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Double orifice mitral valve: a case report and review of management

Majid AA

J Cardiovasc Surg (Torino), 1991 Nov-Dec;32(6):837-9.
PMID: 1836465

This paper reports a case of double orifice mitral valve which was treated conservatively. A new scheme of classification of this entity linked to the accepted lines of surgical treatment is introduced.

Matched MeSH terms: Heart Septal Defects, Atrial/surgery
An Unusual Type of Totally Anomalous Pulmonary Venous Connection to the Superior Cavoatrial Junction

Shamsuddin AM, Wong AR, Anderson RH, Corno AF

World J Pediatr Congenit Heart Surg, 2016 Jul;7(4):490-3.
PMID: 26795906 DOI: 10.1177/2150135115603330

A neonate with cyanosis at birth was found to have a rare type of totally anomalous pulmonary venous connection. The pulmonary veins entered a confluence posterior to the left atrial wall, which drained into the right superior cavoatrial junction. There were no other major structural defects and no evidence of isomerism. Because of the severe cyanosis, and the restrictive nature of the interatrial communication, we performed balloon atrioseptostomy to improve oxygenation. We then achieved successful surgical repair when the baby was aged 7 months.

Matched MeSH terms: Heart Septal Defects, Atrial/surgery*
Beating the odds: a rare case of supracardiac total anomalous pulmonary venous return (TAPVR) in an adult patient

Talib N, Sayuti KA, Abdullah MS, Mohd Zain MR

BMJ Case Rep, 2018 Mar 05;2018.
PMID: 29507009 DOI: 10.1136/bcr-2017-221074

Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect, and patients are usually symptomatic at a very young age. Survival to adulthood without surgical correction is extremely rare. We report a 33-year-old woman with a heart murmur and a history of a successful pregnancy. Echocardiogram revealed a large atrial septal defect with suspicious pulmonary vein anomaly. Chest radiograph demonstrated classical 'snowman' configuration. Cardiac catheterisation was consistent with anomalous pulmonary venous drainage. Cardiac CT confirmed supracardiac TAPVR, whereby all the pulmonary veins drain into the anomalous vein and finally to the superior vena cava. She remained asymptomatic and underwent a successful surgical repair.

Matched MeSH terms: Heart Septal Defects, Atrial/surgery
Ductal Stenting to Retrain the Involuted Left Ventricle in d-Transposition of the Great Arteries

Leong MC, Ahmed Alhassan AA, Sivalingam S, Alwi M

Ann Thorac Surg, 2019 09;108(3):813-819.
PMID: 30998905 DOI: 10.1016/j.athoracsur.2019.03.045

BACKGROUND: Ductal stenting is performed to retrain involuted left ventricles (LVs) in patients with d-transposition of the great arteries and intact ventricular septum (TGA-IVS). However, its efficacy is largely unknown. This study aimed to determine the safety and efficacy of ductal stenting in retraining of the involuted LV in patients with TGA-IVS.
METHODS: This was a single-center, retrospective study. Echocardiographic assessment of the LV geometry, mass, and free wall thickness was performed before stenting and before the arterial switch operation. Patients then underwent the arterial switch operation, and the postoperative outcomes were reviewed.
RESULTS: There were 11 consecutive patients (male, 81.8%; mean age at stenting, 43.11 ± 18.19 days) with TGA-IVS with involuted LV who underwent LV retraining by ductal stenting from July 2013 to December 2017. Retraining by ductus stenting failed in 4 patients (36.3%). Two patients required pulmonary artery banding, and another 2 had an LV mass index of less than 35 g/m2. Patients in the successful group had improved LV mass index from 45.14 ± 17.91 to 81.86 ± 33.11g/m2 (p = 0.023) compared with 34.50 ± 10.47 to 20.50 ± 9.88 g/m2 (p = 0.169) and improved LV geometry after ductal stenting. The failed group was associated with an increased need for extracorporeal support (14.5% vs 50%, p = 0.012). An atrial septal defect-to-interatrial septum length ratio of more than 0.38 was associated with failed LV retraining.
CONCLUSIONS: Ductal stenting is an effective method to retrain the involuted LV in TGA-IVS. A large atrial septal defect (atrial septal defect-to-interatrial septum length ratio >0.38) was associated with poor response to LV retraining.

Matched MeSH terms: Heart Septal Defects, Atrial/surgery*