Determination of anomalous pulmonary venous return with high-pitch low-dose computed tomography in paediatric patients

Background: In this study, we aimed to image pulmonary venous return anomalies and associated cardiovascular and pulmonary abnormalities by high-pitch low-dose computed tomography (CT) in children. Materials and methods: Forty-one patients with total or partial anomalous pulmonary venous return anomalous between May 2012 and June 2019 were retrospectively reviewed. The anomalies were determined using high-pitch low-dose CT. The patients’ mean age was 3 years (6 months to 15 years), and 24 of them were female. Results: There were 10 patients with total pulmonary venous return anomalies (TPVRA) and 31 patients with partial pulmonary venous return anomalies (PPVRA). Six (60%) patients with TPVRA had the supracardiac type, 2 (20%) had the cardiac type, and 2 (20%) had the mixed type. All patients with TPVRA had a large atrial septal defect (ASD), 1 patient also had patent ductus arteriosus, and 1 patient had right cardiac hypertrophy. Forty cases of PPVRA were found in 31 patients. Twenty-seven (67%) of them were right-sided, and 13 were left-sided (33%). Twenty (65%) patients also had an additional cardiovascular anomaly (ASD in 12 patients, persistent superior vena cava in 4 patients, patent ductus arteriosus in 3 patients, and aortic coarctation in 2 patients). Of the 27 patients with right-sided PPVRA, it drained into the superior vena cava in 19 patients, the right atrium in 5 patients, and the inferior vena cava in 3 patients. In left-sided cases, the anomalous pulmonary vein drained into the left innominate vein in 9 patients, and in 4 patients, there were accessory pulmonary veins that drained into the left innominate vein. Many of the patients had additional lung anomalies, including pneumonic infiltration (n = 12), atelectasis (n = 8), and lobar emphysema (n = 5), and some of these findings coexisted. Conclusions: Anomalous pulmonary venous drains and associated cardiac and extra-cardiac anomalies can be detected reliably and quickly with high-pitch low-dose CT without sedation in paediatric patients

The utility of multidetector computed tomography for evaluation of congenital heart disease

Background: Congenital heart diseases (CHD) are the leading cause of birthdefect-related deaths. Multidedector computed tomography (MDCT) plays animportant role for imaging CHD in addition to echocardiography and providesa comprehensive evaluation of complex heart malformations for the referringcardiologist. The aim of the study was to evaluate the utility of MDCT in theassessment of CHD.Materials and methods: A 102 patients with CHD were investigated after initialassessment by echocardiography. The information obtained by MDCT and findingsof echocardiography were reviewed together by paediatric cardiologistsand cardiac radiologists. Perioperative anatomic descriptions, wherever available(n = 34) formed the gold standard for the comparison.Results: The clinical consensus diagnosis defined 154 cardiovascular lesions inthe patients. The results were classified in groups. We present the appearanceof various congenital cardiac lesions seen in clinical practice.Conclusions: MDCT provides important information about anatomic details ofCHD for the referring cardiologist. The evaluation of different anatomic structuressuch as heart, great vessels, lungs and abdomen is possible in one acquisitionwith this technique

Infected cardiac hydatid cyst

A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cys

Mitral valve replacement and tricuspid annuloplasty via right mini-thoracotomy in a patient with tracheostomy

This report describes our experience in performing mitral valve replacement and tricuspid annuloplasty via a right mini-thoracotomy in a patient with tracheostomy. A 24-year-old woman was admitted with shortness of breath and palpitations. She had subglottic tracheal stenosis and tracheostomy due to tracheal intubation of long duration. Echocardiography revealed chronic severe mitral and tricuspid valve regurgitation. We planned to perform at first the cardiac, and then the tracheal operation, because her left ventricular function was worsening. To eliminate the potential complications of sternotomy in patients with tracheostomy, we used right mini-thoracotomy. We performed mechanical mitral valve replacement for the mitral valve and De Vega annuloplasty for the tricuspid valve. The patient was transferred to the tracheal surgery clinic after the 20th day. Tracheal resection and anastomosis were performed in this department. Three months later, the patient was asymptomatic. We believe that the right mini-thoracotomy approach is a good technique for mitral valve replacement in patients with tracheostomy