Outcomes of One-Stage Surgical Repair for Berry Syndrome in Neonates

Successful one-stage surgical repair in a rare adult patient with berry syndrome

BACKGROUND

Berry syndrome is a rare congenital cardiac malformation, herein we report an adult male patient who was successfully repaired by one-stage surgery.

CASE DESCRIPTION

18-year-old male patient presenting symptoms of chest tightness and shortness for over a year presented to outpatient clinic in our department to have corrective procedure heart. CTA revealed an Aortopulmonary Window (APW) type III, measuring 4.6 cm in maximum diameter. The right pulmonary artery originated from the ascending aorta, and the pulmonary trunk exhibited dilation with dimensions of 8.3 cm × 5.7 cm × 5.9 cm. Additional findings included Interrupted Aortic Arch (IAA) type A, intact ventricular septum, and Patent Ductus Arteriosus (PDA). Echocardiography showed bidirectional shunt at the level of APW in severe pulmonary hypertension. The right heart catheterization indicated a mean pulmonary artery pressure of 70mmHg and a pulmonary artery resistance of 5 Wood units. We evaluated after two weeks of treatment with epoprostenol at a rate of 20 ng/(kg. min) and found a significant improvement in pulmonary-artery pressure. Finally, we communicated with the patient's family and decided to proceed with the procedure.

CONCLUSIONS

For complex cardiovascular malformations, the ideal treatment strategy must be tailored to the characteristics of the patient to provide maximum efficacy and safety.

Innovative cardiovascular casting technique features the complex malformation of berry syndrome

BACKGROUND

Prenatal diagnosis of Berry syndrome, a rare combination of cardiac anomalies including aortopulmonary window (APW), aortic origin of the right pulmonary artery (RPA), interrupted aortic arch (IAA), hypoplastic aortic arch, or coarctation of the aorta (COA), poses a significant challenge. Due to the rarity of the disease, and the limited case reports available to features the complex malformation of Berry syndrome postpartum, this article introduces an innovative approach to visually showcase this unusual disease. The proposed method provides a comprehensive display of the structural deformities, offering valuable insights for clinical practitioners seeking to comprehend this condition.

CASE PRESENTATION

In this report, we present a case where fetal echocardiography aided in diagnosing Berry syndrome, which was later confirmed through postpartum cardiovascular casting. Our experience highlights the importance of using the three-vessel view to diagnose APW and aortic origin of the right pulmonary artery. Additionally, obtaining true cross-sectional and sagittal views by continuously scanning from the three-vessel-trachea view to the long-axis view of the aortic arch is necessary to image IAA or coarctation of the aortic arch.

CONCLUSIONS

Early and accurate prenatal diagnosis of Berry syndrome is feasible and our cardiovascular cast can perfectly display the microvascular morphology of the fetal heart, which may have great application prospects for postpartum diagnosis and teaching of complex cardiac abnormalities.

Unraveling the Trio of Interrupted Descending Aorta, Aortic Stenosis, and Bicuspid Aortic Valve: A Complex Cardiovascular Conundrum

Interrupted descending aorta (IDA) is an extremely rare congenital heart defect characterized by a complete loss of connection between the ascending and descending aorta. This condition is typically diagnosed in infancy or early childhood, but there have been very few cases reported in adulthood. Here, we present a unique case of an IDA in a 16-year-old patient with concomitant aortic stenosis (AS) and bicuspid aortic valve (BAV), making it an extremely rare scenario. This case highlights the importance of early diagnosis and appropriate management in patients with an IDA, particularly when in association with other cardiovascular abnormalities.