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Intelligent diagnosis of atrial septal defect in children using echocardiography with deep learning

虚拟现实与智能硬件（中英文） 2024年第3期6卷 217-225页

作者： Yiman LIU Size HOU Xiaoxiang HAN Tongtong LIANG Menghan HU Xin WANG Wei GU Yuqi ZHANG Qingli LI Jiangang CHEN Shanghai Key Laboratory of Multidimensional Information Processing School of Communication&Electronic EngineeringEast China Normal UniversityShanghaiChina Department of Pediatric Cardiology Shanghai Children's Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Department of Applied Mathematics Xi'an Jiaotong-Liverpool UniversitySchool of ScienceSuzhouChina School of Health Sciences and Engineering University of Shanghai for Science and TechnologyShanghaiChina Minhang District Centers for Disease Control and Prevention ShanghaiChina Faculty of Traditional Chinese Medicine Naval Medical UniversityShanghaiChina Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation Ministry of EducationShanghai 201203China

Background atrial septal defect(ASD)is one of the most common congenital heart *** diagnosis of ASD via transthoracic echocardiography is subjective and *** The objective of this study was to evaluate the feasibility and accuracy of automatic detection of ASD in children based on color Doppler echocardiographic static images using end-to-end convolutional neural *** proposed depthwise separable convolution model identifies ASDs with static color Doppler images in a standard *** the standard views,we selected two echocardiographic views,i.e.,the subcostal sagittal view of the atrium septum and the low parasternal four-chamber *** developed ASD detection system was validated using a training set consisting of 396 echocardiographic images corresponding to 198 ***,an independent test dataset of 112 images corresponding to 56 cases was used,including 101 cases with ASDs and 153 cases with normal *** The average area under the receiver operating characteristic curve,recall,precision,specificity,F1-score,and accuracy of the proposed ASD detection model were 91.99,80.00,82.22,87.50,79.57,and 83.04,*** The proposed model can accurately and automatically identify ASD,providing a strong foundation for the intelligent diagnosis of congenital heart diseases.

关键词： Deep learning atrial septal defect Echocardiography

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Impact of atrial septal defect Closure on Mortality in Older Patients

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Congenital Heart Disease 2024年第1期19卷 93-105页

作者： Sipawath Khamplod Yodying Kaolawanich Khemajira Karaketklang Nithima Ratanasit Division of Cardiology Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Her Majesty Cardiac Center Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Department of Medicine Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

Background:atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left *** closure of ASD has been associated with excellent outcomes and lower complication ***,there is limited evidence regarding the prognosis of ASD closure in older *** study aims to evaluate the mortality rates in older ASD patients with and without ***:A retrospective cohort study was conducted on patients aged 40 years or older with ASD between 2001 and *** were followed up to assess all-cause *** and multivariable analyses were performed to identify the predictors of mortality.A p-value of<0.05 was considered statistically signiﬁ***:The cohort consisted of 450 patients(mean age 56.6±10.4 years,77.3%female),with 66%aged between 40 and 60 years,and 34%over 60 *** the cohort,299 underwent ASD closure(201 with transcatheter and 98 with surgical closure).During the median follow-up duration of 7.9 years,51 patients *** unadjusted cumulative 10-year rate of mortality was 3%in patients with ASD closure,and 28%in patients without ASD closure(log-rank p<0.001).Multivariable analysis revealed that age(hazard ratio[HR]1.04,95%conﬁdence interval[CI]1.006–1.06,p=0.01),NYHA class(HR 2.75,95%CI 1.63–4.62,p<0.001),blood urea nitrogen(BUN)(HR 1.07,95%CI 1.03–1.12,p<0.001),right ventricular systolic pressure(RVSP)(HR 1.07,95%CI 1.003–1.04,p=0.01),and lack of ASD closure(HR 15.12,95%CI 5.63–40.59,p<0.001)were independently associated with ***:ASD closure demonstrated favorable outcomes in older ***,NYHA class,BUN,RVSP,and lack of ASD closure were identiﬁed as independent factors linked to mortality in this population.

关键词： atrial septal defect congenital heart disease defect closure long-term survival mortality

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Reliability of Echocardiographic Pulmonary Vascular Resistance to Screen for the New Definition of Precapillary Pulmonary Hypertension in Uncorrected Secundum atrial septal defect

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Congenital Heart Disease 2024年第3期19卷 315-324页

作者： Risalina Myrtha Hasanah Mumpuni Real Kusumanjaya Marsam Dyah Wulan Anggrahini Anggoro Budi Hartopo Lucia Kris Dinarti Department of Cardiology and Vascular Medicine Faculty of MedicineUniversitas Sebelas MaretSurakarta57126Indonesia Department of Cardiology and Vascular Medicine Universitas Sebelas Maret HospitalSukoharjo57161Indonesia Department of Cardiology and Vascular Medicine Faculty of MedicinePublic Healthand NursingUniversitas Gadjah MadaYogyakarta55281Indonesia Department of Cardiology and Vascular Medicine Dr.Sardjito HospitalYogyakarta55284Indonesia

Background and Objective:The most feared complication of uncorrected secundum atrial septal defect(ASD)is pulmonary arterial hypertension(PAH).Pulmonary vascular resistance(PVR)is crucial in detecting precapil-lary pulmonary hypertension(PH)to guide the need for PAH-specific *** is a change in the cut-off value of PVR according to the recently updated PH *** echocardiographic PVR(PVRecho)correlates to PVR by right heart catheterization(RHC)(PVRcath)according to the new guidelines has not been *** aim of this study is to determine the reliability of PVRecho in detecting PAH in Uncorrected Ostium Secundum ASD based on the current updated guideline and to help screen the high PVR ***:429 ostium secun-dum ASD in the COngenital HeARt Disease in Adult and Pulmonary Hypertension(COHARD-PH)registry was divided into three groups according to the *** was calculated using Abbas’Formula and compared the its gold standard,the *** correlation between the two methods was *** Bland-Altman plot was used to analyze the agreement between the two *** operating characteristics(ROC)analysis was used to determine the PVRecho cut-off value for high ***:The majority of the population(63.5%)had high *** gender dominated the study population(84%).PVR_(echo) was significantly correlated with PVRcath(r=0.6225,p1.62 WU showed good dis-criminatory power in determining high PVR.

关键词： Pulmonary vascular resistance atrial septal defect echocardiography

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Efficacy and Safety of the atrial septal defect Closure for Patients with Absent or Malaligned Aortic Rim Using a Figulla Flex II Device Flared and Straddling Behind the Aorta

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Congenital Heart Disease 2021年第3期16卷 269-283页

作者： Masataka Kitano Kazuto Fujimoto Atsuko Kato Ken-ichi Kurosaki Isao Shiraishi Department of Pediatric Cardiology National Cerebral and Cardiovascular CenterOsakaJapan Department of Pediatric Cardiology Okinawa Prefectural Nanbu Medical Center&Children’s Medical CenterOkinawa PrefectureJapan

Background:Although transcatheter closure of atrial septal defect(ASD)is safe and effective for patients with sufficient rim,ASD patients with absent and/or malaligned aortic and/or superior rim have higher risks of device embolization and cardiac *** have treated such high-risk patients using a Figulla Flex II(FFII)device shaped flared and straddling behind the aorta because this method would avoid such serious ***,its long-term efficacy and safety remain ***,the midterm efficacy and safety of this method were ***:We retrospectively evaluated the outcome of 47 consecutive patients with such rim(age 6–73 years,weight 17–75 kg,31 females)treated with this method at our hospital between February 2016 and September *** make the flared and straddling shape,we selected a FFII 4–6 mm larger than the balloon sizing diameter by stop-flow *** also studied the device shape,the disc pressure to the Valsalva wall and their changes over 6 months by transesophageal ***:All procedures were successful,and leakage disappeared within 1 *** a mean follow up of 37±12 months,complications included a transient sinus node dysfunction and one I°atrioventricular block within 3 *** device shape changed from bulky to thin:the device waist and thickness significantly decreased by around 1.5 mm and 3.5 mm,respectively(p<0.05),but the two discs remained flared and straddling behind the aorta over 6 months;therefore,the disc edges seldom pressed the Valsalva wall perpendicularly,even though the inner plane of either disc often slightly pressed the ***:ASD closure using a FFII shaped flared and straddling behind the aorta is probably effective and safe for patients with absent and/or malaligned aortic and/or superior rim although requiring care for conduction disorders.

关键词： atrial septal defect catheter intervention device embolization cardiac erosion conduction disorder

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Home-made fenestrated amplatzer occluder for atrial septal defect and pulmonary arterial hypertension

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Journal of Geriatric Cardiology 2011年第2期8卷 127-129页

作者： Fabio Dell＇Avvocata Gianluca Rigatelli Paolo Cardaioli Massimo Giordan Section of Congenital and Structural Heart Disease Interventions Cardiovascular Diagnosis and Endoluminal Interventions Rovigo General Hospital Viale Tre Martiri 45100 Rovigo Italy

We report the management of a patient with secundum atrial septal defect （ASD） and severe pulmonary hypertension. A 65-year-old male with recently diagnosed atrial septal defect was referred to our centre for decompensated right heart failure with rest and exercise induced dispnea and severe pulmonary hypertension. Right heart catheterization confirmed a mean pulmonary pressure of about 55 mmHg and a Qp/Qs of 2.7. An occlusion test with a compliant large balloon demonstrated partial fall of pulmonary arterial pressure. The implantation of a home-made fenestrated Amplatzer ASD Occluder （ASO） was planned in order to decrease left-to-right shunt and promote further decrease of pulmonary arterial pressure in the long-term. Thus, by means of mechanical intracardiac echocardiography study with a 9F 9 MHz Ultralce catheter （Boston Scientific Corp.）, we selected a 34 mm ASO for implantation. Four millimeter fenestration was made inflating a 4 mm non-compliant coronary balloon throughout the waist of the ASO, which was successfully implanted under intmcardiac echocardiography. After six months, a decrease of pulmonary arterial pressure to 24 mmHg and full compensated right heart failure was observed on transthoracic echocardiography and clinical examination. This case suggests that Wanscatheter closure with home-made fenestrated ASD in elderly patients with severe pulmonary hypertension is feasible.

关键词： atrial septal defect pulmonary arterial hypertension interventional therapy

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Perioperative anesthesia management in pediatric liver transplant recipient with atrial septal defect:A case report

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World Journal of Clinical Cases 2022年第29期10卷 10638-10646页

作者： Lan Liu Pei Chen Li-Li Fang Li-Na Yu Department of Anesthesiology The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina Department of Anesthesiology Hangzhou Women's HospitalHangzhou 310008Zhejiang ProvinceChina

BACKGROUND Preoperative conditions in pediatric liver transplant recipients are understandably *** with adults,children have lesser compensatory abilities and demand greater precision during procedural *** the setting of endstage liver disease,the heightened perioperative risk of coexistent cardiovascular pathology may impact graft survival as *** for anesthesia and perioperative management are thus more rigorous,calling for individualized treatments that reflect specific cardiovascular constraints and proposed surgical *** SUMMARY Reports of perioperative anesthesia management and liver transplant prognostication in pediatric patients with concurrent atrial septal defects are ***,we detail the course of liver transplantation in a child with dual afflictions,focusing on perioperative anesthesia management and the important contributions of the anesthesiologist(pre-and perioperatively) to a positive therapeutic outcome,despite the clinical hurdles *** Children with atrial septal defects bear substantially more than customary perioperative risk during orthotopic liver transplants,given their compromised cardiopulmonary reserves and functional *** preoperative cardiovascular assessments,including use of agitated-saline contrast echocardiography(to characterize intracardiac shunting) and multidisciplinary deliberation,may offer insights into structural cardiac pathophysiologic effects and transplantrelated hemodynamic changes that impact new *** the same time,active and effective monitoring and other measures should be taken to maintain hemodynamic stability in the perioperative period,avoid entry of bubbles into the circulation,and ease congestion in newly grafted *** efforts are crucial for transplantation success and graft survival.

关键词： Pediatric liver transplant atrial septal defect Anesthesia Case report

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Cryoballoon pulmonary vein isolation and left atrial appendage occlusion prior to atrial septal defect closure: A case report

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World Journal of Clinical Cases 2022年第12期10卷 3872-3878页

作者： Yu-Cheng Wu Mei-Xiang Wang Ge-Cai Chen Zhong-Bao Ruan Qing-Qing Zhang Department of Cardiology Taizhou People’s HospitalTaizhou 225300Jiangsu ProvinceChina Department of Endocrinology Taizhou People’s HospitalTaizhou 225300Jiangsu ProvinceChina

BACKGROUND In patients who suffer from both atrial fibrillation(AF)and atrial septal defect(ASD),cryoballoon pulmonary vein isolation(PVI),sequential left atrial appendage(LAA)occlusion and ASD closure could be a strategy for effective prevention of stroke and right heart *** SUMMARY A 65-year-old man was admitted to our institution due to recurrent episodes of palpitations and shortness of breath for 2 years,which had been worsening over the last 48 *** had a history of AF,ASD,coronary heart disease with stent implantation and *** and laboratory examinations showed no *** score of CHA2DS2VASc was 3,and HAS-BLED was *** revealed a 25-mm secundum *** vein(PV)and LAA anatomy were assessed by cardiac computed *** mapping with 10-pole Lasso catheter was performed following ablation of all four PVs with complete *** the cryoballoon PVI,the patient underwent LAA occlusion under transesophageal echocardiographic ***,a 34-mm JIYI ASD occlude device was implanted.A follow-up transesophageal echocardiography at 3 mo showed proper position of both devices and neither thrombi nor leakage was *** Sequential cryoballoon PVI and LAA occlusion prior to ASD closure can be performed safely in AF patients with ASD.

关键词： atrial fibrillation atrial septal defect Cryoballoon Pulmonary vein isolation Left atrial appendage occlusion Case report

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Misdiagnosis of unroofed coronary sinus syndrome as an ostium primum atrial septal defect by echocardiography:A case report

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World Journal of Clinical Cases 2022年第5期10卷 1592-1597页

作者： Jin-Ling Chen Cai-Gui Yu Dai-Jiao Wang Hong-Bin Chen Department of Echocardiography Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina Department of Pulmonary and Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina

BACKGROUND Unroofed coronary sinus syndrome(UCSS)is a rare congenital heart disease,which has variable morphologic features and is strongly associated with persistent left superior vena cava(PLSVC).However,it is often difficult to visualize the left-to-right shunt pathway through the CS by transthoracic echocardiography(TTE).CASE SUMMARY A 37-year-old female was admitted to the hepatological surgery department of a hospital with complaint of subxiphoid pain that had started 1 wk *** examination revealed a grade 3/6 systolic murmur at the left margin of the sternum,between the 2nd and 3rd intercostal *** patient underwent echocardiography and was diagnosed with ostium primum atrial septal defect(ASD);thus,she was subsequently transferred to the cardiovascular surgery department.A second TTE evaluation before surgery showed type IV UCSS with secundum ***-heart contrast echocardiography(RHCE)showed that the right atrium and right ventricle were immediately filled with microbubbles,but no microbubble was observed in the ***,negative filling was observed at the right atrium orifice of the CS and right atrium side of the secundum atrial *** identified UCSS combined with secundum ASD but without PLSVC in this *** This rare case of UCSS highlights the value of TTE combined with RHCE in confirming UCSS with ASD or PLSVC.

关键词： Congenital heart disease Coronary sinus atrial septal defect Persistent left superior vena cava Echocardiography Right heart contrast echocardiography Case report

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Changes in Reverse Cardiac Remodeling after Percutaneous atrial septal defect Closure in Children and Adults

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Congenital Heart Disease 2021年第3期16卷 211-220页

作者： Geena Kim Hong Ryang Kil Department of Pediatrics Chungnam National University Sejong HospitalChungnam National University School of MedicineSejong30099Korea Department of Pediatrics Chungnam National University HospitalChungnam National University School of MedicineDaejeon35105Korea

Background:The influence of the timing of transcatheter atrial septal defect(ASD)closure on ventricular remodeling at 6 months after ASD closure is *** study investigated changes in cardiac remodeling after transcatheter closure of large ASDs according to patient age at the time of the ***:In this study,41 children and 43 adults underwent percutaneous closure of a large *** remodeling was assessed by two-dimensional echocardiography and electrocardiography before and at 6 months after ASD ***:The age of the children and adults were 2.8±3.1 and 50.0±15.6 years,*** Qp/Qs ratio of all patients was 2.24±*** right atrial(RA)maximal dimension and right ventricular(RV)transverse diameter were significantly decreased and the left ventricular(LV)dimension was significantly increased at 6 months after ASD ***,the difference in RA and RV dimension changes between the groups was not statistically *** difference in left atrial(LA)dimension changes between the groups was also not statistically significant,but the LV dimension significantly increased in children compared with that in adults(P=0.018).The RV/LV ratio was decreased after ASD closure,and a significant difference was found in the RV/LV ratio changes between the *** ECG,the PR interval was significantly more decreased in adults than in children(P=0.003).Conclusions:In conclusion,the LV diameter was significantly more increased in children than in adults at 6 months after percutaneous ASD ***,cardiac remodeling after percutaneous ASD closure varies in children and adults.

关键词： atrial septal defect ventricular remodeling

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Completed atrioventricular block induced by atrial septal defect occluder unfolding:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5715-5721页

作者： Chuan He Yang Zhou Si-Si Tang Li-Hong Luo Kun Feng Department of Cardiology Affiliated Hospital of Chengdu UniversityChengdu 610081Sichuan ProvinceChina

BACKGROUND An atrial septal defect is a common condition and accounts for 25%of adult congenital heart *** occlusion is a widely used technique for the treatment of secondary aperture-type atrial septal defects(ASDs).CASE SUMMARY A 30-year-old female patient was diagnosed with ASD by transthoracic echocardiography(TTE)1 year *** electrocardiogram showed a heart rate of 88 beats per minute,normal sinus rhythm,and no change in the ST-T *** admission,TTE showed an atrial septal defect with a left-to-right shunt,aortic root short-axis section with an ASD diameter of 8 mm,a parasternal four-chamber section with an ASD diameter of 9 mm,and subxiphoid biatrial section with a diameter of 13 *** occlusion was *** intraoperative TTE scan showed that the atrial septal defect was oval in shape,was located near the root of the aorta,and had a maximum diameter of 13 mm.A 10-F sheath was placed in the right femoral vein,and a 0.035°hard guidewire was used to establish the transport track between the left pulmonary vein and the inferior vena cava.A shape-memory alloy atrial septal occluder with a waist diameter of 20 mm was placed successfully and located *** showed that the double disk unfolded well and that the clamping of the atrial septum was *** after the disc was revealed,electrocardiograph monitoring showed that the ST interval of the inferior leads was prolonged,the P waves and QRS waves were separated,a junctional escape rhythm maintained the heart rate,and the blood pressure began to *** removing the occluder,the elevation in the ST segment returned to normal immediately,and the sinus rhythm returned to average approximately 10 min *** consulting the patient’s family,we finally decided to withdraw from the *** Compression of the small coronary artery,which provides an alternative blood supply to the atrioventricular nodule during the operation,leads to the emerg

关键词： Completed atrioventricular block atrial septal defect occluder atrial septal defect Transthoracic echocardiography Case report

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