Role of perioperative echocardiography in repair of incomplete shone complex: A case series

Kumar, Alok; Bhat, Imran; Kumar, Bhupesh; Shyam, Kst

doi:10.4103/aca.aca_80_18

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Few interatrial or interventricular communication cases have been described in association with this complex [ 8 , 9 ]. Their presence may have contributed to a delay in the presentation and to the worsening of symptoms [ 10 ]. The pathogenesis of coarctation in this complex could be explained by a hemodynamic theory where perimembranous ventricular septal defect and patent ductus arteriosus or sub-aortic or abnormal vessel stenosis (left superior vena cava) leads to reduced aortic flow during fetal life and therefore hypoplasia of the isthmic region.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of left superior vena cava (LSVC) in association with LV obstacles was reported in 39.6% of cases, as Agniletti et al [ 8 ], found.this correlation might be explained by the mechanical impact of this last on the growth of the left heart, increasing the occurrence of obstructive involvements on the left side [ 7 ]. This anatomical variant must be identified during open-heart cardiac surgery, to use appropriate cannulation procedures, to redirect the vast volume of systemic venous blood that reaches the heart via the coronary sinus [ 10 ]. In patients with Shone complex, the presence of an LSVC should be ruled out before a pacemaker is implanted.…”

Section: Discussionmentioning

confidence: 99%

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Shone syndrome revealed by treatment-resistant hypertension

Boulouiz

Kossir

Mouedder

et al. 2021

Annals of Medicine and Surgery

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Introduction and importance: Shone complex is a congenital heart defect consisting of four obstructive defects in the left heart: a mitral supravalvular ring, sub-aortic stenosis, parachute mitral valve, and coarctation of the aorta (CoA), which affects only a small minority of people. Case presentation We report the case of a 25-year-old woman with a past medical history of moderate mitral stenosis, since she was 10-year-old with uncontrolled high blood pressure, treated with nicardipine. admitted to our emergency department with high blood pressure: 190/80 mmhg, in whom The transthoracic echocardiography (TTE) revealed: sub-mitral membrane, with a single sub-papillary muscle, and coarctation of the aorta and the CT scan showed narrowed aortic arch and a left superior vena cava allowing to retain shone syndrome as the main diagnosis. The patient was treated with an antihypertensive treatment combining (perindopril/indapamide/amlodipine) while waiting for surgery. Clinical discussion In this mini-review, we aim to describe this rare pathological condition its pathophysiological thoughts, and the way to diagnosis this complex early. Conclusion Treatment required the coordinated efforts of a team of specialists. It could be either surgical with different method or by Trans catheter treatments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Shone syndrome revealed by treatment-resistant hypertension

Boulouiz

Kossir

Mouedder

et al. 2021

Annals of Medicine and Surgery

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“…The patient outcome of Shone's syndrome is widely variable because of the diversity and complex nature of cardiac anomalies itself. It is reported that operative outcome is excellent in Shone's syndrome patients [17] and surgical intervention is recommended to be undertaken early before the onset of pulmonary hypertension [18] .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Shone’s Syndrome by Fetal Echocardiography

Li¹,

Wu²,

Sun³

2020

Preprint

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“…The patient outcome of Shone's syndrome is widely variable because of the diversity and complex nature of cardiac anomalies itself 4 . It is reported that operative outcome is excellent in Shone's syndrome patients 19 and surgical intervention is recommended to be undertaken early before the onset of pulmonary hypertension 20 .…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of Shone’s syndrome: ultrasonographic features and differential diagnosis with coarctation of the aorta

Li¹,

Zhao²,

Wu³

et al. 2020

Preprint

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Objective：To improve the prenatal diagnosis of Shone’s syndrome and identify the mitral valve obstruction associated with the anomaly by comparing the fetal echocardiographic features between Shone’s syndrome and coarctation of the aorta (CoA). Method: Between January 2015 to December 2019, 17 fetuses were diagnosed with Shone’s syndrome prenatally and 8 were analyzed in our final study, their data were compared to normal controls and CoA cases. The main points of identification were summarized. Results: By comparing data between three groups, elevated PA/AO ratio and RV/LV ratio were detected in both Shone’s syndrome and CoA cases. However, TVC/MVC ratios was only increased in Shone’s syndrome. Analysis revealed that the TVC/MVC ratio had the best capability in predicting Shone’s syndrome. Ultrasonographic features of mitral valve obstruction in Shone’s syndrome were unique which help clinicians to distinguish the anomaly from CoA, including (1) morphologic changes in short-axis view: restrictive opening of the mitral valve with diastolic deformity, thickened leaflets, echo-enhancement of chordae tendineae and mitral valve, single papillary muscle or dominant papillary muscle; (5) in color Doppler image: decreased antegrade flow and abnormal flow pattern of mitral valve. Conclusion: There are two key points of prenatal diagnosis of Shone’s syndrome which could help fetal cardiologist to distinguish Shone’s syndrome from CoA in clinical practice, including (1) echocardiographic measurements: the elevated TVC/MVC ratio; (2) morphologic changes of mitral valve indicating left ventricle inflow obstruction in two-dimension short-axis section view.

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Role of perioperative echocardiography in repair of incomplete shone complex: A case series

Cited by 4 publications

References 9 publications

Shone syndrome revealed by treatment-resistant hypertension

Shone syndrome revealed by treatment-resistant hypertension

Prenatal Diagnosis of Shone’s Syndrome by Fetal Echocardiography

Prenatal diagnosis of Shone’s syndrome: ultrasonographic features and differential diagnosis with coarctation of the aorta

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