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Yasumoto Y, Nakamura Y, Ushijima M, Yoshiyama D, Kuroda M, Sawa S, Nakayama T, Narita T, Furutachi A, Tsuruta R, Ito Y. An elderly case of aortic stenosis associated with double-chambered right ventricle. J Cardiol Cases 2023; 27:159-161. [PMID: 37012916 PMCID: PMC10066411 DOI: 10.1016/j.jccase.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023] Open
Abstract
Double-chambered right ventricle (DCRV) caused by right ventricular outflow tract obstruction, is a developmental cardiac anomaly in which the anomalous muscle bundles divide the right ventricular cavity into two chambers. Few cases with DCRV coexisting with severe aortic stenosis (AS) have been reported. Moreover, adult cases are extremely uncommon.We report an elderly case of a heavy DCRV with severe AS detected by transthoracic echocardiography and catheterization study. An 85-year-old woman with dyspnea on effort and right-sided heart failure was diagnosed with DCRV and severe AS by echocardiography. She underwent a resection of the anomalous muscle of the right ventricle and aortic valve replacement. Her symptoms disappeared postoperatively and was discharged home. At 2 years postoperatively, she was generally well without recurrence of DCRV. In conclusion, the case of DCRV with AS is rare and surgery is useful to relieve the heart failure symptoms and improve the prognosis of both young and adult patients. Learning objective Double-chambered right ventricle (DCRV) is uncommon in the older population; however, clinicians should consider DCRV in patients with right-sided heart failure as a differential diagnosis. The case of DCRV with aortic stenosis is rare, surgical treatment is particularly useful for these patients to relieve the heart failure symptoms and improve the prognosis in young and adult cases.
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Affiliation(s)
| | - Yoshitsugu Nakamura
- Corresponding author at: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanagasaku, Matsudo, Chiba prefecture, Japan.
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Otero-Luna A, Ghiroli S, Hsia TY, Fahey J, Elder RW. Diagnosis, surgical management, and long-term outcomes of double chambered right ventricle: a rare and challenging disease in the adult population. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2021.101417] [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: 10/20/2022]
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Kwiatek-Wrzosek A, Kordybach-Prokopiuk M, Konka M, Michałowska I, Hoffman P. What to look for in patient with continuous murmur and history of ventricular septal defect? Int J Cardiovasc Imaging 2021; 37:3223-3224. [PMID: 34076824 DOI: 10.1007/s10554-021-02303-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/25/2021] [Indexed: 11/29/2022]
Abstract
During diagnostic process it is very important to conduct scrupulous interview and thorough physical examination. Properly interpreted auscultation phenomena allow for appropriate planning of further imaging studies.
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Affiliation(s)
- Anna Kwiatek-Wrzosek
- Department of Congenital Heart Diseases, National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
| | - Maria Kordybach-Prokopiuk
- Department of Congenital Heart Diseases, National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
| | - Marek Konka
- Department of Congenital Heart Diseases, National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
| | - Ilona Michałowska
- Department Department of Radiology, National Institute of Cardiology, Warsaw, Poland
| | - Piotr Hoffman
- Department of Congenital Heart Diseases, National Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland
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Double-chambered right ventricle in adults: Invasive and noninvasive hemodynamic considerations. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2021.100115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Papakonstantinou NA, Kanakis MA, Bobos D, Giannopoulos NM. Congenital, acquired, or both? The only two congenitally based, acquired heart diseases. J Card Surg 2021; 36:2850-2856. [PMID: 33908651 DOI: 10.1111/jocs.15588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022]
Abstract
Discrete subaortic stenosis (DSS) is a type of left ventricular outflow tract obstruction whereas double-chambered right ventricle is a form of right ventricular outflow tract obstruction. Both of these cardiac malformations share lots of similar characteristics which classify them as acquired developmental heart diseases despite their congenital anatomical substrate. Both of them are frequently associated to ventricular septal defects. The initial stimulus in their pathogenetic process is anatomical abnormalities or variations. Subsequently, a hemodynamic process is triggered finally leading to an abnormal subaortic fibroproliferative process with regard to DSS or to hypertrophy of ectopic muscles as far as double-chambered right ventricle is concerned. In many cases, these pathologies are developed secondarily to surgical management of other congenital or acquired heart defects. Moreover, high recurrence rates after initial successful surgical therapy, particularly regarding DSS, have been described. Finally, an interesting coexistence of DSS and double-chambered aortic ventricle has also been reported in some cases.
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Affiliation(s)
| | - Meletios A Kanakis
- Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Dimitrios Bobos
- Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Nicholas M Giannopoulos
- Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece
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Privitera F, Monte IP, Indelicato A, Tamburino C. A Membranous Septal Aneurysm Causing Right Ventricular Outflow Tract Obstruction in an Adult. J Cardiovasc Echogr 2017; 27:145-148. [PMID: 29142814 PMCID: PMC5672688 DOI: 10.4103/jcecho.jcecho_21_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We describe a case of a 69-year-old female referred for the evaluation of exertional dyspnea, with a small membranous ventricular septal defect (VSD) and right ventricle (RV) outflow tract obstruction. Using transthoracic echo was diagnosed VSD with left to right shunting and transesophageal echo (TEE) was used to a better anatomical characterization. TEE showed a perimembranous subaortic VSD that developed a high-velocity flow in RV. Pulmonary valve appears normal and right ventricular infundibular hypertrophy or double-chambered RV was excluded from the study. Furthermore, TEE showed a malaligned VSD and the presence of perimembranous mobile tissue protruding in RV. We hypothesized that this tissue can be attributed to broken septum aneurysm and protruding during systole, it causes a dynamic RV output tract obstruction.
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Affiliation(s)
- Fiorella Privitera
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, Catania CT, Italy
| | - Ines Paola Monte
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, Catania CT, Italy.,Department of Cardio-Thorax-Vascular and Transplant, A.O.U. Policlinico Catania, Catania CT, Italy
| | - Antonino Indelicato
- Department of Cardio-Thorax-Vascular and Transplant, A.O.U. Policlinico Catania, Catania CT, Italy
| | - Corrado Tamburino
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, Catania CT, Italy.,Department of Cardio-Thorax-Vascular and Transplant, A.O.U. Policlinico Catania, Catania CT, Italy
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Isolated double chambered right ventricle as a rare cause of sudden death in infancy. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2016. [DOI: 10.1016/j.ejfs.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Markley RR, Ali A, Potfay J, Paulsen W, Jovin IS. Echocardiographic Evaluation of the Right Heart. J Cardiovasc Ultrasound 2016; 24:183-190. [PMID: 27721944 PMCID: PMC5050302 DOI: 10.4250/jcu.2016.24.3.183] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 05/03/2016] [Accepted: 07/26/2016] [Indexed: 12/23/2022] Open
Abstract
The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function.
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Affiliation(s)
- Roshanak R Markley
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Asghar Ali
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| | - Jonathan Potfay
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| | - Walter Paulsen
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Ion S Jovin
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
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Myeong JC, Chin JY, Choi JH, Rah YM, Park JH. Tricuspid and pulmonary valve endocarditis associated with double-chambered right ventricle. KOSIN MEDICAL JOURNAL 2015. [DOI: 10.7180/kmj.2015.30.1.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We report a rare case of tricuspid valve and pulmonary valve endocarditis associated with a double-chambered right ventricle in an adult female with pulmonary artery aneurysm and septic pulmonary embolism by Streptococcus mitis. She was treated with aggressive antibiotic therapy followed by debridement of the infective lesion of tricuspid valve, pulmonary valve replacement using xenograft and resection of obstructing muscular bundles in right ventricle.
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Hu G, Zhu X, Li G, Jiang F, Li J. A Case Report of Double-Chambered Right Ventricle Associated with Subaterial Ventricular Septal Defect and Rupture of Right Coronary Sinus Aneurysm. Echocardiography 2015; 32:1438-40. [PMID: 25728324 DOI: 10.1111/echo.12923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital heart disease in which the right ventricle (RV) is divided into two chambers by anomalous muscle bundles. Here, we report a case of DCRV associated with subarterial ventricular septal defect (VSD) and rupture of right coronary sinus aneurysm (RCSA); the patient was diagnosed by echocardiography and later confirmed by surgical operation.
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Affiliation(s)
- Guobing Hu
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Xiangming Zhu
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Guojie Li
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Feng Jiang
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Muresian H. The clinical anatomy of the right ventricle. Clin Anat 2014; 29:380-98. [DOI: 10.1002/ca.22484] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/12/2014] [Indexed: 01/26/2023]
Affiliation(s)
- Horia Muresian
- Cardiovascular Surgery Department; The University Hospital of Bucharest; 169 Splaiul Independentei Bucharest Romania
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Long-term natural history and postoperative outcome of double-chambered right ventricle—Experience from two tertiary adult congenital heart centres and review of the literature. Int J Cardiol 2014; 174:662-8. [DOI: 10.1016/j.ijcard.2014.04.177] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 11/29/2022]
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Shankarappa RK, Patra S, Karur S, Singh A, Nanjappa MC, Chandrasekaran D. An adult patient of double-chambered right ventricle with ventricular septal defect incidentally diagnosed after presentation with acute myocardial infarction. Echocardiography 2013; 30:E312-4. [PMID: 24103007 DOI: 10.1111/echo.12334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The double-chambered right ventricle (DCRV) is a rare congenital heart disease caused by hypertrophic anomalous muscle bands that divide the ventricular cavity, resulting in the formation of a high-pressure proximal chamber and other low-pressure distal one. Because of its evolving nature, its diagnosis is usually made during childhood/adolescence and very rarely during adulthood. It accounts for approximately 0.5-1% of patients with congenital heart disease. We report a case of a 50-year-old man who presented to us with acute inferior wall myocardial infarction (MI). Echocardiography revealed the features of DCRV and ventricular septal defect. Coronary angiogram revealed significant stenosis in right coronary artery. This is the first case where an adult patient with DCRV incidentally diagnosed after presentation with acute MI and had undergone successful coronary angioplasty.
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Affiliation(s)
- Ravindranath K Shankarappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India
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Yabur-Espitia MR, Patiño-Bahena E, Cruz-Prieto B, Espinosa-Islas G, Espínola-Zavaleta N. [Presentation form and evolution of double-chambered right ventricle]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2013; 83:18-23. [PMID: 23422350 DOI: 10.1016/j.acmx.2012.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/19/2012] [Accepted: 12/28/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The double-chambered right ventricle (DCRV) is an uncommon congenital heart disease; it represents the 0,5% of these congenital cardiopathies. OBJECTIVE To describe the clinical and echocardiographic characteristics of a series of 11 patients. METHODS Eleven patients with DCRV were studied. A complete medical history, chest radiograph, electrocardiogram, and transthoracic echocardiography were performed. RESULTS The median age of studied patients was 10 years. The 36.45% of cases were asymptomatic and the diagnosis was made by echocardiography. Other cases had weakness during food in the lactancy stage and worsening of NYHA functional class in older children. The echocardiogram showed double-chambered right by a muscular band in all studied patients. The most frequent associated anomalies were: ventricular septal defect, patent foramen ovale, subvalvular aortic stenosis, and Fallot's Tetralogy. Seven patients went to surgical treatment and now 6 of them are in NYHA functional class i. CONCLUSIONS This paper has a special importance, because is the biggest series of patients with double-chambered right ventricle in Mexico and the results are comparable to the studies reported in the literature. The worsening of the NYHA functional class was the predominate symptom. The clinical manifestations can be presented from the lactancy to adulthood and the degree of obstruction could have a progressive character. The echocardiography is the method of choice in the diagnosis of these patients. The 91% of patients with DCRV who went to surgical treatment had excellent hemodynamic and functional results in the mid-follow-up.
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Affiliation(s)
- Mirna Rocío Yabur-Espitia
- Departamento de Ecocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, México DF, México; Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellín, Colombia
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Cho JS, Youn HJ, Her SH, Ahn SH, Park MW, Choi MS, Lee JB, Baeg JU, Park CS, Kim MJ. Spontaneously healed membranous type ventricular septal defect with malaligned interventricular septal wall and double-chambered right ventricle in a 56-year-old patient. J Cardiovasc Ultrasound 2011; 19:148-51. [PMID: 22073326 PMCID: PMC3209595 DOI: 10.4250/jcu.2011.19.3.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 06/03/2011] [Accepted: 08/17/2011] [Indexed: 11/25/2022] Open
Abstract
A 56-year-old male presented with resting dyspnea and chest discomfort for several years. During transthoracic and transesophageal echocardiography, a spontaneously healed membranous type ventricular septal defect (VSD) with malaligned interventricular septal wall, aneurysmal changes, a subaortic ridge and a double-chambered right ventricle (DCRV) was observed. When combined with DCRV, VSD with malalignment between the outlet and trabecular septa was associated with tetralogy of Fallot. The subaortic ridge was due to turbulent flow caused by the malalignment-type VSD. The VSD with malaligned interventricular septal wall can be developed after aneurismal changes of a perimembranous VSD. We report here in the unusual case of a 56-year-old patient who had a pathology complex comprising DCRV, subaortic ridge, spontaneously healed membranous type VSD with malaligned interventricular septal wall, and survived with surgical treatment.
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Affiliation(s)
- Jung Sun Cho
- Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
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Park JG, Ryu HJ, Jung YS, Kim KJ, Lee BR, Jung BC, Kang H. Isolated double-chambered right ventricle in a young adult. Korean Circ J 2011; 41:272-5. [PMID: 21731569 PMCID: PMC3116106 DOI: 10.4070/kcj.2011.41.5.272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 08/20/2010] [Accepted: 09/27/2010] [Indexed: 11/24/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital heart disorder in which the right ventricle is divided by an anomalous muscle bundle into a high pressure inlet portion and a low pressure outlet portion. We report a case of isolated DCRV without symptoms in adulthood, diagnosed through echocardiography, cardiac catheterization and cardiac magnetic resonance imaging.
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Affiliation(s)
- Jung-Gil Park
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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Nacif MS, Mello RAF, Lacerda Junior OO, Sibley CT, Machado RA, Marchiori E. Double-chambered left ventricle in an adult: diagnosis by CMRI. Clinics (Sao Paulo) 2010; 65:1393-5. [PMID: 21340234 PMCID: PMC3020356 DOI: 10.1590/s1807-59322010001200028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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