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Toubat O, Han JJ, Predina JD, Goldberg LR, Ibrahim ME. Heart Transplantation for Uhl Anomaly in an Adult. JACC Case Rep 2024; 29:102322. [PMID: 38601846 PMCID: PMC11002861 DOI: 10.1016/j.jaccas.2024.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Uhl anomaly is characterized by the morphologic absence of right ventricular myocardium and is an exceedingly rare cause of nonischemic cardiomyopathy. We report the first case of a successful heart transplantation in a 41-year-old patient who presented in cardiogenic shock from Uhl anomaly causing decompensated right ventricular failure.
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Affiliation(s)
- Omar Toubat
- Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jason J. Han
- Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jarrod D. Predina
- Division of Thoracic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lee R. Goldberg
- Division of Cardiovascular Medicine, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael E. Ibrahim
- Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Kim T, Ko H, Byun JH, Lee HD, Kim H, Choi K, Na JY. A Case of Prenatally Diagnosed Uhl's Anomaly with Absent Pulmonary Valve Leaflets and Dysplastic Tricuspid Valve. CHILDREN-BASEL 2021; 8:children8030190. [PMID: 33802527 PMCID: PMC8000458 DOI: 10.3390/children8030190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022]
Abstract
Uhl's anomaly is a very rare malformation of unknown cause, characterized by complete or partial absence of the right ventricular myocardium. The cardiac malformation causes progressive right heart failure, increased right-sided cardiac pressure, massive peripheral edema, and ascites. Patients usually present in infancy and rarely survive to adulthood. Previously, diagnosis was made at post-mortem evaluation, but advances in cardiac imaging now permit diagnosis during fetal life. We report a case of Uhl's anomaly in a newborn baby imaged at 23 + 3 weeks of gestation by fetal echocardiography. There was an aneurysmally dilated thin-walled right ventricle with hypertrophy of the right ventricular apical muscles, the tricuspid valve was dysplastic, and the pulmonary valve leaflets were absent.
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Affiliation(s)
- Taehong Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (T.K.); (H.K.); (J.-H.B.)
| | - Hoon Ko
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (T.K.); (H.K.); (J.-H.B.)
| | - Joung-Hee Byun
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (T.K.); (H.K.); (J.-H.B.)
| | - Hyoung Doo Lee
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (T.K.); (H.K.); (J.-H.B.)
- Correspondence: ; Tel.: +82-55-360-2180
| | - Hyungtae Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (H.K.); (K.C.)
| | - Kwangho Choi
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (H.K.); (K.C.)
| | - Joo-Young Na
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea;
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3
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Faria B, von Hafe P, Ferreira FC, Almeida F, Dias G, Cardoso F, Lourenço MR, Ribeiro S, Lourenço A. Uhl's Anomaly: 10 Years of Follow-Up of an Unoperated Patient. CASE 2020; 4:351-355. [PMID: 33117927 PMCID: PMC7581623 DOI: 10.1016/j.case.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Bebiana Faria
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Pedro von Hafe
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | | | - Filipa Almeida
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Geraldo Dias
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Filipa Cardoso
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Mário Rui Lourenço
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Sílvia Ribeiro
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
| | - António Lourenço
- Serviço de Cardiologia do Hospital Senhora da Oliveira, Guimarães, Portugal
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Cipriani A, Perazzolo Marra M, Bariani R, Mattesi G, Vio R, Bettella N, DE Lazzari M, Motta R, Bauce B, Zorzi A, Corrado D. Differential diagnosis of arrhythmogenic cardiomyopathy: phenocopies versus disease variants. Minerva Med 2020; 112:269-280. [PMID: 32700864 DOI: 10.23736/s0026-4806.20.06782-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Arrhythmogenic cardiomyopathy (ACM) is a genetic heart muscle disease caused by mutations of desmosomal genes in about 50% of patients. Affected patients may have defective non-desmosomal genes. The ACM phenotype may occur in other genetic cardiomyopathies, cardio-cutaneous syndromes or neuromuscular disorders. A sizeable proportion of patients have non-genetic diseases with clinical features resembling ACM (phenocopies). The identification of biventricular and left-dominant phenotypic variants has made differential diagnosis more difficult because of the broader spectrum of phenocopies which requires a detailed clinical study with appropriate evaluation of most prominent and discriminatory disease features. Conditions that enter into differential diagnosis of ACM include heart muscle diseases affecting the right ventricle, the left ventricle, or both. To confirm a conclusive diagnosis of ACM, these differential possibilities need to be reasonably excluded by an accurate and targeted clinical evaluation. This article reviews the clinical and imaging features of major phenocopies of ACM and provides indications for differential diagnosis. The recent etiologic classification of Arrhythmogenic Cardiomyopathies, whose common denominator is the distinctive phenotype characterized by a hypokinetic and non-dilated ventricle with a large amount of myocardial fibrosis underlying its propensity to generate ventricular arrhythmias is also addressed.
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Affiliation(s)
- Alberto Cipriani
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Martina Perazzolo Marra
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Riccardo Bariani
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giulia Mattesi
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Riccardo Vio
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Natascia Bettella
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Manuel DE Lazzari
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Raffaella Motta
- Unit of Radiology, Department of Medicine, Medical School, University of Padua, Padua, Italy
| | - Barbara Bauce
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alessandro Zorzi
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Domenico Corrado
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy -
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Lozano-Espinosa DA, Eraso-Díaz del Castillo AM, Ronderos-Dumit MA, Stapper-Ortega CM, Peña-Graca JP, Mestra-Durango CF. Uhl's anomaly: A rare disease with few therapeutic options. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2020.101227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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