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The Right Ventricle In Adults With Tetralogy Of Fallot

Author : Massimo Chessa
ISBN : 9788847023574
Genre : Medical
File Size : 32.71 MB
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Tetralogy of Fallot is the most common form of cyanotic congenital heart disease, and one of the first to be successfully repaired by congenital heart surgeons. Although “fixed”, patients born with tetralogy of Fallot cannot be considered “cured”. Improving survival and quality of life for this ever-increasing adult population will continue to challenge the current and future generations of cardiologists. Adult patients with tetralogy of Fallot should be seen by a cardiologist specializing in the care of adults with congenital heart disease, to be monitored for late complications. They need to be checked regularly for any subsequent complications or disturbances of heart rhythm. This monograph is intended as both an introduction to the subject and a timely, comprehensive review, and will be welcomed by adult cardiologists, pediatric cardiologists, internists, surgeons, obstetricians, and intensivists who wish to learn about the most recent discoveries and advances concerning tetralogy of Fallot in adults. It will also be of interest to advanced undergraduates wanting to learn more about the subject.
Category: Medical

The Right Ventricle In Health And Disease

Author : Norbert F. Voelkel
ISBN : 9781493910656
Genre : Medical
File Size : 26.27 MB
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The Right Ventricle in Health and Disease provides a comprehensive and up-to-date database and collection of the available information which describes the structure and function of the normal right ventricle. The right ventricular performance and function reserve has now finally moved to the center of the stage as clinicians recognize that the drugs presently used to treat patients with severe pulmonary hypertension do not necessarily improve the performance of the right ventricle and because the survival depends on the right ventricular function that treatment strategies need to be developed to primarily protect the right ventricle from failing. In-depth chapters discuss right heart function and failure in patients with congenital heart diseases, review modern imaging techniques used to describe right ventricular form and function in patients with right heart failure (including cardiac MRI and PET scanning), describe ventricular interdependence: the left ventricle in pulmonary hypertension and discuss the concept of the sick lung circulation and its contribution to right heart failure. Treatment strategies of chronic right heart failure including drugs and mechanical devices are also discussed.
Category: Medical

Right Ventricular Physiology Adaptation And Failure In Congenital And Acquired Heart Disease

Author : Mark K. Friedberg
ISBN : 9783319670966
Genre : Medical
File Size : 55.45 MB
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This book spans topics in both congenital and acquired right heart disease providing readers with detailed information on the physiology, anatomy and myocardial mechanics of the right ventricle (RV), while describing the use of echo and MRI imaging to diagnose, and new developments in surgery and cardiac catheterization to treat. Right Ventricular Physiology, Adaptation and Failure in Congenital and Acquired Heart Disease includes extensive discussion of RV-pulmonary interactions, pulmonary hypertension and ventricular-ventricular interactions, including specific topics in embryology, fetal RV function, RV mechanics, pathophysiology of RV adaptation/ failure, molecular aspects of RV dysfunction, congenital heart disease, pulmonary arterial hypertension, pulmonary valve replacement, stem cell and future therapies.​ It is thus important reading for all cardiovascular medicine professionals, but especially pediatric cardiologists and surgeons, those who manage t hese patients in the cardiac care unit and investigators studying the RV.
Category: Medical

Adult Congenital Heart Disease An Issue Of Cardiology Clinics

Author : Karen K Stout
ISBN : 9780323413275
Genre : Medical
File Size : 21.73 MB
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The full scope of adult congenital heart disease is examined in this issue of the Cardiology Clinics. Topics include Shunt Lesions, Coarctation of the Aorta, Tetralogy of Fallot, Transposition of Great Arteries, Fontan Repair of Single Ventricle Physiology, Arrhythmias in Adult Congenital Heart Disease, Pulmonary Hypertension. It will also feature special articles on Pregnancy, Non-pharmacologic Treatment, Transition and Psychosocial Issues, and Quality Metrics.
Category: Medical

Diagnosis And Management Of Adult Congenital Heart Disease E Book

Author : Michael A. Gatzoulis
ISBN : 9781455710010
Genre : Medical
File Size : 35.74 MB
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Diagnosis and Management of Adult Congenital Heart Disease, by Drs. Gatzoulis, Webb, and Daubeney, is a practical, one-stop resource designed to help you manage the unique challenges of treating long-term adult survivors of congenital heart disease. Authored by internationally known leaders in the field, this edition is the first that truly integrates anatomy and imaging technology into clinical practice, and includes new chapters on cardiac CT for ACHD assessment, critical and perioperative care, anesthesia for ACHD surgery, cardiac resynchronization therapy, and transition of care. Congenital defects are presented with high-quality illustrations and appropriate imaging modalities. Find all the information you need in one user-friendly resource that integrates anatomy, clinical signs, and therapeutic options. Confidently make decisions aided by specific recommendations about the benefits and risks of surgeries, catheter interventions, and drug therapy for difficult clinical problems. Recognize and diagnose morphologic disorders with the help of detailed, full-color diagrams. Quickly find what you need thanks to easily accessible, consistently organized chapters and key annotated references. Keep pace with the latest advancements including five new chapters on cardiac CT for ACHD assessment, critical and perioperative care, anaesthesia for ACHD surgery, cardiac resynchronisation therapy, and transition of care Comply with the latest European Society of Cardiology (ESC) and American College of Cardiology (ACC) practice guidelines - integrated throughout the book - for cardiac pacing and cardiac resynchronisation therapy See imaging findings as they appear in practice and discern subtle nuances thanks to new, high-quality images and illustrations Integrates anatomy, clinical signs and therapeutic options of congenital heart disease both in print and online!
Category: Medical

Heart Failure In Adult Congenital Heart Disease An Issue Of Heart Failure Clinics

Author : Andrew R Opotowsky
ISBN : 9780323263931
Genre : Medical
File Size : 25.23 MB
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This issue of Heart Failure Clinics focuses on Heart Failure in Adult Congenital Heart Disease. As more children with congenital heart disease survive into adulthood, their care is becoming an increasingly important aspect of practice for Cardiologists. In this issue, expert authors review the most current information available about the work-up, diagnosis, and treatment of adult congenital heart disease, including medical therapy and percutaneous and surgical options. Keep up-to-the-minute with the latest developments in the management of heart failure in adult congenital heart disease.
Category: Medical

Kumar And Clark S Clinical Medicine E Book

Author : Parveen Kumar
ISBN : 9780702053047
Genre : Medical
File Size : 74.84 MB
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Kumar & Clark’s Clinical Medicine 8 builds on the prize-winning formula that won the first prize in the BMA Book Awards Medicine Category in 2010 (7th edition) and 2006 (6th edition). ‘This book is comprehensive, student friendly (if still intimidating in size!) and covers such a vast breadth of knowledge. It still remains the primary ‘must-have’ text book of any budding doctor, or qualified one at that. This book is stunning in its breadth and in its ease of use. It still remains as the ‘gold-standard’ thorough guide to clinical medicine its forefathers were.’ BMA Judges 2010 'This is one of a select few books that deserves to be in most doctors' personal possession and it's as simple as that. ...’ Dr Harry Brown. New to this edition: New chapter on palliative medicine. Five times the number of margin clinical photos. New echocardiography images. Double the number of dermatological images; including all the major lesion morphologies covered in a single page. 16 new authors. New sections on protein synthesis, energy production and stem cells. New members of the International Advisory Board from India, South Africa, Poland and the Middle East. 7 new online chapters from the International Advisory Board. Key online features: 30 extra short chapters online, written by members of the International Advisory Board to cover key international issues, such as malaria, envenoming and HIV. Animated practical procedures, including lumbar puncture, central venous and bladder catheterization, arterial cannulation etc. heart and lung sounds, and interactive surface anatomy available online. Full text online through StudentConsult. Add your own notes and bookmarks. Search across all the StudentConsult resources you own online in one place. New to this edition: New chapter on palliative medicine. Five times the number of margin clinical photos. New echocardiography images. Double the number of dermatological images; including all the major lesion morphologies covered in a single page. 16 new authors. New sections on protein synthesis, energy production and stem cells. New members of the International Advisory Board from India, South Africa, Poland and the Middle East. 7 new online chapters from the International Advisory Board.
Category: Medical

Sabiston And Spencer S Surgery Of The Chest E Book

Author : Frank Sellke
ISBN : 9781455700097
Genre : Medical
File Size : 78.31 MB
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Through seven successful editions, Sabiston & Spencer Surgery of the Chest has set the standard in cardiothoracic surgery references. Now, the new 8th Edition, edited by Frank W. Sellke, MD, Pedro J. del Nido, MD, and Scott J. Swanson, MD, carries on this tradition with updated coverage of today's essential clinical knowledge from leaders worldwide. Guidance divided into three major sections—Adult Cardiac Surgery, Congenital Heart Surgery, and Thoracic Surgery—lets you quickly find what you need, while new and revised chapters reflect all of the important changes within this rapidly evolving specialty. Expert Consult functionality—new to this edition—enables you to access the complete contents of the 2-volume set from anyplace with an Internet connection for convenient consultation where and when you need it. This is an ideal source for mastering all of the most important current knowledge and techniques in cardiac and thoracic surgery—whether for specialty board review or day-to-day practice. Features short, focused chapters that help you find exactly what you need. Presents the work of international contributors who offer a global view of the entire specialty. Covers thoracic surgery as well as adult and pediatric cardiac surgery for a practical and powerful single source. Includes nearly 1,100 illustrations that help to clarify key concepts. Features online access to the complete contents of the 2-volume text at for convenient anytime, anywhere reference. Covers the hottest topics shaping today's practice, including the latest theory and surgical techniques for mitral valve disease, advances in the treatment of congenital heart disease, minimally invasive surgical approaches to the treatment of adult and congenital cardiac disease and thoracic disease, stent grafting for aortic disease, and cell-based therapies. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should access to the web site be discontinued.
Category: Medical

The Right Ventricle

Author : Marvin A. Konstam
ISBN : 9781461317739
Genre : Medical
File Size : 42.79 MB
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It is quite natural that literature related to car heart disease, cardiomyopathy, pulmonary and diac structure, function, pathology, and patho pulmonary vascular disease, trauma, acquired valvular disease, congenital disease, and surgi physiology has emphasized the left heart and systemic circulation. The relative lack of im cal considerations. The pathologic and clinical relevance of myocardial infarction of the right portance of the right ventricle was supported by studies performed in the 1940s and 1950s ventricle has only been documented over the which suggested that the right ventricular free last 15 years. The chapter on right ventricular wall could be effectively destroyed in an animal infarction integrates clinical, functional, patho model without detectable untoward hemody physiologic, and pathologic observations to pro namic consequences. The relative inadequacy vide the reader with a thorough review, equally of noninvasive tools to study right ventricular relevant to the clinician and investigator. The contribution on dilated cardiomyopathy pro structure and function obviated detailed and systematic investigation. However, over the vides novel insight into the impact of right ventricular performance on the functional in past 15 years there has been a resurgence of interest in the right ventricle by a variety of capacity accompanying left heart failure. A book dealing with the right ventricle would investigators. The skeptic would argue that this renewed interest resulted from an exhaustion be incomplete without at least cursory reference we have of clinically-related observations that could be to the pulmonary circulation.
Category: Medical

The Right Ventricle In Volume Or Pressure Overload

Author : Aleksandra Trzebiatowska-Krzynska
ISBN : 9789176851678
Genre :
File Size : 84.49 MB
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This study is inspired by the gap in knowledge regarding the timing of cardiac surgery and interventions in adult patients with congenital heart disease. There are many parameters used assessing right ventricular function; however, most of them have pitfalls. Understanding the pathomechanisms by which the heart adapts to congenital defects is probably key to find the answer when it is time to intervene and start discussing treatment options. Heart defects are the most frequently occurring congenital disorders. Less than 50% of individuals with moderate to severe congenital heart defects, e.g. transposition of the great arteries (TGA) or tetralogy of Fallot (TOF), survive to adulthood without intervention. Advances in cardiac surgery and better identification of individuals at risk for sudden cardiac death have increased survival rates. Currently, more than 96% of patients with congenital heart disease survive to at least 16 years of age; most undergo corrective surgery but are not cured, and only a few have normal physiology and anatomy. In many cases, the heart must develop mechanisms of adaptation to the changed conditions after surgery. Consequently, correction of the defect creates residual disease with a risk of future complications. To prevent clinical deterioration and to identify the development of complications, patients need lifelong, regular follow up. The choice of followup modalities depends on the cardiac malformation. The right ventricle (RV) plays an important role, as it is often part of the defect or is influenced by the surgery. In the past, research was focused on assessment of left ventricular function (LV), and the RV was “the forgotten ventricle.” Observations and studies in the last few decades brought increased interest into the RV and revealed the importance of the RV in the prognosis of various cardiac diseases. An understanding of RV morphology, pathophysiology and adaptive mechanisms is crucial for further studies of prognosis as well as for research linked to the use of particular diagnostic modalities. When the RV is exposed to increased pressure load, e.g. in atrially corrected transposition of the great arteries (TGA), adaptation affects the cavity volume as well as the wall thickness. When the RV is volume overloaded, adaptation involves enhancement of the RV cavity volume while the wall thickness often remains unchanged under long time. RV ejection fraction (RVEF) gives some information about changes in RV function, but information on myocardial contractility and contractile reserve is also needed. New functional parameters such as strain—also known as myocardial deformation—provide some information about intrinsic myocardial function. In Paper I, we studied functional parameters such as ejection fraction and strain (radial and longitudinal strain for both ventricles) in patients with Tetralogy of Fallot (TOF) and TGA. Longitudinal RV strain was depressed in both patient groups in comparison with that in healthy individuals, and there were additional differences between the two patient groups. In Paper II, we validated three-dimensional echocardiography (3DEcho) against the cardiac magnetic resonance (CMR) gold standard. The study population was limited to patients with TOF. In general, 3DEcho underestimated RV volumes but was able to identify patients with RV dilatation on CMR with high sensitivity. RV longitudinal free wall strain measured by CMR with a cut-off set at -14% identified patients with depressed exercise capacity and low peak oxygen uptake. In Paper III, we studied a new CMR method to quantify and visualise turbulent flow in the heart and vessels. Turbulent flow can be harmful to tissue, blood cells, and endothelium and can contribute to tissue remodeling. In patients with TOF, turbulent flow can be seen as variance in 2DEcho color Doppler. In CMR, increased turbulent kinetic energy (TKE) could be seen with four-dimensional flow. The RV TKE was increased in patients with TOF with pulmonary regurgitation compared with that in healthy controls. In Paper IV, we validated “knowledge-based reconstruction” (KBR), a novel method to calculate RV volume, against CMR in patients with various types of congenital heart defects. Two-dimensional echocardiogram-based threedimensional RV reconstruction is a relatively uncomplicated method that creates a three-dimensional RV model based on a limited number of predefined points of interest (RV structures such as tricuspid annulus, RV free wall, or pulmonary valve). KBR showed good agreement with CMR (intraclass correlation coefficient = 0.84 for RV end-diastolic volume and 0.89 for ejection fraction) but tended to underestimate RV volumes, which is in line with other methods based on ultrasound. Conclusions: 3DEcho is an evolving modality that is able to identify patients with RV dilatation. It can be used clinically for the follow up of patients with congenital heart diseases, especially those with mildly to moderately dilated RVs. When an intervention seems likely, 3DEcho results should be verified by CMR. CMR-derived measurements of longitudinal and radial strain provide a new understanding of RV remodeling and ventricular interdependence in patients with TOF and TGA. Depressed longitudinal strain may indicate a risk of depressed exercise capacity and, in patients with TGA, clinical deterioration. Further studies in larger populations of patients with congenital heart defects are needed, as the altered RV morphology in such patients makes quantitative assessment especially challenging.