Right-sided cervical aortic arch in Loeys–Dietz syndrome

AbstractLoeys–Dietz syndrome is an autosomal dominant connective tissue disorder that is characterized by skeletal abnormalities, craniofacial malformations, and predisposition for aortic aneurysm with tortuosity. We report a case of a right-sided cervical aortic arch associated with the Loeys–Dietz syndrome. To the best of our knowledge, this combination has not been described in the literature.<Learning objective: The Loeys–Dietz syndrome is characterized by vascular findings such as arterial aneurysm or tortuosity with skeletal and craniofacial malformation. We report for the first time a patient with right-sided cervical aortic arch associated with this syndrome. The patient underwent surgical reconstruction.

Measuring Head Circumference in Neonates Weighing Less Than 2500 Grams

Background: Anthropometric measures are important research goals especially because of racial differences and also variation in measurement techniques. In this study, head circumference in neonates weighing less than 2500 grams in Emam-Hosein hospital in 2018 was assessed. Aim: The aim of this study was to Measuring Head Circumference in Neonates Weighing Less Than 2500 Grams. Methods: In this cross-sectional study, 200 neonates weighing less than 2500 grams in Emam-Hosein hospital in 2018 were enrolled. The head circumference in neonates was determined and also was compared according to gestational age, birth weight, and sex. Results: There were 53% males and 47% females. There were 85.5% preterm neonates. Birth weight was less than 2000 gram in 12.5%. Head circumference was low in 148 cases (74%). The head circumference was not differed by gestational age, birth weight, and sex (p &gt; 0.05). Conclusion: Totally, it may be concluded that head circumference is normal only in ¼ of neonates weighing less than 2500 grams and it is not an optimal goal for growth pattern monitoring

Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium

BACKGROUND: We prospectively studied a group of patients with myocardial infarction (MI), who were candidates for surgical revascularization, to compare the efficacy of dobutamine gated myocardial SPECT with dobutamine stress echocardiography (DSE) for the detection of myocardial viability. MATERIALS AND METHODS: We investigated 224 segments from 14 patients with MI using resting echocardiography and low dose dobutamine stress echocardiography as well as resting, low and high dose dobutamine stress 99mTc-Sestamibi gated SPECT. RESULTS: In total, 13 men and 1 women with a mean age 54.57 years (range, 43 to 71 years) entered the study. Of the 125 dysfunctional segments, as assessed by ECG-gated examination, 53 (23.66% of total) were hypokinetic at rest, 64 (28.57% of total) were akinetic, and 8 (3.57% of total) were dyskinetic. The number of segments with resting wall motion abnormality (considered viable by low dose dobutamine ECG-gated examination) was significantly greater than those showing a contractile improvement in response to dobutamine in echocardiography (39.2% versus 32.8%, respectively, p &lt; 0.05). In addition, in high dose ECG-gated examination, 42 of the 125 dysfunctional segments (33.6%) were viable. In general, the methods were well correlated. CONCLUSION: We found a good agreement between low dose dobutamine gated SPECT and stress dobutamine echocardiography for the detection of inotropic reserve in infarcted areas.

Localized Treatment of Chest Pain is Still Common in Rural Areas

Letter to the Edito

Evolving Indications for Tricuspid Valve Surgery

More attention has been paid to the mitral valve (MV) than the tricuspid valve (TV), and this relative paucity of data has led to confusion regarding the timing of TV surgery. We review the American College of Cardiology/American Heart Association and European Society of Cardiology guidelines to identify areas of concordance (severe tricuspid regurgitation [TR] in a patient undergoing mitral valve surgery); discordance (less than severe TR but with markers for late TR recurrence such as pulmonary hypertension, a dilated TV annulus, atrial fibrillation, permanent transtricuspid pacing wires and others); and disagreement (surgery for primary TR). We provide our perspective from Northwestern University on these issues and where the guidelines are silent (TR in patients undergoing non-mitral valve operations). Finally, we review recent publications on the results of TV repair and replacement. Although there have been scant publications in the past, there have been more useful publications in recent years to guide our decision making