MyMedR

Persistent valve of systemic venous sinus: a cause of neonatal cyanosis

Qureshi AU, Latiff HA, Sivalingam S

Cardiol Young, 2014 Aug;24(4):756-9.

PMID: 24016801 DOI: 10.1017/S1047951113001200

Incomplete involution of valve of systemic venous sinus can present across a spectrum of anatomical lesions ranging from eustachian valve to division of right atrium (cor triatriatum dexter) with overlapping features. We present the case of a neonate presenting with cyanosis, having persistent valve of systemic venous sinus with anatomical details of the redundant tissue in right atrium suggesting an intermediate form between Chiari network and division of right atrium.

Transcatheter closure of multiple muscular ventricular septal defects using Gianturco coils

Latiff HA, Alwi M, Kandhavel G, Samion H, Zambahari R

Ann Thorac Surg, 1999 Oct;68(4):1400-1.

PMID: 10543517

A 10-month-old boy underwent operation to close a large secundum atrial septal defect and multiple muscular ventricular septal defects. Closure of the ventricular septal defects was unsuccessful and led to worsening cardiac failure and inability to wean the patient from mechanical ventilation. Transcatheter closure of the ventricular septal defects using Gianturco coils was undertaken. This technique is an effective alternative for closure of multiple muscular ventricular septal defects in infants and small children.

Right aortic arch with isolation of the left subclavian artery: a rare association with airway obstruction

Yubbu P, Latiff HA, Adam Abbaker AM

Cardiol Young, 2017 Apr;27(3):613-616.

PMID: 27817752 DOI: 10.1017/S1047951116001840

We present two interesting cases of isolated left subclavian artery from the pulmonary artery with symptoms of upper airway obstruction. The first patient had tetralogy of Fallot, pulmonary artery sling, bilateral superior caval veins, and left bronchial isomerism, suggesting heterotaxy syndrome. The second patient had a right aortic arch, isolated left subclavian artery, and bilateral arterial ducts. These two cases are interesting because of their rarity and uncommon presentation.

Modified Tran Viet-Neveux technique of truncus arteriosus repair

Haranal M, Latiff HA, Sivalingam S

Asian Cardiovasc Thorac Ann, 2021 Jul;29(6):563-564.

PMID: 33653150 DOI: 10.1177/0218492321998503

An uncommon mediastinal cyst with a rare neurologic consequence

Sivalingam S, Qureshi AU, Chern LM, Latiff HA

Ann Thorac Surg, 2014 Apr;97(4):e93-5.

PMID: 24694456 DOI: 10.1016/j.athoracsur.2013.12.060

Enteric cysts are uncommon posterior mediastinal cysts, usually presenting with respiratory symptoms in infancy. We present a rare case of posterior mediastinal enteric cyst extending from below the diaphragm and perforating into the left atrium, causing a thromboembolic cerebral infarct in a 5-year-old boy.

Aneurysmal dilatation without distal obstruction: a rare complication of valved bovine jugular vein conduit

Qureshi AU, Abbaker AE, Sivalingam S, Latiff HA

World J Pediatr Congenit Heart Surg, 2014 Apr;5(2):348-51.

PMID: 24668992 DOI: 10.1177/2150135113509819

Valved bovine jugular vein (Contegra) conduit is considered a suitable choice for pediatric population with congenital heart defect requiring right ventricle to main pulmonary artery connection. Intermediate follow-up studies have shown the propensity of developing distal conduit stenosis and valve thrombosis. We present a rare case of aneurysmal dilatation of the conduit leading to valve failure requiring conduit explantation.

Transcatheter closure of muscular ventricular septal defect using the Amplatzer devices

Djer MM, Latiff HA, Alwi M, Samion H, Kandavello G

Heart Lung Circ, 2006 Feb;15(1):12-7.

PMID: 16473785

From November 1997 to June 2002, percutaneous transcatheter closure of muscular ventricular septal defects was attempted in seven patients. Four patients had single and three had multiple defects. Surgical closure was performed in two patients in an attempt to close a perimembranous defect, leaving behind a large apical muscular defect, which was successfully closed using a device in one patient, whilst the second patient succumbed to septicemia/endocarditis 3 weeks after failure of device implantation. One patient had previous pulmonary artery banding and in another intraoperative placement of two Clamshell devices followed by additional transcatheter closure using Gianturco coils in two different sessions was performed.

Right Ventricular Perforation Caused by a Pacing Catheter Two Weeks After Insertion in a Neonate With Congenital Atrioventricular Block

Ota N, Suzuki R, Latiff HA, Sivalingam S

Ann Thorac Surg, 2015 Oct;100(4):1471.

PMID: 26434454 DOI: 10.1016/j.athoracsur.2015.06.084

Transcatheter closure of defects within the oval fossa using the Amplatzer Septal Occluder

Latiff HA, Alwi M, Samion H, Kandhavel G

Cardiol Young, 2002 May;12(3):224-8.

PMID: 12365167

This study reviewed the short-term outcome of transcatheter closure of the defects within the oval fossa using an Amplatzer Septal Occluder. From January 1997 to December 2000, 210 patients with defects within the oval fossa underwent successful transcatheter closure. We reviewed a total of 190 patients with left-to-right shunts, assessing the patients for possible complications and the presence of residual shunts using transthoracic echocardiogram at 24 h, 1 month, 3 months and one year. Their median age was 10 years, with a range from 2 to 64 years, and their median weight was 23.9 kg, with a range from 8.9 to 79 kg. In 5 patients, a patent arterial duct was closed, and in 2 pulmonary balloon valvoplasty performed, at the same sitting. The median size of the Amplatzer device used was 20 mm, with a range from 9 to 36 mm. The median times for the procedure and fluoroscopy were 95 min, with a range from 30 to 210 min, and 18.4 min, with a range from 5 to 144 min, respectively. Mean follow-up was 20.8 +/- 12.4 months. Complete occlusion was obtained in 168 of 190 (88%) patients at 24 h, 128 of 133 (96.2%) at 3 months, and 103 of 104 (99%) at one year. Complications occurred in 4 (2.1%) patients. In one, the device became detached, in the second the device embolized into the right ventricular outflow tract, the lower end of the device straddled in the third, and the final patient had significant bleeding from the site of venupuncture. There were no major complications noted on follow-up. We conclude that transcatheter closure of defects within the oval fossa using the Amplatzer Septal Occluder is safe and effective. Long-term follow-up is required, nonetheless, before it is recommended as a standard procedure.

The value of transesophageal echocardiography in transcatheter closure of atrial septal defects in the oval fossa using the Amplatzer septal occluder

Latiff HA, Samion H, Kandhavel G, Aziz BA, Alwi M

Cardiol Young, 2001 Mar;11(2):201-4.

PMID: 11293739

BACKGROUND: From January, 1997, as part of an international multicentric trial, we have been closing small-to-moderate atrial septal defects within the oval fossa using the Amplatzer Septal Occluder (ASO, AGA Medical).

METHODS: All patients with defects within the oval fossa deemed potentially suitable for transcatheter closure were investigated by transesophageal echocardiography with the aim of gaining extra information that might alter the decision to use the device to close the defect. Views were obtained in transverse and longitudinal planes, permitting measurements of the diameter of the defect, and its distance from the atrioventricular valves, coronary sinus, and pulmonary veins. Additionally, we sought to identify multiple defects, and to exclude sinus venosus defects.

RESULTS: Of 56 patients with left-to-right shunts, 41 (73.2%) were deemed suitable for closure with the Amplatzer Septal Occluder. All underwent the procedure successfully, with no complications. This includes 5 patients with multiple small defects that were sufficiently close to the main defect to be closed with a single device. Only two of these had been detected on the transthoracic study. In the remaining 15 of 56 patients, transcatheter closure was deemed unsuitable. In 9 patients, this was due to the limitation of the size of the device available during the period of study, this representing a relative contraindication. In the remaining 6 (10.7%), transcatheter closure was not performed because multiple defects were too far apart to be closed with a single device in 3 patients, two patients were noted to have a sinus venosus defect, and another was noted to have anomalous connection of the right upper pulmonary vein to the right atrium. Excluding patients contraindicated due to the size of the defect alone, transesophageal echocardiography provided extra information in one-tenth of our patients, which altered the decision regarding management.

CONCLUSION: Transesophageal echocardiography is indispensable in the evaluation of patients undergoing transcatheter closure of atrial septal defect.

An accessory mitral valve leaflet causing left ventricular outflow tract obstruction and associated with severe aortic incompetence

Tamin SS, Dillon J, Aizan K, Kadiman S, Latiff HA

Echocardiography, 2012 Feb;29(2):E34-8.

PMID: 22044509 DOI: 10.1111/j.1540-8175.2011.01543.x

This case report describes a 20-year-old woman with Turner's syndrome who presented with reduced effort tolerance limited by dyspnea. She had previously been on pediatric cardiology follow-up for congenital subvalvular aortic stenosis first diagnosed at age 7. Unfortunately she defaulted after two visits before any intervention could be done. Transthoracic echocardiography demonstrated severe aortic incompetence (AI) with a membrane-like structure in the left ventricular outflow tract (LVOT). The mean pressure gradient across the LVOT on continuous wave Doppler was 41 mmHg. The membranous interventricular septum appeared aneurysmal and it was observed that the "subaortic membrane" had a connection to the anterolateral papillary muscle via a strand of chordal tissue. Further images were captured using two-dimensional and three-dimensional transthoracic and transesophageal echocardiography (iE33, Philips Medical Systems, Andover, MA, USA). After a review of the literature it was concluded that this appeared to be an accessory mitral valve (AMV) leaflet causing LVOT obstruction associated with AI. AMV tissue is a rare congenital malformation causing LVOT obstruction. Because it is so unusual, it may not be immediately recognizable even in a high volume echocardiography laboratory. The clue which helped with the diagnosis was the strand of chordal tissue which connected the mass to the papillary muscle. This anomaly is often associated with LVOT obstruction.

Transcatheter occlusion of native persistent ductus arteriosus using conventional Gianturco coils

Alwi M, Kang LM, Samion H, Latiff HA, Kandavel G, Zambahari R

Am J Cardiol, 1997 May 15;79(10):1430-2.

PMID: 9165178 DOI: 10.1016/s0002-9149(97)00160-4

Two hundred eleven patients with small- to moderate-sized native patent ductus arteriosus underwent closure using Gianturco coils, employing the transvenous multiple catheter approach. Short-term results showed a high rate of complete occlusion and a potential long-term complication of mild left pulmonary artery stenosis in a small number of patients.

A rare cause of left ventricular outflow tract mass in infancy: Cardiac papillary fibroelastoma

Haranal M, Febrianti Z, Latiff HA, Rahman SA, Sivalingam S

Asian Cardiovasc Thorac Ann, 2021 Oct;29(8):816-818.

PMID: 33641433 DOI: 10.1177/0218492321998500

Primary cardiac tumors are one of the rare causes of intracardiac masses in pediatric population. Cardiac papillary fibroelastomas are benign cardiac tumors with predilection for valvular endocardium, and the presentation is dictated by the cardiac structure involved and the tumor characteristics. We report an infant with cardiac papillary fibroelastoma manifesting as an asymptomatic left ventricular outflow tract mass. This case is being presented to emphasize the rare occurrence of cardiac papillary fibroelastoma in pediatric population and to be cognizant of this entity when considering differential diagnosis of intracardiac masses in this subgroup.

Fulltext Airway compression: a rare but serious complication following stenting of the patent ductus arteriosus

Rehman R, Chaudhari M, Latiff HA, Stumper O, Alwi M

Postepy Kardiol Interwencyjnej, 2021 Dec;17(4):412-415.

PMID: 35126558 DOI: 10.5114/aic.2021.112526

Fulltext Double outlet both ventricles: A rare ventriculoarterial connection

Haranal M, Sivalingam S, Borhanuddin BK, Srimurugan B, Latiff HA

JTCVS Tech, 2023 Feb;17:151-152.

PMID: 36820341 DOI: 10.1016/j.xjtc.2022.08.023

Mitral valve repair for congenital mitral valve disease: impact of the use of a biodegradable annuloplasty ring

Yakub MA, Sivalingam S, Dillon J, Matsuhama M, Latiff HA, Ramli MF

Ann Thorac Surg, 2015 Mar;99(3):884-90; discussion 890.

PMID: 25579160 DOI: 10.1016/j.athoracsur.2014.09.016

This study compares the midterm results of mitral valve repair using the biodegradable ring versus repair with non-ring annuloplasty techniques for congenital mitral valve disease in young children where it was not possible to use standard commercial rings.

Risk factors for augmentation of the flow of blood to the lungs in pulmonary atresia with intact ventricular septum after radiofrequency valvotomy

Alwi M, Kandavello G, Choo KK, Aziz BA, Samion H, Latiff HA

Cardiol Young, 2005 Apr;15(2):141-7.

PMID: 15845156

Some patients with pulmonary atresia with an intact ventricular septum, mild to moderate right ventricular hypoplasia, and a patent infundibulum remain duct dependent on the flow of blood through the arterial duct despite adequate relief of the obstruction within the right ventricular outflow tract. The objective of our study was to review the risk factors for stenting of the patent arterial duct, or construction of a Blalock-Taussig shunt, in the patients with pulmonary atresia and an intact ventricular septum who remain duct-dependent following radiofrequency valvotomy and dilation of the imperforate pulmonary valve. We reviewed the data from 53 patients seen between November 1995 and December 2001. Of the 47 patients who survived, 6 required stenting of the patent arterial duct, while 4 needed construction of a modified Blalock-Taussig shunt to augment the flow of blood to the lungs at a mean of 7 plus or minus 5.7 days following the initial intervention. The remaining 37 patients required no additional procedures. We compared the findings in these two groups. The mean diameter of the tricuspid valve in the patients requiring early reintervention was 8.5 plus or minus 3.7 millimetres, giving a Z-score of -1.1 plus or minus 1.47, whilst those in the group without early reintervention had values of 10.7 plus or minus 2.2 millimetres, giving a Z-score of -0.58 plus or minus 1.18 (p equal to 0.003). No statistically significant differences were found in right ventricular morphology, McGoon ratio, or residual obstruction across the right ventricular outflow tract after decompression of the right ventricle. The diameter of the tricuspid valve, therefore, appears to be the only factor predicting the need for augmentation of flow of blood to the lungs. As just over one-fifth of our survivors required such augmentation, we hypothesize that stenting of the patent arterial duct may be performed as an integral part of primary transcatheter therapy in patients with pulmonary atresia and intact ventricular septum who have moderate right ventricular hypoplasia and a small tricuspid valve.

Corrigendum to 'Impact of ductal stenting on pulmonary artery reconstruction in patients with duct-dependent congenital heart diseases-an institutional experience' [Interact CardioVasc Thorac Surg 2020;31:221-7.]

Haranal M, Mood MC, Leong MC, Febrianti Z, Latiff HA, Samion H, et al.

Interact Cardiovasc Thorac Surg, 2020 08 01;31(2):285.

PMID: 32706029 DOI: 10.1093/icvts/ivaa152

Inverted left atrial appendage masquerading as a cardiac mass

Leong MC, Latiff HA, Hew CC, Mazlan SL, Osman H

Echocardiography, 2013 Feb;30(2):E33-5.

PMID: 23134298 DOI: 10.1111/echo.12044

An inverted left atrial appendage is a rare phenomenon post cardiac surgery. The lesion presents as an additional mass in the left atrium, which would trigger unnecessary concerns and frequently, a battery of tests. The lesion can be easily diagnosed using echocardiography. We report a case of inverted left atrial appendage in a patient post repair of common arterial trunk. Echocardiographic pictures and features which help to identify this lesion as well as to differentiate it from other possible left atrial mass are described. This article aimed to improve the awareness of sonographers toward this rare but possible post operative lesion.

Fulltext Initial results and medium-term follow-up of stent implantation of patent ductus arteriosus in duct-dependent pulmonary circulation

Alwi M, Choo KK, Latiff HA, Kandavello G, Samion H, Mulyadi MD

J Am Coll Cardiol, 2004 Jul 21;44(2):438-45.

PMID: 15261945 DOI: 10.1016/j.jacc.2004.03.066

Objectives: This study was designed to assess the safety, efficacy, medium-term outcome, and complications of patent ductus arteriosus (PDA) stenting in duct-dependent pulmonary circulation.
Background: Patent ductus arteriosus stenting has been proposed as an alternative to surgical shunt on account of postoperative morbidity and complications of surgical shunting.
Methods: Between April 2000 and February 2003, 69 patients with duct-dependent pulmonary circulation underwent cardiac catheterization with the intent of PDA stenting as first palliative procedure. Patients with critical pulmonary stenosis and pulmonary atresia with intact ventricular septum post-radiofrequency valvotomy who had PDA stenting were excluded. Thirteen more patients were excluded because of branch pulmonary artery (PA) stenosis. The follow-up was by clinical examination, echocardiography, and repeat cardiac catheterization at six to nine months following the procedure.
Results: Patent ductus arteriosus stenting was successful in 51 patients (91.1%) and failed in 5 patients (8.9%). The mean narrowest PDA diameter was 1.9 +/- 0.6 mm. The mean procedure and fluoroscopy time were 95.7 min and 29.4 min, respectively. In one patient the stent dislodged and migrated to the left femoral artery and another patient developed transient intravascular hemolysis. There was no procedure-related mortality. Three patients (5.9%) died one day to two months after the procedure. At follow-up (3.2 months to 2.4 years), 8 patients developed significant stent stenosis requiring reintervention. Seven patients developed worsening of preexisting branch PA stenosis. The freedom from reintervention was 89% and 55% at 6 months and 1 year, respectively.
Conclusions: Patent ductus arteriosus stenting is an attractive alternative to surgical shunt in a majority of patients with duct-dependent circulation. An absolute contraindication to this technique is the presence of branch pulmonary stenosis.

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