Surgical Treatment of Tetralogy of Fallot and Sequelae
Transcript of video: Tetralogy of Fallot is one of the commonest cyanotic congenital heart diseases. As the name implies, there are four defects. One is ventricular septal defect, second is overriding aorta, third is pulmonary stenosis, usually right ventricular outflow tract stenosis and associated right ventricular hypertrophy. Overriding aorta with ventricular septal defect causes right to left shunt and cyanosis so that in infancy, cyanotic spells may also be there and squatting is one of the important symptoms of tetralogy of Fallot. There are several surgical options for tetralogy of Fallot and also some sequelae for...
Source: Cardiophile MD - March 29, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Collection of a few ECGs in congenital heart diseases
Classical QRS pattern in ASD is the rSR’ in V1 suggestive incomplete RBBB. This pattern in ASD is due to RV volume overload. QRS axis is usually rightward, more so when there is severe PAH. Left axis deviation is feature of ostium primum ASD. First degree AV block may be noted in both primum and secundum ASD. Familial ASD with first degree AV block has been reported in secundum ASD. This type of familial ASD has an autosomal dominant inheritance pattern. There is also a higher incidence of SCD in this group.
IRBBB pattern in ASD
Crochetage sign in ASD, manifest as notching of R wave near the apex in inferior leads (a...
Source: Cardiophile MD - February 14, 2024 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology ECG Library Source Type: blogs
Right Heart Catheterization in Tetralogy of Fallot
With the availability of high resolution echocardiographic images and Doppler echocardiography, role of cardiac catheterization has come down in tetralogy of Fallot and other congenital heart diseases in general. Important risks for cardiac catheterization in a deeply cyanotic infant are the chance of precipitation of a cyanotic spell and thrombotic strokes due to hemoconcentration. Chance of precipitating a cyanotic spell are more when pulmonary angiography is attempted through the already narrow right ventricular outflow tract. Hemocontration is due to the diuresis following contrast angiography, which can be prevented ...
Source: Cardiophile MD - January 15, 2024 Category: Cardiology Authors: Johnson Francis Tags: Angiography and Interventions Source Type: blogs
Ductus Dependent Circulation
Ductus dependent circulation is one in which a patent ductus arteriosus is useful in maintaining the circulation after birth. It is important to rule out such conditions before any PDA closure is planned. PDA dependent circulations can be PDA dependent pulmonary circulation, PDA dependent systemic circulation and PDA dependent mixed circulation. The first group includes pulmonary atresia, tricuspid atresia and tetralogy of Fallot with pulmonary atresia. In those cases, post natal physiological constriction of ductus arteriosus can cause severe hypoxemia, cyanosis and even death. In these cases, there is severe restriction...
Source: Cardiophile MD - June 13, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Clinical Examination of Cardiovascular System For Medical Students
Discussion on blood pressure is not included here as a separate topic is dedicated to it.
Though the most commonly examined pulse is the radial, to check some of the characteristics, a more proximal pulse like the brachial or carotid needs to be examined. Following parameters of the pulse are routinely documented: 1. The rate: Normal rate in adult is 60-100 per minute. It is higher in children. Younger the child, higher the pulse rate.
Rhythm: Regular and irregular rhythms are possible. Mild variation with respiration is called respiratory sinus arrhythmia, with higher rate in inspiration. Respiratory sinus arrhythmia may...
Source: Cardiophile MD - May 30, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a bidirectional Glenn procedure (BDG)? Cardiology Basics
Bidirectional Glenn procedure is done for children with some types of cyanotic congenital heart diseases. The classical Glenn procedure is an end to end anastomosis of the superior vena cava to the right pulmonary artery so that the superior vena caval venous blood does not reach the left pulmonary artery. Bidirectional Glenn (BDG) procedure is an end to side anastomosis of superior vena cava to the right pulmonary artery. Main pulmonary artery is then divided and sutured. BDG helps flow into both pulmonary arteries. BDG is usually followed later by a Fontan repair.
BDG is performed in patients with anatomical or fu...
Source: Cardiophile MD - October 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Fight Aging! Newsletter, June 20th 2022
This study showed a negative relationship between the gaps and the number of senescence cells. Moreover, we found a similar reduction in 30-month-old naturally and 7-month-old D-gal-induced aging rats. Given these consistent data from different eukaryotic organisms, it suggests that the Youth-DNA-GAP is a marker of phenotype-related aging degree
Towards Scaffold-Based Regeneration of Dental Pulp
https://www.fightaging.org/archives/2022/06/towards-scaffold-based-regeneration-of-dental-pulp/
Researchers are working towards the ability to regenerate the dental pulp inside teeth. Full regeneration of teeth ...
Source: Fight Aging! - June 19, 2022 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Fecal Microbiota Transplantation Improves Ovarian Function in Old Mice
Fecal microbiota transplantation from a young individual to an old individual has been shown in animal studies to reset the aging gut microbiome to a more youthful configuration for a lasting period of time. The gut microbiome changes in detrimental ways with age, harmful and inflammatory populations displacing beneficial populations that produce needed metabolites. A fecal microbiota transplant removes these changes, improving health, reducing inflammation, and extending life span in short-lived species. It is a procedure already used in humans, and which should be further developed as a means to improve the health of all...
Source: Fight Aging! - June 13, 2022 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Fight Aging! Newsletter, January 24th 2022
In conclusion, senolytic drugs have shown promising results in the elimination of senescent cells and in alleviating various diseases in animal models. However, in patients, there is a paucity in data on the efficacy and safety of senotherapeutics from clinical trials, including systemic effects and side-effects. In this regard it is important to assess the specificity of senolytics in killing targeted senescent cells and their cytotoxic effects, to identify reliable markers for intervention responses, to elucidate interactions with comorbidities and other drugs, and to standardise administration protocols.
FOXO3...
Source: Fight Aging! - January 23, 2022 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Reviewing the Role of Cellular Senescence in Liver Disease
Senescent cells are play a role in the onset and progression of near every age-related condition. Cells become senescent constantly throughout the body and throughout life, most because they have reached the Hayflick limit to replication. In youth, senescent cells are efficiently removed, either through programmed cell death or by the immune system. With age, the immune system declines in effectiveness. Senescent cells begin to linger and grow in number. These errant cells secrete a mix of pro-growth, pro-inflammation signals that, when present over the long term, disrupt cell and tissue function.
Today's open acce...
Source: Fight Aging! - January 20, 2022 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Major aortopulmonary collateral arteries
Major aortopulmonary collateral arteries (MAPCA) occur in cyanotic congenital heart diseases with decreased pulmonary blood flow (tetralogy of Fallot like physiology). They are a natural protective mechanism to improve pulmonary blood flow. MAPCAs are more likely to occur in pulmonary atresia than in simple tetralogy of Fallot.
MAPCAs can also occur in conditions other than the typical pulmonary atresia with ventricular septal defect. In a retrospective review of such cases, 33 had single ventricle anatomy while the rest had two ventricle anatomy. Among those with single ventricle, 15 had unbalanced complete atrioventricu...
Source: Cardiophile MD - April 23, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Surgery for tetralogy of Fallot
Tetralogy of Fallot is the commonest cyanotic congenital heart disease. Surgical repair has improved remarkably ever since it was first published in 1955 by Lillehei CW et al [1]. Excellent long term survival is now feasible, with 30 year survival ranging from 68.5% to 90.5% [2].
Symptomatic infants with tetralogy of Fallot can undergo either primary surgical repair or a palliative procedure which could be either a systemic to pulmonary shunt or catheter based right ventricular outflow tract or pulmonary valve dilatation [3]. A retrospective study using the UK National Congenital Heart Disease Audit had 1662 infants with...
Source: Cardiophile MD - April 21, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Source Type: blogs
Fontan Circulation
Fontan repair of tricuspid atresia was initiated in late 1960s. Francis Fontan et al reported that surgical repair was carried out in three patients with tricuspid atresia of which two were successful [1]. Inferior venacaval blood was directed to the left lung and the right pulmonary artery received the superior venacaval blood through a cavopulmonary anastomosis. They mentioned that the size of the pulmonary arteries must be large enough and at sufficiently low pressure to allow flow in a cavopulmonary anastomosis.
The first step was a Glenn procedure in which distal end of right pulmonary artery was anastomosed to the ...
Source: Cardiophile MD - April 20, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Source Type: blogs
Intermittent LBBB and P Mitrale or Tricuspidale?
Intermittent LBBB and P Mitrale or Tricuspidale
Intermittent left bundle branch block pattern is seen as wide notched QRS complexes with cycle length of 570 ms. Narrower QRS complexes at cycle length of 600 ms are seen towards the end of the tracing. This can be considered as phasic aberrancy which is rate dependent. Classically rate dependent left bundle branch block is deceleration dependent rather than acceleration dependent. Acceleration dependent block is usually right bundle branch block.
P waves are wide and notched, suggesting left atrial overload. But close scrutiny shows that the initial peak is taller than the...
Source: Cardiophile MD - February 18, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: ECG / Electrophysiology ECG Library Source Type: blogs
Modified Blalock – Taussig shunt
The original Blalock – Taussig (BT) shunt was designed by Helen B Taussig (physician) and Alfred Blalock (surgeon) at the John Hopkins Hospital. This was based on the observation by Helen B Taussig that infants with severe pulmonary stenosis or pulmonary atresia had worsening of cyanosis after spontaneous closure of ductus arteriosus. The BT shunt was an anastomosis between subclavian artery and pulmonary artery, to enhance pulmonary blood flow those infants with severe cyanotic congenital heart disease with low pulmonary blood flow.
Different techniques have been used to modify a BT shunt when it is not technically fea...
Source: Cardiophile MD - December 23, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Blalock – Taussig shunt BT shunt classic Blalock – Taussig shunt Modified Blalock – Taussig shunt modified BT shunt Source Type: blogs
