A condition caused by underdevelopment of the whole left half of the heart. It is characterized by hypoplasia of the left cardiac chambers (HEART ATRIUM; HEART VENTRICLE), the AORTA, the AORTIC VALVE, and the MITRAL VALVE. Severe symptoms appear in early infancy when DUCTUS ARTERIOSUS closes.
A set of surgical procedures performed to establish sufficient outflow to the systemic circulation in individuals with univentricular congenital heart malformations, such as HYPOPLASTIC LEFT HEART SYNDROME, and MITRAL VALVE atresia, associated with systemic outflow obstruction. Follow-on surgeries may be performed and consist of a HEMI-FONTAN PROCEDURE as the stage 2 Norwood procedure and a FONTAN PROCEDURE as the stage 3 Norwood procedure.
Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.
Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)
A procedure in which total right atrial or total caval blood flow is channeled directly into the pulmonary artery or into a small right ventricle that serves only as a conduit. The principal congenital malformations for which this operation is useful are TRICUSPID ATRESIA and single ventricle with pulmonary stenosis.
The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (HEART/embryology) only on the basis of time.
Prenatal interventions to correct fetal anomalies or treat FETAL DISEASES in utero. Fetal therapies include several major areas, such as open surgery; FETOSCOPY; pharmacological therapy; INTRAUTERINE TRANSFUSION; STEM CELL TRANSPLANTATION; and GENETIC THERAPY.
An infant during the first month after birth.
Surgery performed on the heart.
Diversion of the flow of blood from the entrance to the right atrium directly to the pulmonary arteries, avoiding the right atrium and right ventricle (Dorland, 28th ed). This a permanent procedure often performed to bypass a congenitally deformed right atrium or right ventricle.
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion.
The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.
A characteristic symptom complex.
A cardiovascular procedure performed to create a blood supply to the PULMONARY CIRCULATION. It involves making a connection between the subclavian, or carotid branch of the AORTA, or the AORTIC ARCH to the PULMONARY ARTERY.
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
Developmental abnormalities in any portion of the ATRIAL SEPTUM resulting in abnormal communications between the two upper chambers of the heart. Classification of atrial septal defects is based on location of the communication and types of incomplete fusion of atrial septa with the ENDOCARDIAL CUSHIONS in the fetal heart. They include ostium primum, ostium secundum, sinus venosus, and coronary sinus defects.
The hemodynamic and electrophysiological action of the right HEART VENTRICLE.
A condition characterized by the thickening of ENDOCARDIUM due to proliferation of fibrous and elastic tissue, usually in the left ventricle leading to impaired cardiac function (CARDIOMYOPATHY, RESTRICTIVE). It is most commonly seen in young children and rarely in adults. It is often associated with congenital heart anomalies (HEART DEFECTS CONGENITAL;) INFECTION; or gene mutation. Defects in the tafazzin protein, encoded by TAZ gene, result in a form of autosomal dominant familial endocardial fibroelastosis.
This structure includes the thin muscular atrial septum between the two HEART ATRIA, and the thick muscular ventricular septum between the two HEART VENTRICLES.
The circulation of the BLOOD through the LUNGS.
A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.
Determination of the nature of a pathological condition or disease in the postimplantation EMBRYO; FETUS; or pregnant female before birth.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
An abnormal passage between two or more BLOOD VESSELS, between ARTERIES; VEINS; or between an artery and a vein.
The veins that return the oxygenated blood from the lungs to the left atrium of the heart.
The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
The transference of a heart from one human or animal to another.
'Abnormalities, Multiple' is a broad term referring to the presence of two or more structural or functional anomalies in an individual, which may be genetic or environmental in origin, and can affect various systems and organs of the body.
The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.
Echocardiography applying the Doppler effect, with the superposition of flow information as colors on a gray scale in a real-time image.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
A congenital cardiovascular malformation in which the AORTA arises entirely from the RIGHT VENTRICLE, and the PULMONARY ARTERY arises from the LEFT VENTRICLE. Consequently, the pulmonary and the systemic circulations are parallel and not sequential, so that the venous return from the peripheral circulation is re-circulated by the right ventricle via aorta to the systemic circulation without being oxygenated in the lungs. This is a potentially lethal form of heart disease in newborns and infants.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Malformations of CORONARY VESSELS, either arteries or veins. Included are anomalous origins of coronary arteries; ARTERIOVENOUS FISTULA; CORONARY ANEURYSM; MYOCARDIAL BRIDGING; and others.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
The hollow, muscular organ that maintains the circulation of the blood.
Diversion of the flow of blood from the pulmonary veins directly to the aorta, avoiding the left atrium and the left ventricle (Dorland, 27th ed). This is a temporary procedure usually performed to assist other surgical procedures.
Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.
Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.
The period following a surgical operation.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
The main trunk of the systemic arteries.
Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.
Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; SPONTANEOUS ABORTION; INDUCED ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.
Surgery performed on the heart or blood vessels.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.

Biventricular repair approach in ducto-dependent neonates with hypoplastic but morphologically normal left ventricle. (1/199)

OBJECTIVES: Increased afterload and multilevel LV obstruction is constant. We assumed that restoration of normal loading conditions by relief of LV obstructions promotes its growth, provided that part of the cardiac output was preoperatively supported by the LV, whatever the echocardiographic indexes. BACKGROUND: Whether to perform uni- or biventricular repair in ducto dependent neonates with hypoplastic but morphologically normal LV (hypoplastic left heart syndrome classes II & III) remains unanswered. Echocardiographic criteria have been proposed for surgical decision. METHODS: Twenty ducto dependent neonates presented with this anomaly. All had aortic coarctation associated to multilevel LV obstruction. Preoperative echocardiographic assessment showed: mean EDLW of 12.4 +/- 3.03 ml/m2 and mean Rhodes score of -1.73 +/-0.8. Surgery consisted in relief of LV outflow tract obstruction by coarctation repair in all associated to aortic commissurotomy in one and ASD closure in 2. RESULTS: There were 3 early and 2 late deaths. Failure of biventricular repair and LV growth was obvious in patients with severe anatomic mitral stenosis. The other demonstrated growth of the left heart. At hospital discharge the EDLVV was 19.4+/-3.12 ml/m2 (p = 0.0001) and the Rhodes score was -0.38+/-1.01 (p = 0.0003). Actuarial survival and freedom from reoperation rates at 5 years were 72.5% and 46%, respectively. CONCLUSIONS: Biventricular repair can be proposed to ducto dependent neonates with hypoplastic but morphologically normal LV provided that all anatomical causes of LV obstruction can be relieved. Secondary growth of the left heart then occurs; however, the reoperation rate is high.  (+info)

Pattern of pulmonary venous blood flow in the hypoplastic left heart syndrome in the fetus. (2/199)

OBJECTIVE: To determine whether restriction at the atrial septum in the newborn with hypoplastic left heart syndrome can be predicted accurately by examining the pattern of pulmonary venous flow in the fetus. A restrictive atrial septum can contribute to haemodynamic instability before surgery for this lesion and has been associated with an increased mortality. DESIGN: Pulmonary venous pulsed Doppler tracings were compared between fetuses with hypoplastic left heart syndrome and controls. The size of the atrial septal defect on the postnatal echocardiogram was graded according to the degree of restriction. Pulsed Doppler tracings of pulmonary venous blood flow were obtained in 18 fetuses with left atrial outflow atresia and compared with 77 controls, adjusted for gestational age. Postnatal echocardiograms were available for analysis in 13 of 18 neonates. SETTING: A tertiary referral centre for fetal cardiology and paediatric cardiac surgery. RESULTS: Fetuses with hypoplastic left heart syndrome were different from controls in all pulmonary vein indices measured. As assessed from the postnatal echocardiogram, there were seven fetuses with a restrictive atrial septum. In these fetuses, the systolic flow velocity (p < 0.01), S/D ratio (p < 0.01), and peak reversal wave (p < 0.001) in the pulmonary vein tracing showed a good correlation with the degree of restriction. CONCLUSIONS: The Doppler pattern of pulmonary venous flow in the fetus with hypoplastic left heart syndrome appears to be a reliable predictor of restriction of the atrial septum in the neonate. This may help in the immediate post-delivery management of these infants before surgery.  (+info)

Fate of the stented arterial duct. (3/199)

BACKGROUND: The technical aspects of ductal stenting have been reported, but little is known of the fate of the duct after stent implantation. METHODS AND RESULTS: Nineteen patients underwent stent implantation to maintain ductal patency. Eight had hypoplastic left heart (HLH) syndrome, 10 had pulmonary atresia, and 1 had tricuspid atresia. Median survival with HLH was 57 (12 to 907) days. Stent implantation was successful in all cases of HLH, but there were no long-term survivors. Two well-palliated infants died at transplantation. Median survival with duct-dependent pulmonary flow was 183 (0 to 1687) days, with 3 patients well at latest follow-up (56, 55, and 9 months, respectively). There were 2 operative deaths due to ductal spasm and 4 late deaths, 1 due to duct thrombosis, 1 due to chronic lung disease, and 2 of unknown cause. Stent implantation failed in 4 of the 11 cases. Assessment of endothelialization was possible in 13 cases; the stent was partially covered in 3 and fully endothelialized in all 10 cases assessed >8 weeks after implantation. In patients stented for inadequate pulmonary flow, ductal intimal hyperplasia occurred by 9 months in all 3 survivors but responded to repeated dilation. CONCLUSIONS: Ductal stenting cannot be recommended. In patients with HLH, it provides only short-term palliation even when combined with pulmonary artery banding. With duct-dependent pulmonary blood flow, the procedure carries high risk, and duration of palliation is poor. In patients with bilateral ducts and absent central pulmonary arteries, good palliation may be achieved, but repeated angioplasty is necessary to counteract intimal hyperplasia.  (+info)

The hypoplastic left heart syndrome with intact atrial septum: atrial morphology, pulmonary vascular histopathology and outcome. (4/199)

OBJECTIVES: The purpose of this study was to investigate the outcome in infants with hypoplastic left heart syndrome and intact atrial septum and to evaluate the relationship of atrial morphology, left atrial decompression pathway and lung histopathology to outcome. BACKGROUND: In the hypoplastic left heart syndrome, severe restriction at the atrial level results in marked systemic hypoxemia after birth. Infants with intact atrial septum may be at high risk for mortality after Norwood operation. METHODS: Of 316 infants with hypoplastic left heart syndrome seen at our center over a 6.5-year period, 18 (5.7%) had intact atrial septum. Medical records and echocardiograms were reviewed. RESULTS: On echocardiography, three types of intact atrial septal morphology were identified: 1) large left atrium, thick prominent septum secondary with thin septum primary adherent (type A, n = 12); 2) small left atrium with thick, muscular atrial septum (type B, n = 4), and 3) giant left atrium, thin atrial septum with severe mitral regurgitation (type C, n = 2). Seven infants had left atrial decompression pathways that were severely obstructed (3/12 type A, 4/4 type B). Norwood operation was performed in 17 infants; one underwent emergency balloon atrial septostomy and died. Of six early survivors, all with type A atrial morphology and unobstructed decompression pathway, three died after subsequent cavopulmonary surgery. Lung histopathology revealed severely dilated lymphatics and "arterialization" of the pulmonary veins in those with the severest degree of obstruction to left atrial egress (type B atrial morphology). CONCLUSIONS: Despite aggressive intervention, outcome for infants born with hypoplastic left heart syndrome and intact atrial septum is poor. Maldevelopment of the pulmonary vasculature contributes to the high mortality seen. Atrial morphology can be used as a marker for the severity of pulmonary vascular disease.  (+info)

Differential pulmonary flow in hypoplastic left heart syndrome. (5/199)

We report a case of hypoplastic left heart syndrome associated with restrictive interatrial communication and partial anomalous pulmonary venous connection via a right lower pulmonary vein draining to the inferior vena cava. We found unequal pulmonary artery pressure and different pulmonary artery structure, with the right pulmonary artery being lower in pressure and more tortuous and dilated in its peripheral branches than the left. This was attributed to the variant degrees of pulmonary venous obstruction. The left pulmonary venous return was severely obstructed by the restrictive interatrial communication, whereas the anomalous right lower pulmonary vein drained into the inferior vena cava, with less obstruction. To the best of our knowledge, there has never before been a report of differential pulmonary flow associated with a partial anomalous pulmonary vein, in a case of hypoplastic left heart syndrome.  (+info)

Impact of early ventricular unloading on exercise performance in preadolescents with single ventricle Fontan physiology. (6/199)

OBJECTIVES: We sought to determine if early ventricular volume unloading improves aerobic capacity in patients with single ventricle Fontan physiology. BACKGROUND: Surgical strategies for patients with single ventricle include intermediate staging or early Fontan completion to reduce the adverse affects of prolonged ventricular volume load. The impact of this strategy on exercise performance has not been evaluated. METHODS: Retrospectively, we reviewed the exercise stress test results of all preadolescents with single ventricle Fontan physiology. "Volume unloading" was considered to have occurred at the time of bidirectional cavopulmonary anastomosis or at the time of Fontan surgery in those patients who did not undergo intermediate staging. Potential predictors of aerobic capacity were analyzed using multivariate regression. RESULTS: The patients (n = 46) achieved a mean percentage predicted of maximal oxygen consumption (VO2max) of 76.1% +/- 21.1%. The mean age at the time of volume unloading was 2.7 +/- 2.4 years, and the mean age at testing was 8.7 +/- 2 years. Intermediate staging was performed in 16 of 46 patients (35%). In multivariate analysis, younger age at volume unloading was associated with increased aerobic capacity (p = 0.003). Other variables were not predictive. The subgroup of patients who underwent volume unloading before two years of age achieved a mean percentage predicted VO2max of 88.6% +/- 24.1%. CONCLUSIONS: Preadolescents with single ventricle who undergo volume unloading surgery at an early age demonstrate superior aerobic capacity compared with those whose surgery is delayed until a later age.  (+info)

Early survival of infants weighing 2.5 kilograms or less undergoing first-stage reconstruction for hypoplastic left heart syndrome. (7/199)

BACKGROUND: Results of staged palliation for hypoplastic left heart syndrome (HLHS) have improved in recent years; however, certain risk factors have been associated with decreased survival rates. METHODS AND RESULTS: We retrospectively reviewed the medical records of 67 patients weighing +info)

FISH studies in 45 patients with Rubinstein-Taybi syndrome: deletions associated with polysplenia, hypoplastic left heart and death in infancy. (8/199)

Rubinstein-Taybi syndrome (RTS) is a dominant Mendelian disorder characterised by mental retardation, a typical facies, broad thumbs and short stature. Previous reports indicated that 4-25% of RTS patients have a submicroscopic 16p13.3 deletion of the CBP gene. Using FISH and cosmid probes RT100, RT191 and RT203 we studied 45 RTS patients from Germany, the Czech Republic, Austria and Turkey and found four deletions (8.9%, pooled data including other studies: 11%). All deletions were interstitial; three spanned the CBP gene (RT100-RT203) and one was smaller (RT100 only). Previous studies reported no phenotype-genotype correlation between RTS patients with or without a deletion. Our findings suggest a more severe phenotype. The mean age at presentation was 0.96 years in patients with a deletion as against 11.12 years in those without. Patients A and B with a deletion died in infancy which is rare in RTS and was not observed among the other patients. Patients A and D had accessory spleens, Patient A with hypoplastic left heart, abnormal pulmonary lobulation and renal agenesis. This is the second report of hypoplastic left heart and the first report of polysplenia with RTS. The signs suggest a developmental field defect (disturbance of laterality) either as a newly recognised pattern of RTS, or alternatively a novel contiguous gene syndrome.  (+info)

Hypoplastic Left Heart Syndrome (HLHS) is a congenital heart defect in which the left side of the heart is underdeveloped. This includes the mitral valve, left ventricle, aortic valve, and aorta. The left ventricle is too small or absent, and the aorta is narrowed or poorly formed. As a result, blood cannot be adequately pumped to the body. Oxygen-rich blood from the lungs mixes with oxygen-poor blood in the heart, and the body does not receive enough oxygen-rich blood. HLHS is a serious condition that requires immediate medical attention and often surgical intervention.

The Norwood procedure, also known as the Estlander-Norwood procedure, is a surgical treatment for congenital heart defects in infants and children. Specifically, it is used to address truncus arteriosus and pulmonary atresia with ventricular septal defect (PA/VSD), which are complex conditions that affect the formation of the aorta and pulmonary artery.

The Norwood procedure involves a series of surgical steps aimed at creating a new aorta and improving blood flow to the lungs. The surgery typically includes three main components:

1. Transection of the main pulmonary artery and creation of a neoaorta using the proximal portion of the pulmonary artery and the native aorta.
2. Construction of a systemic-to-pulmonary shunt, which allows blood from the systemic circulation to flow into the lungs for oxygenation. This can be done using the patient's own tissue (such as the subclavian artery) or a synthetic tube.
3. Closure of the ventricular septal defect (VSD) to prevent mixing of oxygenated and deoxygenated blood in the heart.

The Norwood procedure is usually performed in the first few weeks of life, and it is often followed by additional surgeries as the child grows, such as the bidirectional Glenn and Fontan procedures. These procedures aim to further improve blood flow and oxygenation while minimizing strain on the heart.

It's important to note that the Norwood procedure carries significant risks and challenges, and it requires a highly specialized team of pediatric cardiologists, surgeons, and other healthcare professionals to perform and manage. However, for many infants with these complex congenital heart defects, the Norwood procedure offers the best chance for long-term survival and improved quality of life.

Congenital heart defects (CHDs) are structural abnormalities in the heart that are present at birth. They can affect any part of the heart's structure, including the walls of the heart, the valves inside the heart, and the major blood vessels that lead to and from the heart.

Congenital heart defects can range from mild to severe and can cause various symptoms depending on the type and severity of the defect. Some common symptoms of CHDs include cyanosis (a bluish tint to the skin, lips, and fingernails), shortness of breath, fatigue, poor feeding, and slow growth in infants and children.

There are many different types of congenital heart defects, including:

1. Septal defects: These are holes in the walls that separate the four chambers of the heart. The two most common septal defects are atrial septal defect (ASD) and ventricular septal defect (VSD).
2. Valve abnormalities: These include narrowed or leaky valves, which can affect blood flow through the heart.
3. Obstruction defects: These occur when blood flow is blocked or restricted due to narrowing or absence of a part of the heart's structure. Examples include pulmonary stenosis and coarctation of the aorta.
4. Cyanotic heart defects: These cause a lack of oxygen in the blood, leading to cyanosis. Examples include tetralogy of Fallot and transposition of the great arteries.

The causes of congenital heart defects are not fully understood, but genetic factors and environmental influences during pregnancy may play a role. Some CHDs can be detected before birth through prenatal testing, while others may not be diagnosed until after birth or later in childhood. Treatment for CHDs may include medication, surgery, or other interventions to improve blood flow and oxygenation of the body's tissues.

Palliative care is a type of medical care that focuses on relieving the pain, symptoms, and stress of serious illnesses. The goal is to improve quality of life for both the patient and their family. It is provided by a team of doctors, nurses, and other specialists who work together to address the physical, emotional, social, and spiritual needs of the patient. Palliative care can be provided at any stage of an illness, alongside curative treatments, and is not dependent on prognosis.

The World Health Organization (WHO) defines palliative care as: "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual."

The Fontan procedure is a type of open-heart surgery used to treat specific types of complex congenital (present at birth) heart defects. It's typically performed on children with single ventricle hearts, where one of the heart's lower chambers (the right or left ventricle) is underdeveloped or missing.

In a normal heart, oxygen-poor (blue) blood returns from the body to the right atrium, then flows through the tricuspid valve into the right ventricle. The right ventricle pumps the blue blood to the lungs, where it picks up oxygen and turns red. Oxygen-rich (red) blood then returns from the lungs to the left atrium, flows through the mitral valve into the left ventricle, and the left ventricle pumps it out to the body through the aorta.

However, in a single ventricle heart, the underdeveloped or missing ventricle cannot effectively pump blood to the lungs and the body simultaneously. The Fontan procedure aims to separate the blue and red blood circulation to improve oxygenation of the body's tissues.

The Fontan procedure involves two stages:

1. In the first stage, usually performed in infancy, a shunt or a band is placed around the pulmonary artery (the blood vessel that carries blood from the heart to the lungs) to control the amount of blood flowing into the lungs. This helps prevent lung congestion due to excessive blood flow.
2. The second stage, the Fontan procedure itself, takes place when the child is between 18 months and 4 years old. During this surgery, the surgeon creates a connection between the inferior vena cava (the large vein that returns blue blood from the lower body to the heart) and the pulmonary artery. This allows oxygen-poor blood to flow directly into the lungs without passing through the underdeveloped ventricle.

The Fontan procedure significantly improves the quality of life for many children with single ventricle hearts, although they may still face long-term complications such as heart failure, arrhythmias, and protein-losing enteropathy (a condition where the body loses too much protein in the stool). Regular follow-up care with a pediatric cardiologist is essential to monitor their health and manage any potential issues.

The fetal heart is the cardiovascular organ that develops in the growing fetus during pregnancy. It starts to form around 22 days after conception and continues to develop throughout the first trimester. By the end of the eighth week of gestation, the fetal heart has developed enough to pump blood throughout the body.

The fetal heart is similar in structure to the adult heart but has some differences. It is smaller and more compact, with a four-chambered structure that includes two atria and two ventricles. The fetal heart also has unique features such as the foramen ovale, which is a hole between the right and left atria that allows blood to bypass the lungs, and the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta and diverts blood away from the lungs.

The fetal heart is responsible for pumping oxygenated blood from the placenta to the rest of the body and returning deoxygenated blood back to the placenta for re-oxygenation. The rate of the fetal heartbeat is faster than that of an adult, typically ranging from 120 to 160 beats per minute. Fetal heart rate monitoring is a common method used during pregnancy and childbirth to assess the health and well-being of the developing fetus.

Fetal therapies are medical interventions that are performed on fetuses before they are born to treat or prevent certain serious conditions that could affect their health and development. These therapies can include both surgical and nonsurgical procedures, and they are typically used when it is determined that the potential benefits of treatment outweigh the risks to both the mother and the fetus.

Some examples of fetal therapies include:

* Fetal surgery: This involves operating on the fetus while it is still in the uterus. Fetal surgery may be used to treat conditions such as spina bifida, congenital diaphragmatic hernia, and twin-to-twin transfusion syndrome.
* Intrauterine blood transfusions: This involves transfusing blood into the fetus through a needle that is inserted through the mother's abdomen and uterus. This may be done to treat conditions such as anemia caused by rhesus (Rh) sensitization or other causes.
* Medication therapy: Certain medications can be given to the mother during pregnancy to help treat or prevent fetal conditions. For example, steroids may be given to help mature the lungs of a premature fetus.

It is important to note that fetal therapies are typically only used in cases where the potential benefits of treatment are considered to outweigh the risks. The decision to undergo fetal therapy should be made carefully and with the guidance of medical professionals who have experience with these procedures.

A newborn infant is a baby who is within the first 28 days of life. This period is also referred to as the neonatal period. Newborns require specialized care and attention due to their immature bodily systems and increased vulnerability to various health issues. They are closely monitored for signs of well-being, growth, and development during this critical time.

Cardiac surgical procedures are operations that are performed on the heart or great vessels (the aorta and vena cava) by cardiothoracic surgeons. These surgeries are often complex and require a high level of skill and expertise. Some common reasons for cardiac surgical procedures include:

1. Coronary artery bypass grafting (CABG): This is a surgery to improve blood flow to the heart in patients with coronary artery disease. During the procedure, a healthy blood vessel from another part of the body is used to create a detour around the blocked or narrowed portion of the coronary artery.
2. Valve repair or replacement: The heart has four valves that control blood flow through and out of the heart. If one or more of these valves become damaged or diseased, they may need to be repaired or replaced. This can be done using artificial valves or valves from animal or human donors.
3. Aneurysm repair: An aneurysm is a weakened area in the wall of an artery that can bulge out and potentially rupture. If an aneurysm occurs in the aorta, it may require surgical repair to prevent rupture.
4. Heart transplantation: In some cases, heart failure may be so severe that a heart transplant is necessary. This involves removing the diseased heart and replacing it with a healthy donor heart.
5. Arrhythmia surgery: Certain types of abnormal heart rhythms (arrhythmias) may require surgical treatment. One such procedure is called the Maze procedure, which involves creating a pattern of scar tissue in the heart to disrupt the abnormal electrical signals that cause the arrhythmia.
6. Congenital heart defect repair: Some people are born with structural problems in their hearts that require surgical correction. These may include holes between the chambers of the heart or abnormal blood vessels.

Cardiac surgical procedures carry risks, including bleeding, infection, stroke, and death. However, for many patients, these surgeries can significantly improve their quality of life and longevity.

A "Heart Bypass, Right" or Right Coronary Artery Bypass Graft (RCA Bypass) is a surgical procedure that aims to improve the blood supply to the right side of the heart. It involves grafting a healthy blood vessel, usually taken from another part of the body, to divert blood flow around a blocked or narrowed section of the right coronary artery (RCA). The RCA supplies blood to the right ventricle and the back of the left ventricle. By creating this bypass, the surgery helps restore adequate oxygenated blood flow to the heart muscle, reducing the risk of damage or failure due to insufficient blood supply, and alleviating symptoms such as angina and shortness of breath.

It is important to note that "Heart Bypass, Right" specifically refers to bypass surgery on the right coronary artery, while a standard "Heart Bypass Surgery," also known as Coronary Artery Bypass Grafting (CABG), typically involves bypassing blockages in multiple coronary arteries.

The pulmonary artery is a large blood vessel that carries deoxygenated blood from the right ventricle of the heart to the lungs for oxygenation. It divides into two main branches, the right and left pulmonary arteries, which further divide into smaller vessels called arterioles, and then into a vast network of capillaries in the lungs where gas exchange occurs. The thin walls of these capillaries allow oxygen to diffuse into the blood and carbon dioxide to diffuse out, making the blood oxygen-rich before it is pumped back to the left side of the heart through the pulmonary veins. This process is crucial for maintaining proper oxygenation of the body's tissues and organs.

Aortic coarctation is a narrowing of the aorta, the largest blood vessel in the body that carries oxygen-rich blood from the heart to the rest of the body. This condition usually occurs in the part of the aorta that is just beyond where it arises from the left ventricle and before it divides into the iliac arteries.

In aortic coarctation, the narrowing can vary from mild to severe, and it can cause a variety of symptoms depending on the severity of the narrowing and the age of the individual. In newborns and infants with severe coarctation, symptoms may include difficulty breathing, poor feeding, and weak or absent femoral pulses (located in the groin area). Older children and adults with mild to moderate coarctation may not experience any symptoms until later in life, when high blood pressure, headaches, nosebleeds, leg cramps, or heart failure develop.

Aortic coarctation is typically diagnosed through physical examination, imaging tests such as echocardiography, CT angiography, or MRI, and sometimes cardiac catheterization. Treatment options include surgical repair or balloon dilation (also known as balloon angioplasty) to open the narrowed section of the aorta. If left untreated, aortic coarctation can lead to serious complications such as high blood pressure, heart failure, stroke, and rupture or dissection of the aorta.

Prenatal ultrasonography, also known as obstetric ultrasound, is a medical diagnostic procedure that uses high-frequency sound waves to create images of the developing fetus, placenta, and amniotic fluid inside the uterus. It is a non-invasive and painless test that is widely used during pregnancy to monitor the growth and development of the fetus, detect any potential abnormalities or complications, and determine the due date.

During the procedure, a transducer (a small handheld device) is placed on the mother's abdomen and moved around to capture images from different angles. The sound waves travel through the mother's body and bounce back off the fetus, producing echoes that are then converted into electrical signals and displayed as images on a screen.

Prenatal ultrasonography can be performed at various stages of pregnancy, including early pregnancy to confirm the pregnancy and detect the number of fetuses, mid-pregnancy to assess the growth and development of the fetus, and late pregnancy to evaluate the position of the fetus and determine if it is head down or breech. It can also be used to guide invasive procedures such as amniocentesis or chorionic villus sampling.

Overall, prenatal ultrasonography is a valuable tool in modern obstetrics that helps ensure the health and well-being of both the mother and the developing fetus.

A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.

For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.

It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.

The Blalock-Taussig (BT) procedure is a type of open-heart surgery used to treat cyanotic heart diseases in infants and children. It is primarily used as a palliative treatment for Tetralogy of Fallot, Truncus Arteriosus, and other complex congenital heart defects.

In this procedure, a connection is created between the subclavian artery (a major artery that branches off from the aorta) and the pulmonary artery (the blood vessel that carries oxygen-depleted blood from the heart to the lungs). This connection helps increase the amount of oxygen-rich blood flowing to the lungs, which in turn improves the oxygen saturation levels in the body.

The Blalock-Taussig procedure is typically performed as a temporary measure until a more definitive surgical repair can be carried out, usually when the child is older and has grown larger. The connection created during the BT procedure may be maintained using a synthetic tube (shunt) or by directly sewing the subclavian artery to the pulmonary artery.

The Blalock-Taussig procedure was first performed in 1945 by Drs. Alfred Blalock and Helen Taussig at Johns Hopkins Hospital, and it has since become a standard surgical technique for treating cyanotic heart diseases in infants and children.

The heart ventricles are the two lower chambers of the heart that receive blood from the atria and pump it to the lungs or the rest of the body. The right ventricle pumps deoxygenated blood to the lungs, while the left ventricle pumps oxygenated blood to the rest of the body. Both ventricles have thick, muscular walls to generate the pressure necessary to pump blood through the circulatory system.

Surgical anastomosis is a medical procedure that involves the connection of two tubular structures, such as blood vessels or intestines, to create a continuous passage. This technique is commonly used in various types of surgeries, including vascular, gastrointestinal, and orthopedic procedures.

During a surgical anastomosis, the ends of the two tubular structures are carefully prepared by removing any damaged or diseased tissue. The ends are then aligned and joined together using sutures, staples, or other devices. The connection must be secure and leak-free to ensure proper function and healing.

The success of a surgical anastomosis depends on several factors, including the patient's overall health, the location and condition of the structures being joined, and the skill and experience of the surgeon. Complications such as infection, bleeding, or leakage can occur, which may require additional medical intervention or surgery.

Proper postoperative care is also essential to ensure the success of a surgical anastomosis. This may include monitoring for signs of complications, administering medications to prevent infection and promote healing, and providing adequate nutrition and hydration.

Atrial septal defect (ASD) is a type of congenital heart defect that involves the septum, which is the wall that separates the two upper chambers of the heart (atria). An ASD is a hole or abnormal opening in the atrial septum, allowing oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. This leads to an overload of blood in the right side of the heart, which can cause enlargement of the heart and increased work for the right ventricle.

ASDs can vary in size, and small defects may not cause any symptoms or require treatment. Larger defects, however, can result in symptoms such as shortness of breath, fatigue, and heart rhythm abnormalities. Over time, if left untreated, ASDs can lead to complications like pulmonary hypertension, atrial fibrillation, and stroke.

Treatment for ASD typically involves surgical closure of the defect or catheter-based procedures using devices to close the hole. The choice of treatment depends on factors such as the size and location of the defect, the patient's age and overall health, and the presence of any coexisting conditions.

Right Ventricular Function refers to the ability of the right ventricle (RV) of the heart to receive and eject blood during the cardiac cycle. The right ventricle is one of the four chambers of the heart and is responsible for pumping deoxygenated blood from the body to the lungs for re-oxygenation.

Right ventricular function can be assessed by measuring various parameters such as:

1. Right Ventricular Ejection Fraction (RVEF): It is the percentage of blood that is ejected from the right ventricle during each heartbeat. A normal RVEF ranges from 45-75%.
2. Right Ventricular Systolic Function: It refers to the ability of the right ventricle to contract and eject blood during systole (contraction phase). This can be assessed by measuring the tricuspid annular plane systolic excursion (TAPSE) or tissue Doppler imaging.
3. Right Ventricular Diastolic Function: It refers to the ability of the right ventricle to relax and fill with blood during diastole (relaxation phase). This can be assessed by measuring the right ventricular inflow pattern, tricuspid valve E/A ratio, or deceleration time.
4. Right Ventricular Afterload: It refers to the pressure that the right ventricle must overcome to eject blood into the pulmonary artery. Increased afterload can impair right ventricular function.

Abnormalities in right ventricular function can lead to various cardiovascular conditions such as pulmonary hypertension, heart failure, and arrhythmias.

Endocardial fibroelastosis (EFE) is a rare heart condition characterized by the thickening and stiffening of the endocardium, which is the inner lining of the heart chambers. This thickening is caused by an overgrowth of fibrous tissue and elastic fibers in the endocardium, particularly affecting the left ventricle and atrium.

EFE can occur as a primary condition or secondary to other heart diseases, infections, or genetic disorders. In some cases, it may be associated with conditions such as congenital heart defects, metabolic disorders, or viral infections like coxsackievirus B.

The symptoms of EFE depend on the severity and underlying cause of the condition. They can include difficulty breathing, poor feeding, failure to thrive, fatigue, and irregular heart rhythms (arrhythmias). In severe cases, EFE can lead to heart failure and require medical intervention such as medications or even a heart transplant.

The exact cause of primary EFE is still unknown, but it is believed to involve genetic factors. Secondary EFE is usually a result of damage to the heart muscle due to various causes, including infections, inflammation, or other underlying conditions. Treatment for EFE focuses on addressing the underlying cause and managing symptoms to prevent further complications.

The heart septum is the thick, muscular wall that divides the right and left sides of the heart. It consists of two main parts: the atrial septum, which separates the right and left atria (the upper chambers of the heart), and the ventricular septum, which separates the right and left ventricles (the lower chambers of the heart). A normal heart septum ensures that oxygen-rich blood from the lungs does not mix with oxygen-poor blood from the body. Any defect or abnormality in the heart septum is called a septal defect, which can lead to various congenital heart diseases.

Pulmonary circulation refers to the process of blood flow through the lungs, where blood picks up oxygen and releases carbon dioxide. This is a vital part of the overall circulatory system, which delivers nutrients and oxygen to the body's cells while removing waste products like carbon dioxide.

In pulmonary circulation, deoxygenated blood from the systemic circulation returns to the right atrium of the heart via the superior and inferior vena cava. The blood then moves into the right ventricle through the tricuspid valve and gets pumped into the pulmonary artery when the right ventricle contracts.

The pulmonary artery divides into smaller vessels called arterioles, which further branch into a vast network of tiny capillaries in the lungs. Here, oxygen from the alveoli diffuses into the blood, binding to hemoglobin in red blood cells, while carbon dioxide leaves the blood and is exhaled through the nose or mouth.

The now oxygenated blood collects in venules, which merge to form pulmonary veins. These veins transport the oxygen-rich blood back to the left atrium of the heart, where it enters the systemic circulation once again. This continuous cycle enables the body's cells to receive the necessary oxygen and nutrients for proper functioning while disposing of waste products.

Aortic valve stenosis is a cardiac condition characterized by the narrowing or stiffening of the aortic valve, which separates the left ventricle (the heart's main pumping chamber) from the aorta (the large artery that carries oxygen-rich blood to the rest of the body). This narrowing or stiffening prevents the aortic valve from opening fully, resulting in reduced blood flow from the left ventricle to the aorta and the rest of the body.

The narrowing can be caused by several factors, including congenital heart defects, calcification (hardening) of the aortic valve due to aging, or scarring of the valve due to rheumatic fever or other inflammatory conditions. As a result, the left ventricle must work harder to pump blood through the narrowed valve, which can lead to thickening and enlargement of the left ventricular muscle (left ventricular hypertrophy).

Symptoms of aortic valve stenosis may include chest pain or tightness, shortness of breath, fatigue, dizziness or fainting, and heart palpitations. Severe aortic valve stenosis can lead to serious complications such as heart failure, arrhythmias, or even sudden cardiac death. Treatment options may include medications to manage symptoms, lifestyle changes, or surgical intervention such as aortic valve replacement.

The aortic valve is the valve located between the left ventricle (the lower left chamber of the heart) and the aorta (the largest artery in the body, which carries oxygenated blood from the heart to the rest of the body). It is made up of three thin flaps or leaflets that open and close to regulate blood flow. During a heartbeat, the aortic valve opens to allow blood to be pumped out of the left ventricle into the aorta, and then closes to prevent blood from flowing back into the ventricle when it relaxes. Any abnormality or damage to this valve can lead to various cardiovascular conditions such as aortic stenosis, aortic regurgitation, or infective endocarditis.

Prenatal diagnosis is the medical testing of fetuses, embryos, or pregnant women to detect the presence or absence of certain genetic disorders or birth defects. These tests can be performed through various methods such as chorionic villus sampling (CVS), amniocentesis, or ultrasound. The goal of prenatal diagnosis is to provide early information about the health of the fetus so that parents and healthcare providers can make informed decisions about pregnancy management and newborn care. It allows for early intervention, treatment, or planning for the child's needs after birth.

Catheterization is a medical procedure in which a catheter (a flexible tube) is inserted into the body to treat various medical conditions or for diagnostic purposes. The specific definition can vary depending on the area of medicine and the particular procedure being discussed. Here are some common types of catheterization:

1. Urinary catheterization: This involves inserting a catheter through the urethra into the bladder to drain urine. It is often performed to manage urinary retention, monitor urine output in critically ill patients, or assist with surgical procedures.
2. Cardiac catheterization: A procedure where a catheter is inserted into a blood vessel, usually in the groin or arm, and guided to the heart. This allows for various diagnostic tests and treatments, such as measuring pressures within the heart chambers, assessing blood flow, or performing angioplasty and stenting of narrowed coronary arteries.
3. Central venous catheterization: A catheter is inserted into a large vein, typically in the neck, chest, or groin, to administer medications, fluids, or nutrition, or to monitor central venous pressure.
4. Peritoneal dialysis catheterization: A catheter is placed into the abdominal cavity for individuals undergoing peritoneal dialysis, a type of kidney replacement therapy.
5. Neurological catheterization: In some cases, a catheter may be inserted into the cerebrospinal fluid space (lumbar puncture) or the brain's ventricular system (ventriculostomy) to diagnose or treat various neurological conditions.

These are just a few examples of catheterization procedures in medicine. The specific definition and purpose will depend on the medical context and the particular organ or body system involved.

A vascular fistula is an abnormal connection or passage between the artery and vein, which usually results from a surgical procedure to create access for hemodialysis in patients with chronic kidney disease. This communication allows blood to flow directly from the artery into the vein, bypassing the capillary network and causing high-flow conditions in the affected area. Over time, the increased pressure and flow can lead to various complications such as venous hypertension, stenosis, aneurysm formation, or even heart failure if left untreated. Vascular fistulas may also occur spontaneously due to certain medical conditions like vasculitis, trauma, or infection, although this is less common.

Pulmonary veins are blood vessels that carry oxygenated blood from the lungs to the left atrium of the heart. There are four pulmonary veins in total, two from each lung, and they are the only veins in the body that carry oxygen-rich blood. The oxygenated blood from the pulmonary veins is then pumped by the left ventricle to the rest of the body through the aorta. Any blockage or damage to the pulmonary veins can lead to various cardiopulmonary conditions, such as pulmonary hypertension and congestive heart failure.

The thoracic aorta is the segment of the largest artery in the human body (the aorta) that runs through the chest region (thorax). The thoracic aorta begins at the aortic arch, where it branches off from the ascending aorta, and extends down to the diaphragm, where it becomes the abdominal aorta.

The thoracic aorta is divided into three parts: the ascending aorta, the aortic arch, and the descending aorta. The ascending aorta rises from the left ventricle of the heart and is about 2 inches (5 centimeters) long. The aortic arch curves backward and to the left, giving rise to the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. The descending thoracic aorta runs downward through the chest, passing through the diaphragm to become the abdominal aorta.

The thoracic aorta supplies oxygenated blood to the upper body, including the head, neck, arms, and chest. It plays a critical role in maintaining blood flow and pressure throughout the body.

Pregnancy is a physiological state or condition where a fertilized egg (zygote) successfully implants and grows in the uterus of a woman, leading to the development of an embryo and finally a fetus. This process typically spans approximately 40 weeks, divided into three trimesters, and culminates in childbirth. Throughout this period, numerous hormonal and physical changes occur to support the growing offspring, including uterine enlargement, breast development, and various maternal adaptations to ensure the fetus's optimal growth and well-being.

Echocardiography is a medical procedure that uses sound waves to produce detailed images of the heart's structure, function, and motion. It is a non-invasive test that can help diagnose various heart conditions, such as valve problems, heart muscle damage, blood clots, and congenital heart defects.

During an echocardiogram, a transducer (a device that sends and receives sound waves) is placed on the chest or passed through the esophagus to obtain images of the heart. The sound waves produced by the transducer bounce off the heart structures and return to the transducer, which then converts them into electrical signals that are processed to create images of the heart.

There are several types of echocardiograms, including:

* Transthoracic echocardiography (TTE): This is the most common type of echocardiogram and involves placing the transducer on the chest.
* Transesophageal echocardiography (TEE): This type of echocardiogram involves passing a specialized transducer through the esophagus to obtain images of the heart from a closer proximity.
* Stress echocardiography: This type of echocardiogram is performed during exercise or medication-induced stress to assess how the heart functions under stress.
* Doppler echocardiography: This type of echocardiogram uses sound waves to measure blood flow and velocity in the heart and blood vessels.

Echocardiography is a valuable tool for diagnosing and managing various heart conditions, as it provides detailed information about the structure and function of the heart. It is generally safe, non-invasive, and painless, making it a popular choice for doctors and patients alike.

Heart transplantation is a surgical procedure where a diseased, damaged, or failing heart is removed and replaced with a healthy donor heart. This procedure is usually considered as a last resort for patients with end-stage heart failure or severe coronary artery disease who have not responded to other treatments. The donor heart typically comes from a brain-dead individual whose family has agreed to donate their loved one's organs for transplantation. Heart transplantation is a complex and highly specialized procedure that requires a multidisciplinary team of healthcare professionals, including cardiologists, cardiac surgeons, anesthesiologists, perfusionists, nurses, and other support staff. The success rates for heart transplantation have improved significantly over the past few decades, with many patients experiencing improved quality of life and increased survival rates. However, recipients of heart transplants require lifelong immunosuppressive therapy to prevent rejection of the donor heart, which can increase the risk of infections and other complications.

'Abnormalities, Multiple' is a broad term that refers to the presence of two or more structural or functional anomalies in an individual. These abnormalities can be present at birth (congenital) or can develop later in life (acquired). They can affect various organs and systems of the body and can vary greatly in severity and impact on a person's health and well-being.

Multiple abnormalities can occur due to genetic factors, environmental influences, or a combination of both. Chromosomal abnormalities, gene mutations, exposure to teratogens (substances that cause birth defects), and maternal infections during pregnancy are some of the common causes of multiple congenital abnormalities.

Examples of multiple congenital abnormalities include Down syndrome, Turner syndrome, and VATER/VACTERL association. Acquired multiple abnormalities can result from conditions such as trauma, infection, degenerative diseases, or cancer.

The medical evaluation and management of individuals with multiple abnormalities depend on the specific abnormalities present and their impact on the individual's health and functioning. A multidisciplinary team of healthcare professionals is often involved in the care of these individuals to address their complex needs.

Gestational age is the length of time that has passed since the first day of the last menstrual period (LMP) in pregnant women. It is the standard unit used to estimate the age of a pregnancy and is typically expressed in weeks. This measure is used because the exact date of conception is often not known, but the start of the last menstrual period is usually easier to recall.

It's important to note that since ovulation typically occurs around two weeks after the start of the LMP, gestational age is approximately two weeks longer than fetal age, which is the actual time elapsed since conception. Medical professionals use both gestational and fetal age to track the development and growth of the fetus during pregnancy.

Echocardiography, Doppler, color is a type of ultrasound test that uses sound waves to create detailed moving images of the heart and its blood vessels. In this technique, color Doppler is used to visualize the direction and speed of blood flow through the heart and great vessels. The movement of the red blood cells causes a change in frequency of the reflected sound waves (Doppler shift), which can be used to calculate the velocity and direction of the blood flow. By adding color to the Doppler image, it becomes easier for the interpreting physician to understand the complex three-dimensional motion of blood through the heart. This test is often used to diagnose and monitor various heart conditions, including valve disorders, congenital heart defects, and cardiac muscle diseases.

Cardiac catheterization is a medical procedure used to diagnose and treat cardiovascular conditions. In this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel in the arm or leg and threaded up to the heart. The catheter can be used to perform various diagnostic tests, such as measuring the pressure inside the heart chambers and assessing the function of the heart valves.

Cardiac catheterization can also be used to treat certain cardiovascular conditions, such as narrowed or blocked arteries. In these cases, a balloon or stent may be inserted through the catheter to open up the blood vessel and improve blood flow. This procedure is known as angioplasty or percutaneous coronary intervention (PCI).

Cardiac catheterization is typically performed in a hospital cardiac catheterization laboratory by a team of healthcare professionals, including cardiologists, radiologists, and nurses. The procedure may be done under local anesthesia with sedation or general anesthesia, depending on the individual patient's needs and preferences.

Overall, cardiac catheterization is a valuable tool in the diagnosis and treatment of various heart conditions, and it can help improve symptoms, reduce complications, and prolong life for many patients.

Transposition of the Great Vessels is a congenital heart defect in which the two main vessels that carry blood from the heart to the rest of the body are switched in position. Normally, the aorta arises from the left ventricle and carries oxygenated blood to the body, while the pulmonary artery arises from the right ventricle and carries deoxygenated blood to the lungs. In transposition of the great vessels, the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This results in oxygen-poor blood being pumped to the body and oxygen-rich blood being recirculated back to the lungs, which can lead to serious health problems and is often fatal if not corrected through surgery soon after birth.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Coronary vessel anomalies refer to abnormalities in the structure, origin, or course of the coronary arteries or veins. These vessels are responsible for delivering oxygenated blood to the heart muscle. Some common types of coronary vessel anomalies include:

1. Anomalous Origin of the Coronary Artery (AOCA): This occurs when one or both of the coronary arteries originate from an abnormal location in the aorta. The left coronary artery may arise from the right sinus of Valsalva, while the right coronary artery may arise from the left sinus of Valsalva. This can lead to ischemia (reduced blood flow) and potentially life-threatening complications such as sudden cardiac death.
2. Coronary Artery Fistula: A fistula is an abnormal connection between a coronary artery and another chamber or vessel in the heart. Blood flows directly from the high-pressure coronary artery into a low-pressure chamber, bypassing the capillaries and leading to a steal phenomenon where oxygenated blood is diverted away from the heart muscle.
3. Coronary Artery Aneurysm: An aneurysm is a localized dilation or bulging of the coronary artery wall. This can lead to complications such as thrombosis (blood clot formation), embolism (blockage caused by a clot that travels to another location), or rupture, which can be life-threatening.
4. Myocardial Bridge: In this condition, a segment of the coronary artery passes between the muscle fibers of the heart, instead of running along its surface. This can cause compression of the artery during systole (contraction) and lead to ischemia.
5. Kawasaki Disease: Although not strictly an anomaly, Kawasaki disease is a pediatric illness that can result in coronary artery aneurysms and other complications if left untreated.

Coronary vessel anomalies may be asymptomatic or present with symptoms such as chest pain, shortness of breath, palpitations, or syncope (fainting). Diagnosis typically involves imaging techniques such as coronary angiography, computed tomography (CT) angiography, or magnetic resonance angiography. Treatment depends on the specific anomaly and may involve medications, percutaneous interventions, or surgical correction.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.

A heart bypass surgery, also known as coronary artery bypass grafting (CABG), is a surgical procedure performed to improve blood flow to the heart in patients with severe coronary artery disease. In a left heart bypass, specifically, the left internal thoracic artery or the left great saphenous vein is used to create a bypass graft for the left anterior descending (LAD) coronary artery, which is the primary blood supplier to the front part of the heart. This surgical procedure helps to restore adequate oxygenated blood supply to the heart muscle and alleviate symptoms such as angina and shortness of breath, thereby reducing the risk of heart attacks and improving overall cardiac function.

Doppler echocardiography is a type of ultrasound test that uses high-frequency sound waves to produce detailed images of the heart and its blood vessels. It measures the direction and speed of blood flow in the heart and major blood vessels leading to and from the heart. This helps to evaluate various conditions such as valve problems, congenital heart defects, and heart muscle diseases.

In Doppler echocardiography, a small handheld device called a transducer is placed on the chest, which emits sound waves that bounce off the heart and blood vessels. The transducer then picks up the returning echoes, which are processed by a computer to create moving images of the heart.

The Doppler effect is used to measure the speed and direction of blood flow. This occurs when the frequency of the sound waves changes as they bounce off moving objects, such as red blood cells. By analyzing these changes, the ultrasound machine can calculate the velocity and direction of blood flow in different parts of the heart.

Doppler echocardiography is a non-invasive test that does not require any needles or dyes. It is generally safe and painless, although patients may experience some discomfort from the pressure applied by the transducer on the chest. The test usually takes about 30 to 60 minutes to complete.

Cardiopulmonary bypass (CPB) is a medical procedure that temporarily takes over the functions of the heart and lungs during major heart surgery. It allows the surgeon to operate on a still, bloodless heart.

During CPB, the patient's blood is circulated outside the body with the help of a heart-lung machine. The machine pumps the blood through a oxygenator, where it is oxygenated and then returned to the body. This bypasses the heart and lungs, hence the name "cardiopulmonary bypass."

CPB involves several components, including a pump, oxygenator, heat exchanger, and tubing. The patient's blood is drained from the heart through cannulas (tubes) and passed through the oxygenator, where it is oxygenated and carbon dioxide is removed. The oxygenated blood is then warmed to body temperature in a heat exchanger before being pumped back into the body.

While on CPB, the patient's heart is stopped with the help of cardioplegia solution, which is infused directly into the coronary arteries. This helps to protect the heart muscle during surgery. The surgeon can then operate on a still and bloodless heart, allowing for more precise surgical repair.

After the surgery is complete, the patient is gradually weaned off CPB, and the heart is restarted with the help of electrical stimulation or medication. The patient's condition is closely monitored during this time to ensure that their heart and lungs are functioning properly.

While CPB has revolutionized heart surgery and allowed for more complex procedures to be performed, it is not without risks. These include bleeding, infection, stroke, kidney damage, and inflammation. However, with advances in technology and technique, the risks associated with CPB have been significantly reduced over time.

The postoperative period is the time following a surgical procedure during which the patient's response to the surgery and anesthesia is monitored, and any complications or adverse effects are managed. This period can vary in length depending on the type of surgery and the individual patient's needs, but it typically includes the immediate recovery phase in the post-anesthesia care unit (PACU) or recovery room, as well as any additional time spent in the hospital for monitoring and management of pain, wound healing, and other aspects of postoperative care.

The goals of postoperative care are to ensure the patient's safety and comfort, promote optimal healing and rehabilitation, and minimize the risk of complications such as infection, bleeding, or other postoperative issues. The specific interventions and treatments provided during this period will depend on a variety of factors, including the type and extent of surgery performed, the patient's overall health and medical history, and any individualized care plans developed in consultation with the patient and their healthcare team.

Hemodynamics is the study of how blood flows through the cardiovascular system, including the heart and the vascular network. It examines various factors that affect blood flow, such as blood volume, viscosity, vessel length and diameter, and pressure differences between different parts of the circulatory system. Hemodynamics also considers the impact of various physiological and pathological conditions on these variables, and how they in turn influence the function of vital organs and systems in the body. It is a critical area of study in fields such as cardiology, anesthesiology, and critical care medicine.

The aorta is the largest artery in the human body, which originates from the left ventricle of the heart and carries oxygenated blood to the rest of the body. It can be divided into several parts, including the ascending aorta, aortic arch, and descending aorta. The ascending aorta gives rise to the coronary arteries that supply blood to the heart muscle. The aortic arch gives rise to the brachiocephalic, left common carotid, and left subclavian arteries, which supply blood to the head, neck, and upper extremities. The descending aorta travels through the thorax and abdomen, giving rise to various intercostal, visceral, and renal arteries that supply blood to the chest wall, organs, and kidneys.

A fatal outcome is a term used in medical context to describe a situation where a disease, injury, or illness results in the death of an individual. It is the most severe and unfortunate possible outcome of any medical condition, and is often used as a measure of the severity and prognosis of various diseases and injuries. In clinical trials and research, fatal outcome may be used as an endpoint to evaluate the effectiveness and safety of different treatments or interventions.

Pregnancy outcome refers to the final result or status of a pregnancy, including both the health of the mother and the newborn baby. It can be categorized into various types such as:

1. Live birth: The delivery of one or more babies who show signs of life after separation from their mother.
2. Stillbirth: The delivery of a baby who has died in the womb after 20 weeks of pregnancy.
3. Miscarriage: The spontaneous loss of a pregnancy before the 20th week.
4. Abortion: The intentional termination of a pregnancy before the fetus can survive outside the uterus.
5. Ectopic pregnancy: A pregnancy that develops outside the uterus, usually in the fallopian tube, which is not viable and requires medical attention.
6. Preterm birth: The delivery of a baby before 37 weeks of gestation, which can lead to various health issues for the newborn.
7. Full-term birth: The delivery of a baby between 37 and 42 weeks of gestation.
8. Post-term pregnancy: The delivery of a baby after 42 weeks of gestation, which may increase the risk of complications for both mother and baby.

The pregnancy outcome is influenced by various factors such as maternal age, health status, lifestyle habits, genetic factors, and access to quality prenatal care.

Cardiovascular surgical procedures refer to a range of surgeries performed on the heart and blood vessels to treat or manage various cardiovascular conditions. These surgeries can be open or minimally invasive, and they aim to correct structural abnormalities, improve blood flow, or replace damaged or diseased parts of the cardiovascular system.

Some common types of cardiovascular surgical procedures include:

1. Coronary artery bypass grafting (CABG): This surgery involves taking a healthy blood vessel from another part of the body and using it to create a detour around a blocked or narrowed coronary artery, improving blood flow to the heart muscle.
2. Heart valve repair or replacement: When one or more heart valves become damaged or diseased, they may not open or close properly, leading to reduced blood flow or leakage of blood backward through the valve. In these cases, surgeons may repair or replace the affected valve with a mechanical or biological prosthetic valve.
3. Aneurysm repair: An aneurysm is a weakened area in the wall of an artery that can bulge and potentially rupture, causing severe bleeding. Surgeons can repair an aneurysm by reinforcing the weakened area with a graft or by replacing the affected section of the blood vessel.
4. Heart transplant: In cases where heart failure is irreversible and all other treatment options have been exhausted, a heart transplant may be necessary. This procedure involves removing the damaged heart and replacing it with a healthy donor heart.
5. Ventricular assist devices (VADs): These are mechanical pumps that can be implanted to help support heart function in patients with advanced heart failure who are not candidates for heart transplants. VADs can help improve blood flow, reduce symptoms, and increase the patient's quality of life.
6. Minimally invasive procedures: Advances in technology have led to the development of several minimally invasive cardiovascular surgical procedures, such as robotic-assisted heart surgery, video-assisted thoracoscopic surgery (VATS), and transcatheter aortic valve replacement (TAVR). These techniques typically involve smaller incisions, reduced blood loss, shorter hospital stays, and faster recovery times compared to traditional open-heart surgeries.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

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