PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Endocardial Cushion Defects”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

A case report of surgical treatment of a dog with atrioventricular septal defect (incomplete form of endocardial cushion defect).

A 3-month-old female collie was diagnosed as having atrioventricular septal defect with ostium primum atrial septal defect (PASD). The diagnosis was made by echocardiographic observation of the PASD and goose-neck deformity on left ventriculogram. The PASD was treated surgically with a patch graft under cross-circulation cardiopulmonary bypass (CC). The PASD was identified above the ventricular septum after right atriotomy. The patch graft was sutured along the fibrous tissue of the tricuspid annulus on the ventricular side of the PASD to avoid injuring the conduction system. After the operation, cardiac function and renal output were well preserved, but the dog died 33 hr later. At postmortem examination, a mitral cleft was identified.

Animals↗

[The diagnostic value of M-mode, 2D, and Doppler echocardiography in incomplete endocardial cushion defect].

The diagnostic value of ultrasonography in cases with incomplete endocardial cushion defect which has been verified by subsequent operation was studied. By the M-mode ultrasound examination an enlarged right ventricle, a narrowed outflow tract of left ventricular and an abnormal pattern of mitral value were shown. By the aid of 2-DE its diagnostic accuracy in this disease was almost 100%. Characteristically the ostium primum (atrial septal) defect and anterior mitral cleft were demonstrated. And by pulsed Doppler the signs of mitral regurgitation and the spectral features of atrial shunt could be found. Therefore, it is proposed that ultrasonographic examination could readily take the place of traumatic angiocardiography in the diagnosis of this disease.

Adolescent↗

[A case of incomplete endocardial cushion defect with mirror-image dextrocardia, IVC defect and azygos connection].

A case of incomplete endocardial cushion defect associated with mirror-image dextrocardia, IVC defect and azygos connection is reported. Intracardiac defect was corrected under moderate hypothermia with cardiopulmonary bypass. Three venous drainage cannulas were necessary to be indwelled into SVC, hepatic vein and right common iliac vein to maintain adequate venous drainage for extra-corporeal circulation. Thus, anomaly of venous system, which is commonly associated with mirror-image dextrocardia, must be recognized correctly and prepared before intracardiac correction.

Azygos Vein↗

Use of the mitral valve-tricuspid valve distance as a marker of fetal endocardial cushion defects.

OBJECTIVE: The purpose of this study was to compare the mitral valve-tricuspid valve distance in second-trimester fetuses with normal cardiac anatomy versus those fetuses with endocardial cushion defects. STUDY DESIGN: We identified fetuses between 16 and 24 weeks of gestation. The distance between the insertions of the medial leaflets of the mitral and tricuspid valves were obtained. Linear regression curves were generated. RESULTS: The mean mitral valve-tricuspid valve distance for 86 fetuses with normal cardiac anatomy was 2.02 mm, compared with 0.37 mm in 13 fetuses with endocardial cushion defects ( P = .0001). Linear regression curve correlating mitral valve-tricuspid valve distance with gestational age showed a gradual slope (R 2 = 0.28; P < .0001). With a mitral valve-tricuspid valve distance < 5th percentile as a marker for the diagnosis of endocardial cushion defect gave a sensitivity of 69.2%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 95.6%, and a false-positive rate of 0% ( P = .0001). CONCLUSION: The mitral valve-tricuspid valve distance is useful clinically in the detection of endocardial cushion defects in second-trimester fetuses.

Endocardial Cushion Defects↗

The angiocardiographic appearance of the endocardial cushion defect in selected transposition and malposition complexes.

Although the angiocardiographic features of the endocardial cushion defect (ECD) have been well described in the patient with two normally related ventricles (D-ventricular loop in situs solitus) and normally related great arteries, little attention has been focused on the angiocardiographic appearance of the ECD in patients with complex cardiovascular disease. Because of recent surgical advances in the treatment of single ventricle and double outlet right ventricle complexes, it has become increasingly important to document the status of the atrioventricular valves in these patients. The angiocardiographic features of the ECD are therefore described in two patients, one with D-loop, single left ventricle and outlet chamber, D-transposition of the great arteries, bilateral conus and pulmonary stenosis and the other with dextrocardia, situs inversus, double outlet right ventricle, common atrioventricular canal and pulmonary stenosis. In both patients, the left ventricular outflow tract, despite aortic-mitral discontinuity, is characterized by elongation, scalloping and serration, and the classic appearance of the "gooseneck" deformity is observed on left ventricular angiography. It thus appears that aortic-mitral continuity and two well-formed, normally related ventricles and great arteries are not invariable necessary to the manifestation of the "gooseneck" deformity in the patient with complex cardiovascular disease and associated endocardial cushion defect.

Abnormalities, Multiple↗

[Successful intrauterine digoxin therapy for fetal complete atrioventricular block with endocardial cushion defect: a case report].

We report herein a case of fetal complete atrioventricular block accompanied with endocardial cushion defect, successfully diagnosed and treated, in utero, with transplacental digitalization. A 23-year-old Japanese woman, at 20 weeks of gestation, was referred to the Maternity and Perinatal Care Unit of Kyushu University Hospital because of fetal continuous bradycardia. B-mode scanning and dual M-mode echocardiography revealed that the fetus had complete atrioventricular block with endocardial cushion defect with a ventricular rate of 60 beats per minute. At 23 weeks of gestation, it was found that the fractional shortenings (FSs) in both ventricles and the ventricular rate had decreased, with an increase in pericardial effusion. Thus, we diagnosed the fetus as having cardiac failure. Transplacental digoxin treatment was started and continued for 10 weeks, after which fetal pericardial effusion, as well as FSs ameliorated. The pregnancy was interrupted by cesarean section at 33 weeks of gestation due to a decrease in FSs with an accumulation of fetal ascites. A 1780g female infant was delivered and a pacemaker was implanted surgically, immediately after birth. She is alive and well at the time of writing.

Adult↗

[A case of tricuspid and mitral valve replacement for incomplete endocardial cushion defect].

A 56-year-old female who was diagnosed incomplete endocardial cushion defect, underwent closure of ostium primum defect and repair of mitral cleft 2 years ago. Mitral and tricuspid ring annuloplasty was done 9 months after the first operation because of an increment of mitral and tricuspid valve regurgitation. The Third operation, mitral valve replacement by mechanical valve and tricuspid valve replacement by bioprosthetic valve, was performed because of the gradually increased mitral stenosis and tricuspid regurgitation. Post-operative course was uneventful. Resected anterior cusp of mitral and tricuspid valve revealed hypertrophy and shortness macroscopically, and revealed fibrosis and calcification histopathologically. It was considered that remarkable regurgitation was due to secondary change of both valves. We concluded that valve replacement should be performed for case of secondary change of atrioventricular valve in adult patient.

Endocardial Cushion Defects↗

[Surgical treatment of incomplete endocardial cushion defect in elderly patients].

We experienced 5 surgical cases of incomplete endocardial cushion defect who were 50 years old or older. Preoperatively, 3 cases were in New York Heart Association (NYHA) class II and 2 in class III. Catheterization study showed that systolic pulmonary arterial pressure was 24 to 48 (average; 38) mmHg and pulmonary-to-systemic flow ratio was 3.4 to 8.1 (average; 5.2). Left ventriculography showed mitral valve regurgitation (grade I-1 cases, grade II-3, grade III-1) with cleft and goose neck sign in all cases. Single atrium and patent foramen ovalis were associated in each one case. At operation, suture of mitral cleft and patch closure of ostium primum defect from mitral valve side were performed. Postoperatively, NYHA class, cardiomegaly, pulmonary arterial pressure and mitral regurgitation improved remarkably in all patients. During the follow-up period from 18 to 126 months (average; 57), right bundle branch block and supraventricular arrhythmia in electrocardiogram disappeared in 3 of 4 and 4 of 5 cases, respectively. Surgical treatment and postoperative course of incomplete ECD were reviewed in over-50-year-old patients, in reference to 17 surgical cases in Japan.

Electrocardiography↗

[Surgical treatment of endocardial cushion defect in 3 elderly patients].

We performed surgical treatment for partial endocardial cushion defect in 3 patients over fifty year old. Case 1 was a 55-year-old-male with TR of grade II. Case 2 was a 59-year-old-female with TR and MR, and was repaired mitral cleft by a mattress suture. She needed infusion of dopamine (over 5 micrograms/kg/min) for 6 days and therapy of mediastinitis postoperatively. Case 3 was 56-year-old-male without atrioventricular valve regurgitation. Preoperative left ventricular volume was small in all patients, therefore perioperative circulatory control, mainly water balance, and respiratory control were importance. All patients survived, and both decreasing of CTR and improvement of NYHA classification were recognized in all three patients. In conclusion the operation for ECD in even elder patients was effective, but intensive care needed perioperatively.

Endocardial Cushion Defects↗

Endocardial cushion defect: further studies of "isolated" versus "syndromic" occurrence.

The isolated occurrence of endocardial cushion defect (ECD) has been suggested to differ from its occurrence within the context of a syndrome, with regard to the nature (complete or partial) of the defect and the associated cardiovascular malformations. Analysis of data derived from the Baltimore-Washington Infant Study of congenital cardiovascular malformations supports the observation that "syndromic" ECD tends to be of the complete atrioventricular canal type and is less frequently associated with left cardiac anomalies than the isolated form. However, each syndrome has a unique impact on the overall cardiovascular "phenotype", including the ECD. This is especially true for Down and Ivemark syndromes, which are most frequently associated with ECD, but also for other syndromes as well. It is also suggested that isolated ECD is specifically associated with gastrointestinal and urinary tract anomalies. However, in Down syndrome ECD appears to be a specific cardiovascular expression of the trisomic state that is unrelated to other noncardiac malformations. Additional information on the association of ECD with other less common genetic syndromes is needed in order to further investigate the possible genetic basis of this cardiac defect.

Case-Control Studies↗

[A surgical repair of complete endocardial cushion defect associated with single atrium, persistent left superior vena cava draining into the left atrium, hemiazygos connection and double orifice mitral valve].

Successful surgical repair of a 1-year-old girl of complete endocardial cushion defect associated with single atrium, persistent left superior vena cava draining into the left atrium, hemiazygos connection and double orifice mitral valve was reported. We repaired the endocardial cushion defect by using an endocardial cushion prosthesis and a new atrial septum was created to allow the left superior vena cava draining into the right atrium. We made no treatment for the accessory mitral valve orifice because of no regurgitation.

Azygos Vein↗

Endocardial cushion defect in a fetus: with intrauterine cytomegalovirus infection and growth retardation: report of an autopsy case.

We describe one case of endocardial cushion defect during the second trimester when a consultative fetal echocardiography was undertaken for fetal intrauterine growth retardation with oligohydramnios. Positive cytomegalovirus IgM in cord blood and cytomegalovirus DNA particles in the amniotic fluid were found incidentally. The relationship between possible intrauterine cytomegalovirus infection and the endocardial cushion defect in this case is not clear.

Adult↗

Sudden unexpected death in an adult patient with endocardial cushion defect.

A 50-year-old male died following a road traffic accident. Postmortem examination revealed that the injuries caused by the accident did not seem to have caused his death. A large ostium primum defect was found, with bridging leaflets attached to the interventricular septum. In this article, we present a case of sudden death with partial endocardial cushion defect and discuss the mechanism of death. We believe that this is the first report of sudden death caused by endocardial cushion defect.

Accidents, Traffic↗

Long-term results after surgical repair of incomplete endocardial cushion defects.

Since 1964, 56 children (mean age, 6.7 years) underwent repair of incomplete endocardial cushion defects. Forty patients had isolated ostium primum defects. Additional congenital defects were present in 17 patients (30%). All patients underwent patch closure of the ostium primum defect and 47 of 56 patients (84%) underwent mitral valvuloplasty. Hospital mortality was 1.8% (one death). Arrhythmias developed in 7 other patients in the early postoperative period, of which six were transient and resolved completely. One patient required early pacemaker placement for complete heart block. Cumulative follow-up was 378 patient-years. There were three late deaths (5.7%), and additional operations were required in 12 patients (22.6%). Seven of these 12 patients required mitral valve replacement for severe mitral regurgitation. The mean interval between initial repair and mitral valve replacement was 4.2 years, with only three valves needing replacement within 12 months. There was a significant correlation between the severity of mitral regurgitation before initial repair and subsequent need for mitral valve replacement. Late onset atrial arrhythmias have developed in 6 patients. Current functional status has been evaluated in 50 of 52 surviving patients and 88.5% are in NYHA class I, with the remainder in class II.

Adolescent↗

[Successful surgical correction of incomplete endocardial cushion defect in a 65-year-old female].

We report a case of surgical correction of a 65-year-old female. She presented severe congestive heart failure and preoperative cardiac catheterization showed massive left to right shunt (87%), mild mitral regurgitation, severe tricuspid regurgitation and pulmonary hypertension. The operative procedure consisted of annuloplasty of mitral valve (Kay's method), patch closure of the ostium primum defect and annuloplasty of tricuspid valve. Postoperative examination showed complete competence of mitral valve and improved functional capacity. This is the fourth successful case report of surgical correction of incomplete endocardial cushion defect in patients older than 65-year-old in Japan to our knowledge. Surgical correction of incomplete endocardial cushion defect should be recommended even in elder patients.

Age Factors↗

Subxiphoid cross-sectional echocardiographic imaging of the "goose-neck" deformity in endocardial cushion defect.

The cross-sectional echocardiographic demonstration of the "goose-neck" deformity is described in four patients with endocardial cushion defect. The diagnosis was confirmed in each patient by left ventricular angiocardiogram. The subxiphoid approach of cross-sectional echocardiography in diastole allowed visualization of an elongated, narrowed, and somewhat horizontally inclined configuration of the left ventricular outflow tract, which appeared almost identical to that obtained by angiocardiography. In systole, the right border of the left ventricle was composed of the cleft anterior mitral leaflet, the left-sided line of which was convex toward the left ventricular cavity. The mitral valvular echoes were thickened, jagged and irregular, which seemed to correspond to the scalloped appearance of the right border of the left ventricular silhouette in a systolic phase of the left ventricular angiocardiogram. There were no obvious differences between the goose-neck configuration of complete-type endocardial cushion defect and that of ostium primum atrial septal defect.

Echocardiography↗

[Surgical treatment for endocardial cushion defect in an elderly patient with pulmonary hypertension].

We performed surgery for a partial endocardial cushion defect (ECD) in a 67-year-old female patient with pulmonary hypertension. The patient had grade 2 tricuspid regurgitation and pulmonary hypertension (Pp/Ps = 0.58, Rp = 8.4 Um2). The operative procedure involved patch closure of the ostium primum and tricuspid annuloplasty with a Carpentier ring. The postoperative course was uneventful and the pulmonary hypertension improved (Pp/Ps = 0.33). Surgery for partial ECD should be recommended even for elderly patients.

Aged↗