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Pulmonary Perfusion Asymmetry in Patients after Repair of Tetralogy of Fallot: A 4D Flow MRI-Based Study

Congenital Heart Disease 2022年第2期17卷 117-128页

作者： Elena Panaioli Duarte Martins Marc Antoine Isorni Diala Khraiche Antoine Legendre Nathalie Boddaert Damien Bonnet filippo crea Francesca Raimondi Unite Medico-Chirurgicale de Cardiologie Congénitale et Pediatrique Centre de Référence des Maladies Cardiaques Congénitales ComplexesHopital Universitaire Necker-Enfants MaladesUniversitéde ParisParisFrance Department of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly Catholic University of the Sacred Heart RomeItaly Pediatric Cardiology Department Hospital de Santa CruzCentro Hospitalar Lisboa OcidentalLisbonPortugal Centre de Cardiologie Evecquemont ParisFrance Pediatric Radiology Unit Hôpital Universitaire Necker-Enfants MaladesUniversitéde ParisParisFrance Decision and Bayesian Computation Computation Biology DepartmentNeuroscience DepartmentParisFrance School of Biomedical Engineering&Imaging Sciences King’s College LondonLondonUK

Background:Repaired Tetralogy of Fallot(rTOF)patients may have residual lesions such as main(MPA)and branch pulmonary artery stenosis(BPAS).While MPA stenosis is well studied,few data are available on BPAS in rTOF.We aimed to describe pulmonary perfusion in a large paediatric cohort of rTOF and its impact on right ventricular and outflow-tract hemodynamics using 4D flow CMR.Methods:130 consecutive patients(mean age at CMR 14.3±4.6 years)were retrospectively reviewed.96 patients had transannular patch without valve preservation while 34 patients had conserved annulus or valved conduit.A pulmonary blood flow ratio(right pulmonary artery(RPA)/left pulmonary artery(LPA))between 0.75 and 1.56 was considered normal.Results:Asymmetric pulmonary perfusion was present in 59/130 patients(45%),with 54/59(91%)having left lung hypoperfusion(blood flow ratio>1.56).RPA/LPA perfusion ratio in the whole cohort was independently associated with the LPA Z-score(−0.053,p=0.007),the RPA regurgitant fraction(RF)(0.013,p=0.011)and previous LPA stenting(0.648,p=0.004).Decreasing LPA%perfusion(and conversely increasing RPA%perfusion)was significantly associated with higher MPA diameter Z-score(−0.06,p=0.007).On multivariate analysis,MPA Z-score was independently associated with pulmonary RF(0.48,pcreased RVEF in patients after transannular patch.

关键词： Tetralogy of fallot cardiac MRI 4D flow MRI pulmonary perfusion

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Percutaneous management of vascular access in transfemoral transcatheter aortic valve implantation

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World Journal of Cardiology 2014年第8期6卷 836-846页

作者： Ilaria Dato Francesco Burzotta Carlo Trani filippo crea Gian Paolo Ussia Institute of Cardiology Catholic University of the Sacred Heart00168 RomeItaly Department of Cardiovascular Disease Tor Vergata University00133 RomeItaly

Transcatheter aortic valve implantation(TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde access from the femoral artery using large sheaths(16-24 F). Vascular access complications are a clinically relevant issue in TAVI procedures since they are reported to occur in up to one fourth of patients and are strongly associated with adverse outcomes. In the present paper, we review the different types of vascular access site complications associated with transfemoral TAVI. Moreover, we discuss the possible optimal management strategies with particular attention to the relevance of early diagnosis and prompt treatment using endovascular techniques.

关键词： Transfemoral transcatheter aortic valve implantation Vascular access complication Percutaneous management

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Collateral findings during computed tomography scan for atrial fibrillation ablation:Let's take a look around

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World Journal of Cardiology 2016年第4期8卷 310-316页

作者： Francesco Perna Michela Casella Maria Lucia Narducci Antonio Dello Russo Gianluigi Bencardino Gianluca Pontone Gemma Pelargonio Daniele Andreini Nicola Vitulano Francesca Pizzamiglio Edoardo Conte filippo crea Claudio Tondo Cardiac Arrhythmia Unit Agostino Gemelli University Hospital Cardiac Arrhythmia Research Centre Centro Cardiologico MonzinoIRCCS

The growing number of atrial fibrillation catheter ablation procedures warranted the development of advanced cardiac mapping techniques, such as image integration between electroanatomical map and cardiac computed tomography. While scanning the chest before catheter ablation, it is frequent to detect cardiac and extracardiac collateral findings. Most collateral findings are promptly recognized as benign and do not require further attention. However, sometimes clinically relevant collateral findings are detected, which often warrant extra diagnostic examinations or even invasive procedure, and sometimes need to be followed-up over time. Even though reporting and further investigating collateral findings has not shown a clear survival benefit, almost all the working groups providing data on collateral findings reported some collateral findings eventually coming out to be malignancies, sometimes at an early stage. Therefore, there is currently no clear agreement about the right strategy to be followed.

关键词： Collateral findings Incidental findings Incidentalomas Cardiac computed tomography Image integration

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CODE-EHR:临床研究中运用结构化电子医疗记录的最佳实践框架

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英国医学杂志中文版 2022年第12期25卷 721-729页

作者： Dipak Kotecha Folkert W Asselbergs Stephan Achenbach Stefan DAnker Dan Atars Colin Baigent Amitava Banerjee Birgit Beger Cunnar Brobert Barbara Casadei Cinzia Ceccarelli Martin R Cowie filippo crea Maureen Cronin Spiros Denaxas Andrea Derix Donna Fitzsimons Martin Fredriksson Chris PGale Georgios V Ckoutos Wim Goettsch Harry Hemingway Martin Ingvaris Adrian Jonas's Robert Kazmierski Susanne Logstrup R Thomas Lumbers Thomas F Lischer Paul McGreavy leana L Pina Lothar Roesiga Carl Steinbeisser Mats Sundgren Benoit Tyl Chislaine van Thiel Kees van Bochove Panos EVardas Tiago Villanueva Marilena Vrana Wim Weber Franz Weidinger Stephan Windecker Angela Wood Diederick E Grobbee 创新药物计划BigData@Heart联盟欧洲心脏病协会 CODE-EHR国际共识小组宋奇繁(译) 汪奕名(译) 不详重庆医药高等专科学校

改善患者生存质量是全球临床医学的发展目标,大数据是实现其发展的关键所在。技术进步使结构化电子医疗记录得以常规化,也可能会改善缺失重要临床证据的问题。虽然大数据及其相关分析在新冠大流行期间发挥了重要作用,但也存在严重的缺... 详细信息

改善患者生存质量是全球临床医学的发展目标,大数据是实现其发展的关键所在。技术进步使结构化电子医疗记录得以常规化,也可能会改善缺失重要临床证据的问题。虽然大数据及其相关分析在新冠大流行期间发挥了重要作用,但也存在严重的缺陷。证实、核验、数据隐私以及对科学研究社会责任的践行是一项重要挑战。欧洲心脏病协会和BigData@Heart联盟已经收集了包括患者代表、临床医生、科研人员、监管机构、期刊编辑和企业代表在内的多元化国际参与者,提出了CODE-EHR的最低标准框架。为改进研究设计、提高信息透明度提供方法手段,同时为实现医疗保健数据的稳健并能够有效运用制定了技术路线图。

关键词：大数据数据隐私 CODE 技术路线图科研人员信息透明度医疗保健最低标准

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