Texas Heart Institute Journal Volume 42: Issue 3

Patients with congenital heart disease and pulmonary valve disease need multiple procedures over their lifetimes to replace their pulmonary valves. Chronic pulmonary stenosis, regurgitation, or both have untoward effects on ventricular function and on the clinical status of these patients. To date, all right ventricle–pulmonary artery conduits have had relatively short lifespans. Percutaneous pulmonary valve implantation, although relatively new, will probably reduce the number of operative procedures that these patients will have to undergo over a lifetime. Refinement and further development of this procedure holds promise for the extension of this technology to other patient populations.

Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium.

We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at 4 months in group C, and at 6 months in group D. Each collected sample was divided into 2 parts, one for calcium-content measurement by means of atomic-absorption spectroscopy, and one for morphologic and histopathologic examinations.

When compared with the autologous pericardium, calcium levels in the heterologous pericardium were higher in groups B, C, and D (P <0.0001, P <0.0002, and P <0.0006, respectively). As embedding time increased, calcium levels in the heterologous pericardium increased faster than those in the autologous, especially in group D. Disorganized arrangements of collagenous fibers, marked calculus, and ossification were seen in the heterologous pericardium. Inflammatory cells—mainly lymphocytes and small numbers of macrophages—infiltrated the heterologous pericardium.

The autologous pericardium showed a stronger ability to resist calcification. Our results indicate that autologous pericardium might be a relatively better choice for valvuloplasty.

The present study aims to determine the efficacy and reliability of cardiovascular magnetic resonance imaging in establishing the diagnosis and prognosis of pulmonary hypertension in children.

This is a retrospective comparison of 25 children with pulmonary hypertension and a control group comprising 19 healthy children. The diagnosis of pulmonary hypertension was made when the mean pulmonary artery pressure was ≥25 mmHg by catheter angiography.

The children with pulmonary hypertension had significantly lower body mass indices than did the healthy children (P=0.048). In addition, the children with pulmonary hypertension had significantly larger main pulmonary artery diameters and ascending aortic diameters (both P=0.001) but statistically similar ratios of main pulmonary artery diameter-to-ascending aortic diameter. If the main pulmonary artery diameter was ≥25 mm, pediatric pulmonary hypertension was diagnosed with 72% sensitivity and 84% specificity. In the event that the ratio of main pulmonary artery diameter-to-ascending aorta diameter was ≥1, pediatric pulmonary hypertension was diagnosed with 60% sensitivity and 53% specificity. When compared with children who had New York Heart Association functional class II pulmonary hypertension, the children with functional class III pulmonary hypertension had significantly larger main (P=0.046), right (P=0.036), and left (P=0.003) pulmonary arteries.

Cardiovascular magnetic resonance imaging is useful in the diagnosis of children with pulmonary hypertension. Pediatric pulmonary hypertension can be diagnosed with high sensitivity and specificity when the main pulmonary artery diameter measures ≥25 mm.

Stafford Cohen, MD. 196 pages. Salem (NH): Free People Publishing; 2014. Hardcover: US $26.95; ISBN: 978-0-9838131-6-3. Trade paperback: US $19.95; ISBN: 978-09838131-7-0. Available from Amazon.com and Barnes & Noble.

Paul Zoll, MD

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Field of Medicine: Cardiology; medical history.

Format: Hardcover and paperback book. Trim size: 6 × 9 inches.

Recommended Readership: Cardiologists, internists, medical historians, trained first responders, and patients with implanted pacemakers or defibrillators.

Purpose: To present a wide-ranging view of Paul Maurice Zoll (1911–99) through a detailed and exceedingly well-referenced analysis of the man himself, his discoveries and innovations, and the

In Memoriam: Ali Massumi, MD (1945–2015)

Treating the Patient Who Has the Disease

Percutaneous Pulmonary Valve Placement

Is Autologous or Heterologous Pericardium Better for Valvuloplasty? A Comparative Study of Calcification Propensity

Magnetic Resonance Imaging in Pediatric Pulmonary Hypertension

Adjusted Left Atrial Emptying Fraction as a Predictor of Procedural Outcome after Catheter Ablation for Atrial Fibrillation

A Review of the JNC 8 Blood Pressure Guideline

Target-Specific Oral Anticoagulants: Should We Switch from Warfarin?

Evidence For and Against Dietary Recommendations to Prevent Cardiovascular Disease

Overweight versus Obese: Different Risk and Different Management

Perioperative Management of Antithrombotic and Antiplatelet Therapy

Anomalous Origin of the Left Main Coronary Artery from the Right Coronary Artery with a Preaortic Course

ACAOS Is Better Revealed by Intravascular Ultrasonography than by Computed Tomographic Angiography

Sinus Pause in Association with Lyme Carditis

Late Postoperative Prosthetic Pulmonary Valve Endocarditis in a 13-Year-Old Girl with Repaired Tetralogy of Fallot

Unusual Presentation of Listerial Myocarditis and the Diagnostic Value of Cardiac Magnetic Resonance

Paracardiac Gossypiboma (Textiloma) in 2 Patients

Large Patent Ductus Arteriosus in a 44-Year-Old Woman Leading to Calcium Deposition in the Left Atrium and Mitral and Aortic Valves

Percutaneous Closure of a Coronary Artery-to-Vein Graft Anastomotic Pseudoaneurysm Presenting as Acute Coronary Syndrome after Recent Coronary Artery Bypass Grafting

Left Atrial Myxoma Causing Coronary Steal: An Atypical Cause of Angina

Unicuspid Unicommissural Aortic Valve: An Extremely Rare Congenital Anomaly

Abstract

Adult-Onset Still's Disease and Cardiac Tamponade: A Rare Association

Ductal Stent Implantation in Tetralogy of Fallot with Aortic Arch Abnormality

Transapical Closure of a Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa

Possible Role for Cryoballoon Ablation of Right Atrial Appendage Tachycardia when Conventional Ablation Fails

Intramural Hemangioma of the Left Ventricle: Accurate Noninvasive Diagnosis and Surgical Treatment

Thrombus-in-Transit Entrapped in a Patent Foramen Ovale and Related to Underlying Antiphospholipid Syndrome

Ductus Arteriosus Aneurysm with Organized Thrombus in a Neonate: Echocardiograms from Diagnosis to Resolution

Paul Zoll, MD: The Pioneer Whose Discoveries Prevent Sudden Death

Mitral Regurgitation 43 Years after Commissurotomy by Dr. Denton A. Cooley

Lamin A/C Mutations Do Not Cause Left Ventricular Hypertrabeculation/Noncompaction

George J. Reul, MD: A Tribute

Accidental Left Ventricular Placement of a Leadless Micra Pacemaker Through a Patent Foramen Ovale

Impact of a Cardiology-Based Shock Team on Institutional Venoarterial Extracorporeal Membrane Oxygenation Use for Cardiogenic Shock

A Case of a Multistent Scaffold Approach for Treatment of a Coronary Artery Aneurysm

Rhabdomyosarcoma Involving the Left Atrium and the Mitral Valve