Subclavian artery pseudoaneurysm long after the division of modified Blalock –Taussig shunt
AbstractA massive but asymptomatic left subclavian artery pseudoaneurysm was diagnosed in a 30-year-old female patient with transposition of the great arteries, ventricular septal defect, and pulmonary atresia. After undergoing bilateral modified Blalock –Taussig shunts at the age of 4 months and 3 years, respectively, she underwent the Rastelli operation and division of both shunts at the age of 6 years of age. The pseudoaneurysm was not discovered at the follow-up investigation at age 14. During the time period from age 18 to 30 years, she w as lost to follow-up, she was confirmed to be free from infectious disease, traumatic accident, or vasculitis. Pregnancy-induced hypertension was not associated during her pregnancy. Graft replacement of the left subclavian artery and redo right ventricular outflow tract reconstruction were successf ully performed under deep hypothermic circulatory arrest at the age of 33 years.
Contributors : Lucas C Pantaleao ; Susan E Ozanne ; Ania WilczynskaSeries Type : Expression profiling by high throughput sequencingOrganism : Mus musculusObesity during pregnancy is associated with fetal growth restriction in the offspring. We used RNA next generation sequencing analysis (HiSeq2000) to have a snapshot of the placenta transcriptome at embryonic day 19 to examine whether mice exposed to maternal obesity had significant changes in their transcriptome which may lead to growth restriction in the fetus.
Conclusions. Seven years following PFT, the patient gained limb strength with a functional elbow and wrist, although with diminished digital dexterity and sensation. Based on data presented by other programs and our own experience, PFT is indicated for select patients.
Pulmonary endarterectomy (PEA) is a curative surgical option for patients with chronic thromboembolic pulmonary hypertension (CTEPH), a disease resulting from chronic pulmonary thromboembolism. The role of sarcopenia (i.e. low skeletal muscle mass) has been shown to be associated with adverse outcomes in surgical populations, but its significance with PEA remains unknown. We sought to evaluate the association of sarcopenia with measures of CTEPH severity and post-operative hospital outcomes.
Pulmonary endarterectomy (PEA) is curative for suitable chronic thromboembolic pulmonary hypertension (CTEPH) patients. Careful anticoagulation prevents postoperative bleeding and thromboembolic recurrence. Heparinization is often guided by aPTT but it can be influenced by Factor VIII - a coagulation factor elevated in CTEPH. Anti-Xa-guided anticoagulation is less affected by other factors. We investigated the correlation between aPTT and Anti-Xa after PEA and the impact of coagulation factors.
Pulmonary artery sarcoma (PAS) is an exceedingly rare disease with historically poor survival. PAS is often mistaken for chronic thromboembolic pulmonary hypertension (CTEPH) owing to similarities in clinical presentation. Controversy exists regarding need to definitively differentiate PAS from CTEPH prior to surgical therapy. Furthermore lung resection would seem inferior palliation to tumor endarterectomy in a predominantly bilateral disease dominated by hemodynamic compromise.
The REVEAL risk score (RRS) predicts 1-year survival in patients with pulmonary arterial hypertension; it also improved with riociguat in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) in the Phase III CHEST-1 study, and predicted survival and clinical worsening-free survival (CWFS) in the long-term extension CHEST-2. RRS 2.0, an updated RRS, was developed based on modified point values, cut-offs, and variables. This post hoc analysis aimed to validate RRS 2.0 in the CHEST database (a population not derived from REVEAL), as done previously, and assess if the tool disc...
Chronic thromboembolic pulmonary hypertension (CTEPH), is a progressive condition characterized by persistent elevation in pulmonary artery pressure due to thromboembolic occlusion of the pulmonary arteries. Little is known about the cells that make up the cast of pulmonary endarterectomy (PEA) and its immune microenvironment. Here we report a map of the cellular landscape of the human PEA specimen using single-cell RNA sequencing.
Pulmonary endarterectomy (PEA) is established as the recommended treatment for chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this work was to review outcomes by era at a high-volume national PEA centre.
Pulmonary arterial hypertension (PAH) is a rare but severe complication of unrepaired atrial septal defect (ASD) and carries a worse prognosis than posttricuspid shunt. In patients with ASD complicated by PAH and right ventricular failure, heart-lung transplantation (HLT) is currently viewed as the best option despite high postoperative mortality. However, the severe donor organ shortage results in high waiting-list mortality. Our objective here was to compare the safety and benefits of double-lung transplantation (DLT) followed by percutaneous ASD closure versus HLT for end-stage ASD-associated PAH.
Pulmonary arterial hypertension (PAH) is rare but remains a fatal disease in infants and children despite the recent introduction of targeted therapies. Lung transplantation (LT), first performed in pediatric patients in the 1980s, is the only potentially life-extending option in patients with end-stage PAH but is possible only in tightly selected patients. Size-matching challenges severely restrict the donor organ pool which, in addition to peculiarities of PAH in infants, results in high mortality while on the waiting list.