Hypoplastic left heart syndrome with premature closure of foramen ovale: report of an unusual type of totally anomalous pulmonary venous return

Differential expression of serum biomarkers in hemodialysis patients with mild cognitive decline: A prospective single-center cohort study

Studies suggest that hemodialysis patients are at a higher risk for cognitive decline than healthy individuals; however, underlying mechanisms have not been fully elucidated. We aimed to investigate the roles of serum biomarkers, such as brain-derived neurotrophic factor (BDNF), inflammatory cytokines, fibroblast growth factor (FGF)-23 and its co-receptor α-klotho and platelet (PLT) count in mild cognitive decline (MCD) of patients undergoing hemodialysis in this prospective cohort study. Serum levels of BDNF, tumour necrosis factor (TNF)-α, interleukin (IL)-6 and the number of PLT were significantly altered in the MCD group compared with those in healthy controls (HCs) or those with normal cognitive function (NCF). Although serum α-klotho and FGF-23 levels were significantly altered in the MCD group, there were no statistical differences between the MCD and NCF groups. Serum BDNF levels and PLT counts were significantly correlated with cognitive test scores. Receiver operating characteristic (ROC) curves demonstrated that BDNF and PLT were potential biomarkers for improved MCD diagnosis in patients with hemodialysis. These findings suggest that hemodialysis-related MCD is associated with altered BDNF, TNF-α and IL-6 levels as well as PLT counts and that serum BDNF levels and PLT counts are potential biomarkers for hemodialysis-related MCD diagnosis.

Anomalous Pulmonary Venous Connection With an Intraparenchymal Course

An intraparenchymal course of the pulmonary venous pathway within one lung in anomalous pulmonary venous connection is a rare and poorly recognized variation. We report three new cases and summarize the remaining 19 known cases of this infrequent anomaly. We expect that this review will call attention to this unusual pattern of pulmonary venous drainage and enhance prospective diagnosis.

Premature closure of the foramen ovale secondary to congenital aortic valvular stenosis in a stillborn

Premature closure of the foramen ovale is a rare and deleterious condition that can occur as an isolated defect or in association with other congenital and cardiovascular anomalies. We report on the pathologic findings in a 22-week stillborn male fetus with premature closure of the foramen ovale, severe aortic valve stenosis, cardiomegaly, intact atrial and ventricular septa, hypoplasia of the ascending aorta, and hypoplastic aortic arch with a preductal coarctation ridge. To the best of our knowledge, this is only the second report on this rare constellation of complex congenital cardiac defects.

Normally connected anomalously draining obstructed pulmonary veins in an infant with mitral atresia: clinical presentation and catheter management

A patient with hypoplastic left ventricle and double outlet right ventricle underwent pulmonary artery band as a newborn. At age 3 months, cardiac catheterization demonstrated complete closure of his atrial septal defect with decompression of the left atrium via a small levo-cardinal vein. Thus, he had normally connected, anomalously draining obstructed pulmonary veins. He underwent successful catheter intervention with excellent release of the obstruction. This rare finding and technical aspects of catheter intervention are discussed.

Echocardiographic demonstration of an unusual pulmonary venous pathway in a patient with left ventricular inflow obstruction

A newborn infant with mitral atresia and a restrictive patent foramen ovale had normal pulmonary venous connection to the left atrium demonstrated by echocardiography. However, pulmonary venous blood then coursed through an unusual pathway in the roof of the left atrium into the right atrium. This case illustrates the need for the echocardiographer to be reminded of and then search for unusual drainage pathways in cases of left ventricular inflow obstruction, even when the pulmonary veins connect normally.