Scimitar Syndrome

弯刀综合征
  • 文章类型: Case Reports
    探讨超声心动图检测在胎儿弯刀综合征(SS)产前早期诊断中的临床价值,并制定更好,更准确的管理策略以改善预后。
    对2016年4月1日至2021年6月1日诊断为SS的所有病例的病历和胎儿超声心动图检查结果进行了回顾性分析。总结其超声心动图特征及区别点,收集了全面的临床数据和预后信息.
    6名患者在研究期间被诊断为SS。主要相关异常包括房间隔缺损(n=3),右下肺静脉异常(n=2),室间隔缺损(n=1),和右主动脉弓(n=1)。手术后,所有患者肺静脉血流通畅,无肺动脉高压.平均随访时间24个月,在此期间,五名婴儿接受了SS手术干预。
    全面的产前筛查,特别是胎儿胸部的冠状和矢状结合视图,可以准确诊断正确的SS。这种方法不仅有助于及时干预,而且为儿童的未来福祉提供了至关重要的预后见解。
    UNASSIGNED: To investigate the clinical value of echocardiographic detection in the prenatal early diagnosis of Scimitar syndrome (SS) in fetuses, and to develop better and more accurate management strategies for improved prognosis.
    UNASSIGNED: A retrospective analysis was conducted on medical records and fetal echocardiographic findings of all cases diagnosed as SS between April 1, 2016 and June 1, 2021. To summarize its echocardiographic features and distinguishing points, comprehensive clinical data and prognostic information were gathered.
    UNASSIGNED: Six patients were diagnosed with SS during the study period. Major associated abnormalities included atrial septal defect (n = 3), right inferior pulmonary vein anomalies (n = 2), ventricular septal defect (n = 1), and right aortic arch (n = 1). Post-surgery, all patients exhibited unobstructed pulmonary vein flow and absence of pulmonary hypertension. The average follow-up duration was 24 months, during which five infants underwent surgical intervention for SS.
    UNASSIGNED: Comprehensive prenatal screening, particularly combined coronal and sagittal views of the fetal thorax, enables accurate diagnosis of right SS. This approach not only aids in timely intervention but also provides crucial prognostic insights for the child\'s future well-being.
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  • 文章类型: Case Reports
    弯刀综合征是一种先天性疾病,其特征是部分肺静脉异常回流到下腔静脉(IVC)。成年后的临床表现很少见。管理方法尚未被普遍接受,可能具有挑战性。个性化和多学科的团队决策往往是必要的。我们介绍了一个诊断为复杂先天性心脏病的有症状患者的病例,包括50岁时的弯刀综合征和房间隔缺损。手术修复,涉及使用心包补片在左心房植入弯刀静脉,已执行。尽管进行了手术矫正,呼吸困难持续存在,出现咯血.诊断检查显示重新插入的静脉严重狭窄。通过经皮介入支架植入成功治疗。患者自手术以来一直无症状。弯刀综合征可以在成年期首次诊断,临床表现可能有所不同。诊断检查需要CT血管造影,磁共振扫描,和导管插入在选定的情况下。重新植入的肺静脉(PV)狭窄可以在手术矫正后数年发展,咯血可能作为提示进一步PV成像的警告症状。在有症状的情况下,使用支架进行经皮血管介入治疗是必要的,并且可以带来长期的成功。
    Scimitar syndrome is a congenital disorder characterized by partial anomalous pulmonary venous return to the inferior vena cava (IVC). Clinical manifestation in adulthood is infrequent. The management approach has not been universally accepted and may be challenging. Individually tailored and multidisciplinary team-based decisions are often necessary. We present the case of a symptomatic patient diagnosed with complex congenital heart disease, including scimitar syndrome and atrial septal defect at the age of 50 years. Surgical repair, involving scimitar vein implantation in the left atrium using a pericardial patch, was performed. Despite surgical correction, dyspnea persisted, and hemoptysis developed. A diagnostic workup revealed a critical stenosis of the re-inserted vein. This was successfully treated by percutaneous intervention with stent implantation. The patient has remained asymptomatic since the procedure. Scimitar syndrome can be first diagnosed in adulthood, and clinical manifestations can vary. Diagnostic workup necessitates a CT angiogram, magnetic resonance scan, and catheterization in selected cases. Stenoses of re-implanted pulmonary veins (PVs) can develop years after surgical correction, and hemoptysis may serve as a warning symptom prompting further PV imaging. Percutaneous vascular intervention using a stent is warranted in symptomatic cases and can lead to long-term success.
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  • 文章类型: Case Reports
    弯刀综合征或肺静脉叶综合征是一种罕见的,心肺发育的复杂多变的先天性异常,其特征是下腔静脉右侧肺静脉引流异常,右肺畸形,动脉供应异常,有时是心脏畸形。尽管有这些严重的异常现象,他们的介绍是多种多样的,从无症状到严重症状,特别是在新生儿和婴儿早期。一些有症状的病例被误诊为反复下呼吸道感染或心力衰竭,缺少潜在的先天性异常。考虑到相关的严重并发症,如肺动脉高压和高死亡率,准确和及时的诊断是强制性的。这需要高度怀疑,不仅是临床医生,也是放射科医生在无症状儿童中遇到暗示性胸部X光片。尽管如此,该疾病被命名的经典放射学发现仅在所有病例中的约50%中可见,在受影响的婴儿中只有10%。我们强调这种情况,以提高临床医生和放射科医生对弯刀综合征的怀疑。
    没有声明。
    The Scimitar syndrome or pulmonary venolobar syndrome is a rare, complex and variable congenital anomaly of cardiopulmonary development characterised by an abnormal right-sided pulmonary venous drainage in the inferior vena cava, malformation of the right lung, abnormal arterial supply and sometimes cardiac malformations. These serious anomalies notwithstanding, their presentation is varied, ranging from asymptomatic to severe symptoms, particularly in the neonatal and early infantile period. Some symptomatic cases are misdiagnosed as recurrent lower respiratory tract infections or as heart failure, missing the underlying congenital anomaly. Considering associated serious complications such as pulmonary hypertension and a high mortality rate, accurate and timely diagnosis is mandatory. This requires a high index of suspicion, not only by clinicians but also by radiologists who encounter suggestive chest radiographs in asymptomatic children. Still, the classic radiological finding for which the condition is named is seen in only about 50% of all cases and only 10% in affected infants. We highlight this case to heighten clinicians\' and radiologists\' suspicions about Scimitar syndrome.
    UNASSIGNED: None declared.
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  • 文章类型: Journal Article
    完全异常肺静脉连接(TAPVC)是一种罕见的先天性缺陷,其中肺静脉丛无法与左心房(LA)连接。手术修复是TAPVC的主要治疗方法,但影响结果的因素尚未完全了解。本研究调查了TAPVC手术修复的早期结果及相关因素。对2012年至2022年接受手术修复的TAPVC患者进行回顾性队列分析。从医疗记录中收集数据,并补充电话验证。人口特征,手术数据,诊断测试,并对结果进行了分析。统计分析包括卡方,t检验,并使用SPSS进行多变量逻辑回归。共有88例患者接受了TAPVC手术修复,导致21.6%的死亡率。体重和旁路时间与患者生存率显著相关。女性患者死亡的可能性更高。解剖类型对死亡率没有显著影响。肺静脉阻塞(PVO)患者的死亡率更高。值得注意的是,心上型和心下型的垂直静脉结扎术与较低的死亡率相关。总之,我们的研究确定了导致TAPVC手术后死亡率较高的几个关键因素,包括低重量,女性性别,延长旁路时间,术前静脉阻塞。突出了外科技术的重要性,特别是无情的方法,我们主张对其进行细致的考虑,以实现更好的结果。此外,我们的研究结果表明,与垂直静脉结扎相关的死亡率可能会降低,这可能会降低修复后心力衰竭的风险。我们建议进一步严格的研究,以获得对TAPVC手术干预的全面见解。
    Total anomalous pulmonary venous connection (TAPVC) is a rare congenital defect where pulmonary venous plexus fails to connect with the left atrium (LA). Surgical repair is the primary treatment for TAPVC, but factors influencing outcomes are not fully understood. This study investigates the early outcomes of surgical repair for TAPVC and associated factors. A retrospective cohort analysis was conducted on TAPVC patients who underwent surgical repair between 2012 and 2022. Data were collected from medical records and supplemented with phone call validation. Demographic characteristics, surgical data, diagnostic tests, and outcomes were analyzed. Statistical analysis included chi-square, t-tests, and multivariate logistic regression using SPSS. A total of 88 patients underwent surgical repair for TAPVC, resulting in a mortality rate of 21.6%. Weight and bypass time were significantly associated with patient survival. Female patients had a higher likelihood of death. The anatomic type did not significantly influence mortality. Patients with pulmonary venous obstruction (PVO) experienced a higher mortality rate. Notably, ligation of the vertical vein in supracardiac and infracardiac types was associated with lower mortality. In conclusion, our study identifies several key factors contributing to higher mortality rates following TAPVC surgery, including low weight, female gender, prolonged bypass time, and preoperative vein obstruction. Highlighting the significance of surgical technique, particularly the sutureless approach, we advocate for its meticulous consideration to achieve improved outcomes. Furthermore, our findings indicate a potential decrease in mortality associated with vertical vein ligation, which may mitigate the risk of post-repair heart failure. We suggest further rigorous studies to gain comprehensive insights into TAPVC surgical interventions.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:完全肺静脉异位连接(TAPVC)是一种罕见的先天性心脏病,其特征是所有肺静脉都无法连接到左心房。我们以前的文献计量学文章仅总结了TAPVC研究中引用最多的100篇论文的特征。本研究的目的是使用综合文献计量分析来考察发展历史,当前状态,以及TAPVC领域的未来趋势。
    方法:2000年至2023年之间发表的所有TAPVC出版物均来自WebofScienceCoreCollection。按出版年份对出版物和引文数据进行定量分析,国家,机构,作者,和日记。共同作者和共现分析使用VOSviewer进行,使用CiteSpace识别关键字和参考突发。采用皮尔森检验检验两个连续变量之间的相关性。
    结果:截至2023年7月20日,我们确定了368种出版物,引文为3320。这些出版物发表在132种期刊上,由来自47个国家的457个机构的1835名研究人员撰写。关于出版物的数量,顶级国家,顶级机构,顶级作者,顶级期刊是美国(n=82),上海交通大学(n=13),陈慧文(n=9),胸外科和小儿心脏病学年鉴(每个n=29),分别。对于引用次数,顶级国家,顶级隶属关系,顶级作者,顶级期刊是美国(n=1348),多伦多大学(n=250),ChristopherA.Caldarone(n=315),和胸外科年鉴(n=746),分别。国家出版物数量与GDP显著相关(R=0.887,P<0.001),研发(R&D)支出(R=0.375,P=0.013),人口(R=0.694,P<0.001),和期刊(R=0.751,P<0.001)。国家引用次数与GDP显著相关(R=0.881,P<0.001),研发支出(R=0.446,P=0.003),人口(R=0.305,P=0.037),和期刊(R=0.917,P<0.001)。TAPVC领域的国际合作没有得到很好的发展。最常引用的出版物讨论了TAPVC患者死亡率和再手术率的时代变化。最常见的关键词是“完全性肺静脉连接异常”和“先天性心脏病”。关键字“病例报告”最近出现,平均发生年为2021.8。共现分析将26个关键词分为六个主题:TAPVC的手术修复,术后肺静脉狭窄,TAPVC患者的手术修复,超声心动图在TAPVC诊断中的应用,超声心动图在TAPVC产前诊断中的应用,无缝合技术在右心房异构或单心室TAPVC患者手术修复中的应用。引用脉冲串检测识别出32个引用脉冲串,其中七个在2023年之前一直持续引用。
    结论:本研究进行了文献计量分析,以全面概述TAPVC研究。我们希望为促进TAPVC领域的发展提供新的思路。
    BACKGROUND: Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease characterized by the inability of all pulmonary veins to connect to the left atrium. Our previous bibliometric article summarized the characteristics of only the 100 most cited papers in TAPVC research. The purpose of this study was to use comprehensive bibliometric analysis to examine the development history, current status, and future trends in the field of TAPVC.
    METHODS: All publications on TAPVC published between 2000 and 2023 were collected from the Web of Science Core Collection. The publication and citation data were quantitatively analyzed by publication year, country, institution, author, and journal. Co-authorship and co-occurrence analyses were performed using VOSviewer, and keyword and reference bursts were identified using CiteSpace. Pearson\'s test was used to examine the correlations between two continuous variables.
    RESULTS: As of July 20, 2023, we identified 368 publications with 3320 citations. These publications were published in 132 journals and authored by 1835 researchers from 457 institutions in 47 countries. For the number of publications, the top country, top institution, top author, and top journals were the United States (n = 82), Shanghai Jiao Tong University (n = 13), Huiwen Chen (n = 9), and Annals of Thoracic Surgery and Pediatric Cardiology (n = 29 each), respectively. For the number of citations, the top country, top affiliation, top author, and top journal were the United States (n = 1348), University of Toronto (n = 250), Christopher A. Caldarone (n = 315), and Annals of Thoracic Surgery (n = 746), respectively. The number of national publications significantly correlated with GDP (R = 0.887, P < 0.001), research & development (R&D) expenditure (R = 0.375, P = 0.013), population (R = 0.694, P < 0.001), and journals (R = 0.751, P < 0.001). The number of national citations significantly correlated with GDP (R = 0.881, P < 0.001), R&D expenditure (R = 0.446, P = 0.003), population (R = 0.305, P = 0.037), and journals (R = 0.917, P < 0.001). International collaboration in the field of TAPVC was not well developed. The most commonly cited publication discussed era changes in mortality and reoperation rate in TAPVC patients. The most common keywords were \"total anomalous pulmonary venous connection\" and \"congenital heart disease\". The keyword \"case report\" appeared most recently, with an average occurrence year of 2021.8. The co-occurrence analysis grouped 26 keywords into six themes: surgical repair of TAPVC, postoperative pulmonary vein stenosis, surgical repair of TAPVC patients with heterotaxy, application of echocardiography in diagnosing TAPVC, application of echocardiography in the prenatal diagnosis of TAPVC, and application of the sutureless technique in the surgical repair of TAPVC patients with right atrial isomerism or a single ventricle. Citation burst detection identified 32 references with citation bursts, seven of which had ongoing citation bursts until 2023.
    CONCLUSIONS: This study conducted a bibliometric analysis to provide a comprehensive overview of TAPVC research. We hope to offer new ideas for promoting development in the field of TAPVC.
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  • 文章类型: Case Reports
    马蹄肺(HL)是一种罕见的先天性异常,表现为双肺融合,在心脏后面,通常与各种支气管肺和心血管畸形有关。多探测器对比增强CT是显示病理和相关畸形的首选成像方式。文献中用于这种情况的命名法存在不一致。为了解决歧义,作者强调,只有两个术语:HL和假性HL在影像学上用于描述这种先天性畸形的变异。
    对4例HL的成像特征的描述,与它们相关的畸形和术语的回顾。
    Horseshoe lung (HL) is a rare congenital anomaly represented by the fusion of both lungs, posterior to the heart, and is typically associated with various bronchopulmonary and cardiovascular malformations. Multi-detector contrast enhanced CT is the imaging modality of choice to demonstrate the pathology and associated malformations. There has been inconsistency in the nomenclature used for such cases in literature. To resolve ambiguity, the authors emphasise that only two terms: HL and pseudo-HL be used on imaging to describe variants of this congenital malformation.
    UNASSIGNED: A description of the imaging features in four cases of HL, with their associated malformations and a review of the nomenclature.
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  • 文章类型: Journal Article
    弯刀综合征是与肺静脉回流异常相关的先天性心血管异常的复杂频谱的一部分。根据参与的程度,治疗可以是期待或手术。预后和生存一直存在争议,一些结果支持早期手术管理。这项研究旨在披露结果并描述管理层,在三级转诊医疗中心接受治疗的弯刀综合征患者的临床和影像学特征.纵向描述性观察研究。该研究包括2011年1月至2022年12月在我们机构诊断为弯刀综合征的所有患者。社会人口统计学和临床特征的描述,使用的诊断工具,治疗特点,并提供患者结果。包括11名患者,诊断时的平均年龄为5岁(CI0-17),其中6人为女性(54.55%)。9名(81.82%)患者胸片上有弯刀静脉的证据,六(54.55%)心脏右旋,六(54.55%)肺发育不全,五(45.45%)右肺动脉发育不全,3例(27.27%)有主肺经。四名(36.36%)患者有马蹄形肺,其中4人(36.36%)有支气管肺隔离症。在协会中,两名(18.18%)患者被发现有房间隔缺损,三(27.27%)室间隔缺损,其中一人(9%)患有法洛四联症。2例(18.18%)患者出现肺动脉高压。七个(63.64%)需要手术治疗以纠正弯刀静脉,2例患者死于无关的并发症。弯刀综合征提出了诊断和治疗挑战,需要采用多学科方法进行及时护理。胸部X线摄影和CT扫描是主要的诊断工具,与其他心脏缺陷或显著的血流动力学影响一起,通常需要手术干预。医疗管理对轻度至中度病例有效。由于研究的局限性,患者的长期预后仍然不确定。但预期寿命的改善与持续护理。
    Scimitar Syndrome is part of a complex spectrum of congenital cardiovascular anomalies related to anomalous pulmonary venous return. Depending on the extent of involvement, treatment can be either expectant or surgical. Prognosis and survival have been controversial, with some results supporting early surgical management. This research aims to disclose the outcomes and describe the management, clinical and imaging characteristics of patients diagnosed with Scimitar Syndrome treated in a tertiary referral healthcare center. Longitudinal descriptive observational study. The study included all patients diagnosed with scimitar syndrome in our institution between January/2011 and December/2022. A description of the sociodemographic and clinical characteristics, diagnostic tools used, treatment features, and patient outcomes is provided. Eleven patients were included, with a mean age at diagnosis of five years (CI 0-17), six of which were female (54.55%). Nine (81.82%) patients had evidence of a scimitar vein on the chest radiograph, six (54.55%) cardiac dextroposition, six (54.55%) pulmonary hypoplasia, five (45.45%) right pulmonary artery hypoplasia, and three (27.27%) had aortopulmonary collaterals. Four (36.36%) patients had horseshoe lungs, and four (36.36%) had bronchopulmonary sequestration. In the associations, two (18.18%) patients were found to have an atrial septal defect, three (27.27%) ventricular septal defect, and one (9%) had Tetralogy of Fallot. Pulmonary hypertension was demonstrated in two (18.18%) patients. Seven (63.64%) required surgical management to correct the scimitar vein, and two patients died due to unrelated complications. Scimitar syndrome presents diagnostic and treatment challenges, necessitating a multidisciplinary approach for timely care. Chest radiography and CT scans are primary diagnostic tools, with surgical intervention often warranted alongside other heart defects or significant hemodynamic repercussions. Medical management is effective for mild to moderate cases. Long-term patient outcomes remain uncertain due to study limitations, but improved life expectancy is anticipated with ongoing care.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    弯刀综合征,一种罕见的先天性心脏异常,涉及肺静脉异常引流到全身静脉,导致独特的成像特征,类似于弯曲的剑。此病例报告提供了巴基斯坦弯刀综合征的独特实例,强调其临床重要性和管理的挑战。一名26岁的女性,从小就有反复的肺部感染和呼吸道症状,被诊断患有弯刀综合征。放射学评估,包括胸部X光片,计算机断层扫描肺血管造影(CTPA),经胸超声心动图,确认存在源自右半膈并与下腔静脉(IVC)连接的弯曲血管。病人和她的医疗团队选择了保守的管理,涉及多学科护理,为感染量身定制的治疗方法,定期监测。弯刀综合征的罕见性需要仔细的诊断和管理决策。虽然经常推荐手术干预,该病例证明了根据患者偏好和不断变化的临床病程选择保守治疗的复杂性.文献综述揭示了手术和保守方法的不同结果,强调个性化战略的必要性。放射技术,比如CTPA和MRI,在诊断和监测中起着举足轻重的作用。此病例报告强调了弯刀综合征的临床意义,特别是在报告病例有限的地区,就像巴基斯坦。多学科管理方法,关于保守治疗的决策过程,独特的放射学发现有助于医学界对这种罕见疾病的理解。
    Scimitar syndrome, a rare congenital cardiac anomaly, involves abnormal pulmonary vein drainage into systemic veins, leading to distinct imaging features resembling a curved-blade sword. This case report presents a unique instance of scimitar syndrome in Pakistan, emphasizing its clinical importance and the challenges of management. A 26-year-old female with a history of recurrent pulmonary infections and respiratory symptoms since childhood was diagnosed with scimitar syndrome. Radiological assessments, including chest X-rays, computed tomography pulmonary angiograms (CTPA), and transthoracic echocardiography, confirmed the presence of a curved vessel originating from the right hemidiaphragm and connecting with the inferior vena cava (IVC). The patient and her medical team opted for conservative management, involving multidisciplinary care, tailored treatment for infections, and regular monitoring. The rarity of Scimitar syndrome necessitates careful diagnosis and management decisions. While surgical intervention is often recommended, this case demonstrates the complexities of choosing conservative management based on patient preferences and the evolving clinical course. A literature review reveals varied outcomes of surgical and conservative approaches, emphasizing the need for personalized strategies. Radiological techniques, such as CTPA and MRI, play pivotal roles in diagnosis and monitoring. This case report underscores the clinical significance of scimitar syndrome, particularly in regions with limited reported cases, like Pakistan. The multidisciplinary management approach, the decision-making process regarding conservative treatment, and the unique radiological findings contribute to the medical community\'s understanding of this rare condition.
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