The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Bradley P. Knight - One of the best experts on this subject based on the ideXlab platform.
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Double transseptal catheterization guided by real-time 3-dimensional transesophageal echocardiography
Heart Rhythm, 2007Co-Authors: Kiam Khiang Lim, Lissa Sugeng, Roberto M. Lang, Bradley P. KnightAbstract:547-5271/$ -see front matter © 2008 Heart Rhythm Society. All rights reserved sophagus to the level of the left Atrium (LA). Three 8F ransvenous sheaths were introduced into the right femoral ein. A quadripolar electrophysiology catheter was advanced hrough a sheath and positioned in the coronary sinus, and n ablation catheter was advanced through a long guiding heath (SRO, St. Jude Medical, St Paul, MN) to the right trium (RA). Transseptal puncture was performed using a transseptal heath and dilator (SL1, St. Jude Medical) and a standard rockenbrough transseptal needle. The dilator was withrawn from the superior vena cava and manipulated to ause tenting of the intra-atrial septum at level of the fossa valis (FO) as imaged with RT3D-TEE (Figure 1). The eedle was advanced to puncture the septum during continFigure 2 FO fossa ovalis; LA left Atrium; RA right Atrium.
Masakazu Kohno - One of the best experts on this subject based on the ideXlab platform.
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Contrast transesophageal echocardiography in diagnosing congenital enlargement of the right Atrium: A case report
Angiology, 2003Co-Authors: Kazushi Yukiiri, Yuichiro Takagi, Katsufumi Mizushige, Yoshihiro Wada, Koji Ohmori, Kojiro Tanimoto, Takashi Ueda, Masakazu KohnoAbstract:Congenital malformation of the right Atrium or the coronary sinus is rare, and cases are clas sified into 1 of the following 4 categories: (1) congenital enlargement of right Atrium, (2) single diverticulum, (3) multiple diverticula of the right Atrium, and (4) diverticulum of the coronary sinus. This report presents a 63-year-old man with cardiomegaly and no chest symptoms. A chest radiograph revealed an enlarged cardiac silhouette with a prominent right heart border. Although a transesophageal echocardiography revealed marked enlargement of the right Atrium, neither further anomaly nor massive regurgitation was observed. The systolic pulmonary artery pressure derived from the peak velocity of mild tricuspid regurgitation was 38 mm Hg. Secondary enlargement of the right Atrium due to atrial septal defect or pulmonary venous connection anomaly was deemed negligible by use of transesophageal contrast echocardiography, and primary enlargement of the right Atrium was confirmed. Trans esophageal echocardiogra...
Kiam Khiang Lim - One of the best experts on this subject based on the ideXlab platform.
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Double transseptal catheterization guided by real-time 3-dimensional transesophageal echocardiography
Heart Rhythm, 2007Co-Authors: Kiam Khiang Lim, Lissa Sugeng, Roberto M. Lang, Bradley P. KnightAbstract:547-5271/$ -see front matter © 2008 Heart Rhythm Society. All rights reserved sophagus to the level of the left Atrium (LA). Three 8F ransvenous sheaths were introduced into the right femoral ein. A quadripolar electrophysiology catheter was advanced hrough a sheath and positioned in the coronary sinus, and n ablation catheter was advanced through a long guiding heath (SRO, St. Jude Medical, St Paul, MN) to the right trium (RA). Transseptal puncture was performed using a transseptal heath and dilator (SL1, St. Jude Medical) and a standard rockenbrough transseptal needle. The dilator was withrawn from the superior vena cava and manipulated to ause tenting of the intra-atrial septum at level of the fossa valis (FO) as imaged with RT3D-TEE (Figure 1). The eedle was advanced to puncture the septum during continFigure 2 FO fossa ovalis; LA left Atrium; RA right Atrium.
Louise A Calder - One of the best experts on this subject based on the ideXlab platform.
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congenitally corrected transposition of the great arteries
Heart, 2010Co-Authors: Tim S Hornung, Louise A CalderAbstract:Congenitally corrected transposition of the great arteries (ccTGA) is a rare defect representing approximately 0.5% of all congenital heart disease. ccTGA is characterised by the combination of atrioventricular (AV) discordance and ventriculo-arterial (VA) discordance. Various terms have been used to describe this anatomy: congenitally or physiologically corrected transposition of the great arteries, L-transposition, double discordance and ventricular inversion being the most frequently used. The term ‘congenitally corrected transposition’ is used to differentiate this condition from ‘complete transposition’ (d-TGA) in which there is VA discordance but AV concordance. There is usually normal drainage of the systemic and pulmonary veins to the right and left Atriums respectively. The right Atrium connects via the mitral valve to the morphologic left ventricle which supplies the pulmonary artery. The left Atrium connects via the tricuspid valve to the morphologic right ventricle which supplies the aorta via a sub-aortic infundibulum. The ventricles are most commonly side by side: in patients with situs solitus the morphologic left ventricle is rightward and the morphologic right ventricle is leftward. The anatomy is described as congenitally ‘corrected’ because the flow of blood is normal with the deoxygenated systemic venous blood being pumped to the lungs and the well oxygenated pulmonary venous blood being pumped to the body. Nevertheless, the two wrongs of AV and VA discordance do not make a right, as the morphologic left ventricle (LV) and mitral valve supply the pulmonary circulation and the morphologic right ventricle (RV) and tricuspid valve supply the systemic circulation. The most common anatomical arrangement is situs solitus with L-looping of the ventricles and the aorta anterior and leftward of the pulmonary artery (S,L,L), found in 19/22 of our cases in Auckland (unpublished data). The aorta was anterior and rightward (S,L,D) in two of 21 cases of ccTGA with situs solitus. In patients …
Robert H. Anderson - One of the best experts on this subject based on the ideXlab platform.
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clarifying the atrioventricular junctional anatomy in the setting of double outlet right Atrium
Annals of Pediatric Cardiology, 2015Co-Authors: Saurabh Kumar Gupta, Anunay Gupta, Sivasubramanian Ramakrishnan, Robert H. AndersonAbstract:Double outlet Atrium is a rare cardiac anomaly wherein one of the Atriums, most frequently the right Atrium, opens into both the ventricles. Although seen more commonly in the setting of atrioventricular septal defect, this arrangement can also be found when one of the atrioventricular connections is atretic due to absence of the atrioventricular connection and the other atrioventricular valve straddles the muscular ventricular septum. It is the specific anatomy and connections of the atrioventricular junction that clarifies the situation and distinguishes between these two types of double outlet Atrium. In this report, we present a case of double outlet right Atrium co-existing with the absence of left atrioventricular connection. We then discuss the morphologic aspects of this interesting anomaly.
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Cor triatriatum or divided Atriums: which approach provides the better understanding?
Cardiology in the young, 2014Co-Authors: Tara Bharucha, Diane E. Spicer, Timothy J. Mohun, David Black, G. William Henry, Robert H. AndersonAbstract:It is frequent, in the current era, to encounter congenital cardiac malformations described in terms of "cor triatriatum". But can hearts be truly found with three atrial chambers? The morphological method, emphasised by Van Praagh et al, states that structures within the heart should be defined on the basis of their most constant components. In the atrial chambers, it is the appendages that are the most constant components, and to the best of our knowledge, hearts can only possess two appendages, which can be of either right or left morphology. The hearts described on the basis of "cor triatriatum", nonetheless, can also be analysed on the basis of division of either the morphologically right or the morphologically left Atriums. In this review, we provide a description of cardiac embryology, showing how each of the atrial chambers possesses part of the embryological body, along with an appendage, a vestibule, a venous component, and a septum that separates them. We then show how it is, indeed, the case that the hearts described in terms of "cor triatriatum" can be readily understood on the basis of division of these atrial components. In the right Atrium, it is the venous valves that divide the chamber. In the left Atrium, it is harder to provide an explanation for the shelf that produces atrial division. We also contrast the classic examples of the divided atrial chambers with the vestibular shelf that produces supravalvar stenosis in the morphologically left Atrium, showing that this form of obstruction needs to be distinguished from the fibrous shelves producing intravalvar obstruction.
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Interatrial communication through the mouth of the coronary sinus.
Cardiology in The Young, 2002Co-Authors: Alison L. Knauth, Karen P. Mccarthy, Sandra Webb, Sally P. Allwork, Andrew C. Cook, Robert H. AndersonAbstract:Objectives: We describe the structure of, and suggest an etiology for, the interatrial communication which can occur through the mouth of the coronary sinus. Based on the study of human embryos, we propose that the defect is best explained by dissolution of the wall of the coronary sinus adjacent to the left Atrium, permitting shunting between the Atriums through the right atrial orifice of the sinus. Background: An interatrial communication across the mouth of the coronary sinus defect was first described in 1965 by Raghib and colleagues, its existence being predicated on the basis of incomplete formation of the left "atriovenous fold". Their hypothesis implies that the coronary sinus never develops, and thus the atrial septum itself is incomplete. Methods: We have studied the development of the coronary sinus in a series of human embryos. Based on this work, we present the anatomical findings in 6 specimens with varying degrees of dissolution of the walls of the coronary sinus, and ten specimens with isomerism of the right atrial appendages, in which the sinus has never been formed. Results: The coronary sinus defect is not a hole within the atrial septum, but a communication between the Atriums through the mouth of the sinus. There was a range of defects in our series of specimens with usual atrial arrangement, extending from complete absence of the walls which normally separate the coronary sinus from the left Atrium, to small fenestrations between this vessel and the left atrial cavity. In the hearts with isomerism of the right atrial appendages, however, we never observed an orifice of the coronary sinus. Thus, a coronary sinus defect cannot exist in this setting. Conclusions: Our findings indicate that the defect requires initial formation of the walls of the coronary sinus, but with subsequent dissolution of the wall adjacent to the left Atrium. This produces a communication between the Atriums through the mouth of the sinus.
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ventricular morphology and coronary arterial anatomy in hearts with isomeric atrial appendages
The Annals of Thoracic Surgery, 1999Co-Authors: Hideki Uemura, Robert H. Anderson, Toshikatsu YagiharaAbstract:Background. Knowledge of the precise anatomy can be advantageous when striving to improve surgical results in patients with visceral heterotaxy. Methods. We studied the ventricular mass, and its coronary arterial supply, in 125 specimens with isomeric right and 58 with isomeric left appendages. Results. The situation in which each Atrium connected to its own ventricle was the most common arrangement in hearts with isomeric left appendages. The pattern with both Atriums connecting to the same ventricle was more frequently seen in those with isomeric right appendages. Concordant ventriculoarterial connections were seen in only 4% of cases with isomeric right appendages, but were seen in 45% of those with isomeric left appendages. Abnormal patterns in branching of the coronary arteries were commonly associated with abnormal ventricular architecture. The morphologically right or left ventricular arteries were frequently lacking in those hearts with a dominant ventricle and a rudimentary and incomplete ventricle. A solitary coronary artery was seen in 13%. Conclusions. Recognition of these abnormalities is of clinical importance if optimal surgical strategies are to be established for patients with visceral heterotaxy.
