• Title/Summary/Keyword: Hypoplastic

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A False Diagnosis of Hypoplastic Left Heart Syndrome in a Fetus (태아기에 좌심형성부전증후군으로 잘못 진단되었던 1례)

  • Shin, Youn Jeong;Jang, Sung Hee;Choi, Jung Yun;Han, Eun Sook
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.267-272
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    • 2002
  • Typical hypoplastic left heart syndrome(HLHS) is a distinct pathologic entity with aortic atresia, mitral atresia, very hypoplastic or absent left ventricle and thread like ascending aorta. Occasionally, the lesser degree of hypoplasia is found and is called hypoplastic left heart complex(HLHC) by some authors. This HLHC is often associated with critical aortic stenosis. Fetal echocardiography has enabled us to observe human fetal heart in-utero and to diagnose congenital heart disease prenatally over the last 20 years. The diagnosis of HLHS in fetal echocardiography is based on 2-dimensional echocardio -graphic evidence of a diminutive ascending aorta, aortic atresia, mitral atresia or severe stenosis and a hypoplastic left ventricle. Abnormal flow direction through atrial septum or through isthmus greatly aids the diagnosis. This report shows a fetal case who showed hypoplastic left side chambers and retrograde isthmic flow and was diagnosed with hypoplastic left heart syndrome. After birth, although the baby had tachy-dyspnea for the first 3 weeks, she finally recovered without any intervention and showed catch up growth of left side chambers. This case illustrates the extreme difficulty of assessing left ventricle in a fetus.

Hypoplastic RV: report of 2 cases (우심실 발육부전이 동반된 선천성 심장질환의 치험 2례 보)

  • 박영식
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.632-635
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    • 1984
  • Hypoplastic RV was rarely combined with various other intracardiac anomalies. We experienced the excellent result after surgical correction in these 2 patients. 1. F/7: Combined anomalies were, [1] Hypoplastic Rt. Coronary art.[2] Hypoplastic RV [3] ASD [secundum] & [4] PS [infundibular & valvular] After CP Bypass, [1] Direct suture of ASD [2] Infundibulectomy [3] Pul valvulotomy & [4] Patch enlargement of RVOT with Pericardial monocusp were done 2. F/14: Combined anomalies were, [1] Hypoplastic RV [2] P5 [infundibular] [3] T5 [4] VSD [Type II] [5] ASD [secundum] & [6] 2\ulcornerA-V Block fter CP Bypass, [1] Infundibulectomy [2] Tricuspid valvulotomy [3] Patch repair of VSD & ASD & [4] Implantation of permanent pacemaker were done. Above operations resulted in marked improvement with disappearance of cyanosis & dyspnea.

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Hypoplastic Left Heart Syndrome - Experience in one Patient - (좌심저형성 증후군 경험 1)

  • 장봉현
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.404-410
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    • 1987
  • An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

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Surgical Treatment of the Supravalvular Aortic Stenosis (판막상부 대동맥 협착증의 수술요법)

  • Lee, Won-Yong;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1146-1151
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    • 1990
  • Supravavular aortic stenosis is a congenital narrowing of the ascending aorta just distal to the level of the origins of the coronary arteries, that may be localized or diffuse. Five patients with supravalvular aortic stenosis were operated upon between July, 1986 arid June, 1990. Four of these patients were William`s syndrome [mental retardation, elfin face], and one was isolated supravalvular aortic stenosis. Preoperative diagnosis of the supravalvular aortic stenosis was made by left side cardiac catheterization and angiocardiography. There are three types of supravalvular aortic stenosis such as membranous, hourglass and hypoplastic. Four of our patients were of hourglass type, and one was hypoplastic type. Patch aortoplasty was performed in all cases. Preoperative systolic gradients ranged from 45 to 1SO mmHg [average 102.6 mmHg]: postoperative gradients ranged from 0 to 75 mmHg [average 39 mmHg]. The patient of hypoplastic type has been suffered from mild exercise intolerance even after the operation, and the postoperative echocardiography revealed the systolic gradient of 100 mmHg [preoperative 180 mmHg]. The results of surgery for hourglass type were excellent. But the patient with hypoplastic form would be benefited from some modifications of the operation.

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Acute Lymphoblastic Leukemia with Bone Marrow Infiltration and Hypoplastic Anemia in a German Shepherd (German Shepherd에서 골수침윤과 재생불량성빈혈을 동반한 급성림프모구성백혈병 1증례)

  • 이창우;신남식;최윤주;정동희;권오경;임채형
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.247-251
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    • 2000
  • A male German Shepherd dog, $2{\frac{1}{2}}$years of age, was admitted with sudden anemia, weakness, hyperpyrexia, anorexia and lethargy. The patient showed hypoplastic anemia, thrombocytopenia, absolute and relative lymphocytosis, absolute and relative granulocytopenia, hypoalbuminemia, slight hepatic disorder, slight azotemia, hematuria and proteinuria by the screening examination. The bone marrow aspiration smear showed high cellularity, severs infiltration of lymphoblasts and prolymphocytes, and mitotic figures of lymphoid cells. The liver aspiration smear demonstrated infiltration of lymphoblasts. Acute lymphoblastic leukemia was diagnosed as none of the superficial lymph nodes showed enlargement and marked functional disorder of important organs other than the liver was not found. The patient was treated with vincristine, cyclophophamide, predniosolone for chemotherapy and blood transfusion and either ampicillin or cefoperazone for supportive treatment. But the patient did not show marked remission and died 9 days after the start of the chemptherapy. The necropsy was not permitted.

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Biventricular Repair after Bilateral Pulmonary Artery Banding as a Rescue Procedure for a Neonate with Hypoplastic Left Heart Complex

  • Yun, Jae Kwang;Bang, Ji Hyun;Kim, Young Hwee;Goo, Hyun Woo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.107-111
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    • 2016
  • Hypoplastic left heart complex (HLHC) consists of less severe underdevelopment of the left ventricle without intrinsic left valvular stenosis, i.e., a subset of hypoplastic left heart syndrome (HLHS). HLHC patients may be able to undergo biventricular repair, while HLHS requires single ventricle palliation (or transplant). However, there is no consensus regarding the likelihood of favorable outcomes in neonates with HLHC selected to undergo this surgical approach. This case report describes a neonate with HLHC, co-arctation of the aorta (CoA), and patent ductus arteriosus (PDA) who was initially palliated using bilateral pulmonary artery banding due to unstable ductus-dependent circulation. A postoperative echocardiogram showed newly appearing CoA and progressively narrowing PDA, which resulted in the need for biventricular repair 21 days following the palliation surgery. The patient was discharged on postoperative day 13 without complications and is doing clinically well seven months after surgery.

Translocation of the Aortic Arch with Norwood Procedure for Hypoplastic Left Heart Syndrome Variant with Circumflex Retroesophageal Aortic Arch

  • Lee, Chee-Hoon;Seo, Dong Ju;Bang, Ji Hyun;Goo, Hyun Woo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.389-393
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    • 2014
  • Retroesophageal aortic arch, in which the aortic arch crosses the midline behind the esophagus to the contralateral side, is a rare form of vascular anomaly. The complete form may cause symptoms by compressing the esophagus or the trachea and need a surgical intervention. We report a rare case of a hypoplastic left heart syndrome variant with the left retroesophageal circumflex aortic arch in which the left aortic arch, retroesophageal circumflex aorta, and the right descending aorta with the aberrant right subclavian artery encircle the esophagus completely, thus causing central bronchial compression. Bilateral pulmonary artery banding and subsequent modified Norwood procedure with extensive mobilization and creation of the neo-aorta were performed. As a result of the successful translocation of the aorta, the airway compression was relieved. The patient underwent the second-stage operation and is doing well currently.

Bronchogenic Cyst in Aberrant Hypoplastic Lung Tissue (Aberrant Hypoplastic Lung Tissue 에서 발생한 Bronchogenic Cyst)

  • 김종원;조광현;김의윤
    • Journal of Chest Surgery
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    • v.8 no.1
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    • pp.13-18
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    • 1975
  • Developmental pulmonary abnormalities are known as rare condition. diagnosis was made at autopsy in the early cases reported, however, as diagnostic aids such as X-ray, bronchography, bronchoscopy and exploratory thoracotomy have come into use, the condition is being discovered more often recently in living persons, and it appears to occur with sufficient frequency to merit consideration in the differential diagnosis of certain chest conditions. According to Schneider and Boyden there are three main types of this abnormality: [1] Agenesis, in which there is complete absence of one or both lungs; there is no trace of bronchial or vascular supply or of parenchymal tissue. [2] Aplasia, in which there is suppression of all but a rudimentary bronchus which ends in a blind pouch; there are no vessels or parenchyma. [3] Hypoplasia, in which the bronchus is fully formed but is reduced in size and ends in a _ flesh structure which usually lies within the mediastinum. Rudimentary pulmonary parenchyma may be present around the bronchial stump and often is the site of cystic malformation. We experienced one case of hypoplastic lung with cystic malformation which was originated from a small aberrant rudimentary bronchus, and the rudimentary bronchus was branched from the right side of tracheal end. The diagnosis was finally confirmed by the histopathological finding. Now, we report this case with a brief review of literatures.

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Clinical management of amelogenesis imperfecta in primary dentition

  • Kim, Ga-Yeong
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.12 no.2
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    • pp.31-38
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    • 2003
  • Amelogenesis imperfecta patients suffered common clinical problems of poor esthetics, teeth sensitivity, and loss of occlusal vertical dimension. Amelogenesis imperfecta is a group of inherited disorders primarily affecting dental enamel. Variants of amelogenesis imperfecta generally classified hypoplastic, hypocalcified, or hypomaturation types based on the primary enamel defects. The mildest problems were found in the pitted hypoplastic type whereas the most severe problems were encountered in the hypocalcified type amelogenesis imperfecta. Management stragies include composite resin veneer and jacket crowns for anterior teeth as well as steel crowns for posterior teeth. Knowledge of the clinical features and dental complications of each variants if amelogenesis impecta helps in the diagnosis of the condition and allows institution of early preventive measures. The objective of this paper is to provide a review of the current concepts of the wide spectrum of etiological factors involved in the pathogenesis of this significance clinical entity in the primary dentition.

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Campomelic dysplasia: A review of a rare lethal genetic disorder

  • Kim, Young A
    • Journal of Interdisciplinary Genomics
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    • v.3 no.2
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    • pp.30-34
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    • 2021
  • Campomelic dysplasia (CD) is a rare genetic disorder characterized by multiple skeletal anomalies and the abnormal development of male reproductive organs. To date, the SOX9 gene is the only known causal gene for CD, and approximately 90 causative mutations in SOX9 have been identified worldwide. CD is diagnosed based on clinical characteristics of skeletal dysplasia (e.g., short bowed long bones, kyphoscoliosis, bell-shaped thoracic cage with 11 pairs of ribs, and hypoplastic scapulars), typical facial features of Pierre Robin sequence with cleft palate, and gonadal dysgenesis in 46,XY individuals. Most patients with CD exhibit life-threatening respiratory failure owing to laryngotracheomalacia and hypoplastic thorax during the neonatal period. Although fatal complications decrease after infancy, several medical conditions continue to require proper management. A better understanding of this rare but lethal condition may lead to more appropriate treatments for patients.