Download or read book Ventricular Function and Blood Flow in Congenital Heart Disease written by Mark A. Fogel and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 392 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infants, children and adolescents with congenital heart disease(CHD) are a challenge to manage and an ever-increasing number arereaching adulthood. CHD is one of the most important topics in cardiology today, yetthis book is the only clinically-orientated monograph devotedexclusively to ventricular function and blood flow as it relates toCHD. Written by a distinguished panel of cardiologists, bioengineers,physiologists, and clinical investigators, Ventricular Functionand Blood Flow in Congenital Heart Disease is an extensive andcomprehensive presentation of the key aspects of this branch ofCHD.
Download or read book Blood flow specific assessment of ventricular function written by Alexandru Grigorescu Fredriksson and published by Linköping University Electronic Press. This book was released on 2017-12-06 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The spectrum of cardiovascular diseases is the leading cause of morbidity and mortality globally. Early assessment and treatment of these conditions, acquired as well as congenital, is therefore of paramount importance. The human heart has a great ability to adapt to various hemodynamic conditions by cardiac remodeling. Pathologic cardiac remodeling can occur as a result of cardiovascular disease in an effort to maintain satisfactory cardiac function. With time, cardiac function diminishes leading to disease progression and subsequent heart failure, the end-point of many heart diseases, associated with very poor prognosis. Within the normal cardiac ventricles blood flows in highly organized patterns, and changes in cardiac configuration or function will affect these flow patterns. Conversely, altered flows and pressures can bring about cardiac remodeling. In congenital heart disease, even after corrective surgery, cardiac anatomy and thereby intracardiac blood flow patterns are inherently altered. The clinically most available imaging technique, ultrasound with Doppler, allows only for one-directional flow assessment and is limited by the need of clear examination windows, thus failing to fully assess the complex three-dimensional blood flow within the beating heart. Cardiovascular magnetic resonance imaging (CMR) with phase-contrast has the ability to acquire three-dimensional (3D), three-directional time resolved velocity data (3D + time = 4D flow data) from which visualization and quantification of blood flow patterns over the complete cardiac cycle can be performed. Four functional blood flow components have previously been defined based on the blood route and distribution through the ventricle, where the inflowing blood that passes directly to the outflow is called Direct flow. From these components, various quantitative measures can be derived, such as component volumes and kinetic energy (KE) throughout the cardiac cycle. In addition, the 4D flow technique has the ability to quantify and visualize turbulent flow with increased velocity fluctuations in the heart and vessels, turbulent kinetic energy (TKE). The technique has been developed and evaluated for assessment of left ventricular (LV) blood flow in healthy subjects and in patients with dilated dysfunctional left ventricles, showing significant changes in blood flow patterns and energetics with disease. There is however still no study addressing the gap in the spectrum from the healthy cohorts to patients with moderate to severe left ventricular remodeling. In Paper III, 4D flow CMR was utilized to assess LV blood flow in patients with subtle LV dysfunction, and a shift in blood flow component volumes and KE was seen from the Direct flow to the non-ejecting blood flow components. In patients with both left- and right-sided acquired and congenital heart disease, right ventricular (RV) function is of great prognostic significance, however this ventricle has historically been somewhat overseen. With its complex geometry, advanced physiology and retrosternal location, assessment of the RV is still challenging and the right ventricular blood flow is still incompletely described. In Paper I, the RV blood flow in healthy subjects was assessed, and the proportionally larger Direct flow component was located in the most basal region of the ventricle and possessed higher levels of KE at end-diastole than the other flow components suggesting that this portion of blood was prepared for efficient systolic ejection. In Paper II, the blood flow was assessed in the RV of patients with subtle primary LV disease, and even if conventional echocardiographic or CMR RV parameters did not show any RV dysfunction, alterations of flow patterns suggestive of RV impairment were found in the patients with the more remodeled LVs. With improvements of the cardiovascular health care, including the surgical techniques, the number of adult patients with surgically corrected complex congenital heart diseases increases, one of which is tetralogy of Fallot (ToF). Surgical repair of ToF involves widening of the pulmonary stenosis, which postoperatively may cause pulmonary insufficiency and regurgitation (PR). Disturbed or turbulent flow patterns are rare in the healthy cardiovascular system. With pathological changes, such as valvular insufficiency, increased amounts of TKE have been demonstrated. Turbulence is known to be harmful to organic tissues and could be significant in the development of ventricular remodeling, such as dilation and other complications seen in Fallot patients. In Paper IV, the RV intraventricular TKE levels were assessed in relation to conventional measures of PR. Results showed that RV TKE was increased in ToF patients with PR compared to healthy controls, and that these 4D flow-specific measures related slightly stronger to indices of RV remodeling than the conventional measures of PR. 4D flow CMR analysis of the intracardiac blood flow has the potential of adding to pathophysiological understanding, and thereby provide useful diagnostic information and contribute to optimization of treatment of heart disease at earlier stages before irreversible and clinically noticeable changes occur. The flow specific measures used in this thesis could be utilized to detect these alterations of intracardiac blood flow and could thus act as potential markers of progressing ventricular dysfunction, pathological remodeling or used for risk stratification in adults with early repair tetralogy of Fallot. Visualizations of intracardiac flow patterns could provide useful information to cardiac/thoracic surgeons pre- and post-operatively.
Download or read book Pathophysiology of Congenital Heart Disease written by Forrest H. Adams and published by Univ of California Press. This book was released on 1970 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Heart Failure in Congenital Heart Disease written by Robert. E Shaddy and published by Springer Science & Business Media. This book was released on 2010-11-19 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book will provide both an evidence base and practical recommendations for the treatment of patients with congenital heart disease. It will be a resource to all health care providers, including pediatric cardiologists, pediatric intensivists, pediatric heart surgeons, fetal specialists, maternal fetal medicine specialists, neonatologists, nurses, advanced practice nurses, in addition to trainees in the field. It will summarize world knowledge on the topic of heart failure in patients with congenital heart disease. It will provide an in depth analysis of the current methods of diagnosis and treatment of heart failure. Now that surgical results are at record success rates, more patients with congenital heart disease are surviving, and thus at risk for sequelae from their disease, including heart failure. It will provide evidence based and practical recommendations to the practitioner for the management of heart failure signs and symptoms.
Download or read book Congenital Diseases in the Right Heart written by Andrew N. Redington and published by Springer Science & Business Media. This book was released on 2008-10-29 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: 'Congenital Heart Disease in the Right Heart' is an exhaustive review of the malformations of the right ventricle with particular emphasis on the ability of the ventricle to support circulation and the results of right heart malformations on circulation. Edited by the world’s foremost authorities on the subject, the book benefits from an international team of contributors.
Download or read book Cardiovascular Disability written by Institute of Medicine and published by National Academies Press. This book was released on 2010-12-04 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
Download or read book Adult Congenital Heart Disease written by Sara Thorne and published by Oxford University Press. This book was released on 2017-09-22 with total page 206 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical approach to the investigation and treatment of adult congenital heart disease (ACHD), this fully updated Oxford Specialist Handbook is a concise and accessible overview of a complex condition. Packed with straightforward advice, management strategies and key clinical points, it equips clinicians with a sound understanding of the principles and physiology of ACHD. An ideal reference tool for cardiology trainees, general cardiologists and acute medicine physicians, this second edition of Adult Congenital Heart Disease has been fully reviewed to include new guidelines and increased illustations to aid understanding. Brand new chapters on epidemiology, heart failure, device therapy and transition and transfer of care ensure that Adult Congenital Heart Disease remains the definitive guide to supporting clinicians throughout all aspects of the patient's care.
Download or read book Congenital Heart Disease written by P. Syamasundar Rao and published by BoD – Books on Demand. This book was released on 2012-01-18 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: There are significant advances in the understanding of the molecular mechanisms of cardiac development and the etiology of congenital heart disease (CHD). However, these have not yet evolved to such a degree so as to be useful in preventing CHD at this time. Developments such as early detection of the neonates with serious heart disease and their rapid transport to tertiary care centers, availability of highly sensitive noninvasive diagnostic tools, advances in neonatal care and anesthesia, progress in transcatheter interventional procedures and extension of complicated surgical procedures to the neonate and infant have advanced to such a degree that almost all congenital cardiac defects can be diagnosed and "corrected". Treatment of the majority of acyanotic and simpler cyanotic heart defects with currently available transcatheter and surgical techniques is feasible, effective and safe. The application of staged total cavo-pulmonary connection (Fontan) has markedly improved the long-term outlook of children who have one functioning ventricle. This book, I hope, will serve as a rich source of information to the physician caring for infants, children and adults with CHD which may help them provide optimal care for their patients.
Download or read book Ventricular Mechanics in Congenital Heart Disease written by Giovanni Biglino and published by Frontiers Media SA. This book was released on 2017-08-29 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: Looking at "Horse in Motion", the iconic photograph by E. Muybridge, it is almost possible to hear the horse galloping. The pounding sound of the hoofs hitting the ground -like a drum- can also echo the rythmic beating of the human heart. That sound, that visceral rhythm, reminds us of the link between motion and performance: the perfectly executed stride of the horse, the incredible coordination of multiscale phenomena behind a heart beat. Furthermore, the decomposed sequence in Muybridge's photograph has become a well-known example of breaking motion into its components over time, and as such is reminiscent of those images that are routinely acquired in clinical practice, where the heart appears dilating and shirnking in a sequence of snapshots. The investigation of this motion and its subtleties is essential for refining our understanding of cardiac function, and the appreciation of how and when this motion is no longer perfectly executed can lead us to understand functional impairments and provide insight into the unfolding of pathology. In the presence of congenital heart disease (CHD), cardiac mechanics are altered: from single ventricle physiology to conduction abnormalities to different cardiomyopathies, it is important to both capture and interpret biomechanical changes that occur in the presence of a congenital defect. This special issue in Frontiers in Pediatrics, now an e-book, focuses on 'Ventricular mechanics in congenital heart disease' and looks at current knowledge of phenomena such as systolic/diastolic dysfuction and current methods (chiefly in cardiovascular magnetic resonance imaging and echocardiography) to evaluate cardiac function in the presence of CHD, and then presents a series of original studies that employ both medical imaging and computational modelling techniques to study specific CHD scenarios.
Download or read book Blood Flow Specific Assessment of Ventricular Function written by Alexandru Grigorescu Fredriksson and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The spectrum of cardiovascular diseases is the leading cause of morbidity and mortality globally. Early assessment and treatment of these conditions, acquired as well as congenital, is therefore of paramount importance. The human heart has a great ability to adapt to various hemodynamic conditions by cardiac remodeling. Pathologic cardiac remodeling can occur as a result of cardiovascular disease in an effort to maintain satisfactory cardiac function. With time, cardiac function diminishes leading to disease progression and subsequent heart failure, the end-point of many heart diseases, associated with very poor prognosis. Within the normal cardiac ventricles blood flows in highly organized patterns, and changes in cardiac configuration or function will affect these flow patterns. Conversely, altered flows and pressures can bring about cardiac remodeling. In congenital heart disease, even after corrective surgery, cardiac anatomy and thereby intracardiac blood flow patterns are inherently altered. The clinically most available imaging technique, ultrasound with Doppler, allows only for one-directional flow assessment and is limited by the need of clear examination windows, thus failing to fully assess the complex three-dimensional blood flow within the beating heart. Cardiovascular magnetic resonance imaging (CMR) with phase-contrast has the ability to acquire three-dimensional (3D), three-directional time resolved velocity data (3D + time = 4D flow data) from which visualization and quantification of blood flow patterns over the complete cardiac cycle can be performed. Four functional blood flow components have previously been defined based on the blood route and distribution through the ventricle, where the inflowing blood that passes directly to the outflow is called Direct flow . From these components, various quantitative measures can be derived, such as component volumes and kinetic energy (KE) throughout the cardiac cycle. In addition, the 4D flow technique has the ability to quantify and visualize turbulent flow with increased velocity fluctuations in the heart and vessels, turbulent kinetic energy (TKE). The technique has been developed and evaluated for assessment of left ventricular (LV) blood flow in healthy subjects and in patients with dilated dysfunctional left ventricles, showing significant changes in blood flow patterns and energetics with disease. There is however still no study addressing the gap in the spectrum from the healthy cohorts to patients with moderate to severe left ventricular remodeling. In Paper III , 4D flow CMR was utilized to assess LV blood flow in patients with subtle LV dysfunction, and a shift in blood flow component volumes and KE was seen from the Direct flow to the non-ejecting blood flow components. In patients with both left- and right-sided acquired and congenital heart disease, right ventricular (RV) function is of great prognostic significance, however this ventricle has historically been somewhat overseen. With its complex geometry, advanced physiology and retrosternal location, assessment of the RV is still challenging and the right ventricular blood flow is still incompletely described. In Paper I , the RV blood flow in healthy subjects was assessed, and the proportionally larger Direct flow component was located in the most basal region of the ventricle and possessed higher levels of KE at end-diastole than the other flow components suggesting that this portion of blood was prepared for efficient systolic ejection. In Paper II , the blood flow was assessed in the RV of patients with subtle primary LV disease, and even if conventional echocardiographic or CMR RV parameters did not show any RV dysfunction, alterations of flow patterns suggestive of RV impairment were found in the patients with the more remodeled LVs. With improvements of the cardiovascular health care, including the surgical techniques, the number of adult patients with surgically corrected complex congenital heart diseases increases, one of which is tetralogy of Fallot (ToF). Surgical repair of ToF involves widening of the pulmonary stenosis, which postoperatively may cause pulmonary insufficiency and regurgitation (PR). Disturbed or turbulent flow patterns are rare in the healthy cardiovascular system. With pathological changes, such as valvular insufficiency, increased amounts of TKE have been demonstrated. Turbulence is known to be harmful to organic tissues and could be significant in the development of ventricular remodeling, such as dilation and other complications seen in Fallot patients. In Paper IV , the RV intraventricular TKE levels were assessed in relation to conventional measures of PR. Results showed that RV TKE was increased in ToF patients with PR compared to healthy controls, and that these 4D flow-specific measures related slightly stronger to indices of RV remodeling than the conventional measures of PR. 4D flow CMR analysis of the intracardiac blood flow has the potential of adding to pathophysiological understanding, and thereby provide useful diagnostic information and contribute to optimization of treatment of heart disease at earlier stages before irreversible and clinically noticeable changes occur. The flow specific measures used in this thesis could be utilized to detect these alterations of intracardiac blood flow and could thus act as potential markers of progressing ventricular dysfunction, pathological remodeling or used for risk stratification in adults with early repair tetralogy of Fallot. Visualizations of intracardiac flow patterns could provide useful information to cardiac/thoracic surgeons pre- and post-operatively.
Download or read book Echocardiography in Pediatric and Congenital Heart Disease written by Wyman W. Lai and published by John Wiley & Sons. This book was released on 2012-01-03 with total page 1618 pages. Available in PDF, EPUB and Kindle. Book excerpt: Echocardiography is essential in the practice of pediatric cardiology. A clinical pediatric cardiologist is expected to be adept at the non-invasive diagnosis of congenital heart disease and those who plan to specialize in echocardiography will need to have knowledge of advanced techniques. Echocardiography in Pediatric and Congenital Heart Disease addresses the needs of trainees and practitioners in this field, filling a void caused by the lack of material in this fast-growing area. This new title comprehensively covers the echocardiographic assessment of congenital heart disease, from the fetus to the adult, plus acquired heart disease in children. Topics covered include: ultrasound physics laboratory set-up a protocol for a standard pediatric echocardiogram quantitative methods of echocardiographic evaluation, including assessment of diastolic function in depth coverage of congenital cardiovascular malformations acquired pediatric heart disease topics of special interest, such as 3D echocardiography, transesophageal echocardiography, and fetal echocardiography The approach of this book is a major advancement for educational materials in the field of pediatric cardiology, and greatly enhances the experience for the reader. An accompanying DVD with moving images of the subjects covered in the textbook will further enhance the learning experience.
Download or read book Congenital Heart Disease in the Adult written by Welton M. Gersony and published by McGraw Hill Professional. This book was released on 2002 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides guidelines outlining the frequency of visits, appropriate testing, and criteria for intervention.
Download or read book Principles and Practice of Cardiac Magnetic Resonance in Congenital Heart Disease written by Mark A. Fogel and published by John Wiley & Sons. This book was released on 2010-03-02 with total page 480 pages. Available in PDF, EPUB and Kindle. Book excerpt: CMR is a powerful tool in the armamentarium of pediatric cardiology and health care workers caring for patients with congenital heart disease (CHD), but a successful study still presents major technical and clinical challenges. This text was created to give trainees, practitioners, allied professionals, and researchers a repository of dependable information and images to base their use of CMR on. Because CHD presents an intricate web of connections and associations that need to be deciphered, the imager performing CMR needs to understand not only anatomy, physiology, function, and surgery for CHD, but also the technical aspects of imaging. Written by experts from the world’s leading institutions, many of whom pioneered the techniques and strategies described, the text is organized in a logical way to provide a complete understanding of the issues involved. It is divided into three main parts: The Basics of CMR - familiarizes the reader with the minimum tools needed to understand the basics, such as evaluating morphology, ventricular function, and utilizing contrast agents CMR of Congenital and Acquired Pediatric Heart Disease - discusses broad categories of CHD and the use of CMR in specific disease states Special Topics in Pediatric Cardiac MR - covers other important areas such as the complementary role of CT scanning, interventional CMR, the role of the technologist in performing a CMR exam, and more With the ever increasing sophistication of technology, more can be done with CMR in a high quality manner in a shorter period of time than had been imagined as recently as just a few years ago. Principles and Practice of Cardiac Magnetic Resonance in Congenital Heart Disease: Form, Function, and Flow makes a major contribution to applying these techniques to improved patient care. An ideal introduction for the novice or just the curious, this reference will be equally useful to the seasoned practitioner who wants to keep pace with developments in the field and would like a repository of information and images readily availalble.
Download or read book Congenital Heart Disease written by Hideaki Senzaki and published by Springer. This book was released on 2015-01-23 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book comprehensively covers the latest information about ventricular–vascular morphology and function in congenital heart disease (CHD) assessed by various innovative methodologies. Anatomical (morphological) abnormalities in CHD are generally accompanied with abnormal loading conditions, which, in turn, cause ventricular and vascular functional impairments. The functional impairments may also exist independently of the anatomical abnormalities. These two (morphological and functional abnormalities) importantly interact to determine underlying pathophysiology and generate clinical symptoms in CHD. Therefore, detailed and precise assessment of morphology and function is essential to better understand and treat this disease. Recent advances in technology have provided useful tools for this purpose, and novel findings are accumulating. The information contained here will provide researchers and clinicians with invaluable knowledge in this field.
Download or read book Congenital Heart Defects written by Diego F. Wyszynski and published by Oxford University Press, USA. This book was released on 2010 with total page 561 pages. Available in PDF, EPUB and Kindle. Book excerpt: Congenital Heart Defects (CHDs) are the most frequently occurring birth defect, affecting over 25,000 infants a year in the US. This text serves as the definitive reference on the subject, coving all aspects of these malformations. The text includes chapters on the development, epidemiology, genetics, diagnosis, management and prevention of CHDs, and includes additional discussions of the public health and ethical issues of CHDs.
Download or read book The right ventricle in volume or pressure overload written by Aleksandra Trzebiatowska-Krzynska and published by Linköping University Electronic Press. This book was released on 2019-01-07 with total page 82 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study is inspired by the gap in knowledge regarding the timing of cardiac surgery and interventions in adult patients with congenital heart disease. There are many parameters used assessing right ventricular function; however, most of them have pitfalls. Understanding the pathomechanisms by which the heart adapts to congenital defects is probably key to find the answer when it is time to intervene and start discussing treatment options. Heart defects are the most frequently occurring congenital disorders. Less than 50% of individuals with moderate to severe congenital heart defects, e.g. transposition of the great arteries (TGA) or tetralogy of Fallot (TOF), survive to adulthood without intervention. Advances in cardiac surgery and better identification of individuals at risk for sudden cardiac death have increased survival rates. Currently, more than 96% of patients with congenital heart disease survive to at least 16 years of age; most undergo corrective surgery but are not cured, and only a few have normal physiology and anatomy. In many cases, the heart must develop mechanisms of adaptation to the changed conditions after surgery. Consequently, correction of the defect creates residual disease with a risk of future complications. To prevent clinical deterioration and to identify the development of complications, patients need lifelong, regular follow up. The choice of followup modalities depends on the cardiac malformation. The right ventricle (RV) plays an important role, as it is often part of the defect or is influenced by the surgery. In the past, research was focused on assessment of left ventricular function (LV), and the RV was “the forgotten ventricle.” Observations and studies in the last few decades brought increased interest into the RV and revealed the importance of the RV in the prognosis of various cardiac diseases. An understanding of RV morphology, pathophysiology and adaptive mechanisms is crucial for further studies of prognosis as well as for research linked to the use of particular diagnostic modalities. When the RV is exposed to increased pressure load, e.g. in atrially corrected transposition of the great arteries (TGA), adaptation affects the cavity volume as well as the wall thickness. When the RV is volume overloaded, adaptation involves enhancement of the RV cavity volume while the wall thickness often remains unchanged under long time. RV ejection fraction (RVEF) gives some information about changes in RV function, but information on myocardial contractility and contractile reserve is also needed. New functional parameters such as strain—also known as myocardial deformation—provide some information about intrinsic myocardial function. In Paper I, we studied functional parameters such as ejection fraction and strain (radial and longitudinal strain for both ventricles) in patients with Tetralogy of Fallot (TOF) and TGA. Longitudinal RV strain was depressed in both patient groups in comparison with that in healthy individuals, and there were additional differences between the two patient groups. In Paper II, we validated three-dimensional echocardiography (3DEcho) against the cardiac magnetic resonance (CMR) gold standard. The study population was limited to patients with TOF. In general, 3DEcho underestimated RV volumes but was able to identify patients with RV dilatation on CMR with high sensitivity. RV longitudinal free wall strain measured by CMR with a cut-off set at -14% identified patients with depressed exercise capacity and low peak oxygen uptake. In Paper III, we studied a new CMR method to quantify and visualise turbulent flow in the heart and vessels. Turbulent flow can be harmful to tissue, blood cells, and endothelium and can contribute to tissue remodeling. In patients with TOF, turbulent flow can be seen as variance in 2DEcho color Doppler. In CMR, increased turbulent kinetic energy (TKE) could be seen with four-dimensional flow. The RV TKE was increased in patients with TOF with pulmonary regurgitation compared with that in healthy controls. In Paper IV, we validated “knowledge-based reconstruction” (KBR), a novel method to calculate RV volume, against CMR in patients with various types of congenital heart defects. Two-dimensional echocardiogram-based threedimensional RV reconstruction is a relatively uncomplicated method that creates a three-dimensional RV model based on a limited number of predefined points of interest (RV structures such as tricuspid annulus, RV free wall, or pulmonary valve). KBR showed good agreement with CMR (intraclass correlation coefficient = 0.84 for RV end-diastolic volume and 0.89 for ejection fraction) but tended to underestimate RV volumes, which is in line with other methods based on ultrasound. Conclusions: 3DEcho is an evolving modality that is able to identify patients with RV dilatation. It can be used clinically for the follow up of patients with congenital heart diseases, especially those with mildly to moderately dilated RVs. When an intervention seems likely, 3DEcho results should be verified by CMR. CMR-derived measurements of longitudinal and radial strain provide a new understanding of RV remodeling and ventricular interdependence in patients with TOF and TGA. Depressed longitudinal strain may indicate a risk of depressed exercise capacity and, in patients with TGA, clinical deterioration. Further studies in larger populations of patients with congenital heart defects are needed, as the altered RV morphology in such patients makes quantitative assessment especially challenging.
Download or read book Pathophysiology of Congenital Heart Disease written by Forrest H. Adams and published by Univ of California Press. This book was released on 2023-11-10 with total page 519 pages. Available in PDF, EPUB and Kindle. Book excerpt:
