardiography. Color and spectral Doppler flow imaging were utilized to evaluate the axis, size, situs, cardiac chambers, and both inflow and outflow tracts of the heart as well as the great arteries. Both cases had a severe dilatation of the pulmonary trunk and its branches and an absence or dysplasia of the pulmonary valve, which was associated with subaortic ventricular septal defect (VSD) with an overriding aorta. In addition, the fetus in case 1 showed a patent ductus arteriosus, and the fetus in case 2 showed arterial duct agenesis. Furthermore, color Doppler flow imaging showed a bi-directional multicolored flow signal in the pulmonary valve ring. DIAGNOSES: Both fetuses were diagnosed with APVS associated with TOF. INTERVENTIONS: No therapeutic intervention was performed. OUTCOMES: On the request of the pregnant women and their families, both fetuses were aborted. LESSONS: Although APVS is a rare congenital heart disease and often associated with TOF, it has an overall poor prognosis. Nowadays, it can be easily diagnosed via ultrasonography because of its typical ultrasonographic features, such as aneurysmal dilatation of pulmonary artery, massive regurgitation of the pulmonary valve, VSD, and an overriding aorta. Therefore, early fetal echocardiography screening should be performed for every fetus.
[Mh] Termos MeSH primário: Valva Pulmonar/anormalidades
Tetralogia de Fallot/diagnóstico
[Mh] Termos MeSH secundário: Anormalidades Múltiplas/diagnóstico
Anormalidades Múltiplas/diagnóstico por imagem
Adulto
Ecocardiografia Doppler
Feminino
Cardiopatias Congênitas/diagnóstico
Cardiopatias Congênitas/diagnóstico por imagem
Seres Humanos
Gravidez
Valva Pulmonar/diagnóstico por imagem
Síndrome
Tetralogia de Fallot/diagnóstico por imagem
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007747


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[PMID]:28843325
[Au] Autor:Bhagra CJ; Hickey EJ; Van De Bruaene A; Roche SL; Horlick EM; Wald RM
[Ad] Endereço:Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada; Cambridge University and Papworth NHS Foundation Trusts, Cambridge, United Kingdom.
[Ti] Título:Pulmonary Valve Procedures Late After Repair of Tetralogy of Fallot: Current Perspectives and Contemporary Approaches to Management.
[So] Source:Can J Cardiol;33(9):1138-1149, 2017 Sep.
[Is] ISSN:1916-7075
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Few topics in adult congenital heart disease have approached the level of scrutiny bestowed on pulmonary valve replacement (PVR) strategies late after tetralogy of Fallot (TOF) repair. Despite the successes of primary surgery for TOF, there is a growing group of adults with residual right ventricular outflow tract and pulmonary valve dysfunction. Patients with residual chronic pulmonic regurgitation as a consequence of earlier surgery can later develop symptoms of exercise intolerance and complications including heart failure, tachyarrhythmias, and sudden cardiac death. Optimal timing of PVR has sparked debate, which has catalyzed increasing research efforts over the past decade. Although performance of PVR in the absence of symptoms is currently on the basis of the rationale that achievement of complete reverse remodelling is highly desirable, whether this approach results in improvement in patient outcomes in the long-term has yet to be shown. Surgical PVR and percutaneous pulmonary valve intervention are different techniques with specific advantages and disadvantages that require careful consideration for each individual patient, alongside the need for requisite reinterventions over the course of a patient's lifetime. Criteria pertaining to referral strategies are ever being refined as newer technologies for percutaneous therapies continue to evolve. In this article we review the literature surrounding the indications for, the optimal timing of, and the approaches to pulmonary valve procedures in adults with previously repaired TOF.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/métodos
Insuficiência da Valva Pulmonar/cirurgia
Valva Pulmonar/cirurgia
Tetralogia de Fallot/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Insuficiência da Valva Pulmonar/etiologia
Reoperação
Tetralogia de Fallot/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170828
[St] Status:MEDLINE



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