VERA DEMARCHI AIELLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Classification of Ventricular Septal Defects for the Eleventh Iteration of the International Classification of Diseases-Striving for Consensus: A Report From the International Society for Nomenclature of Paediatric and Congenital Heart Disease(2018) LOPEZ, Leo; HOUYEL, Lucile; COLAN, Steven D.; ANDERSON, Robert H.; BELAND, Marie J.; AIELLO, Vera D.; BAILLIARD, Frederique; COHEN, Meryl S.; JACOBS, Jeffrey P.; KUROSAWA, Hiromi; SANDERS, Stephen P.; III, Henry L. Walters; WEINBERG, Paul M.; BORIS, Jeffrey R.; COOK, Andrew C.; CRUCEAN, Adrian; EVERETT, Allen D.; GAYNOR, J. William; GIROUD, Jorge; GULESERIAN, Kristine J.; HUGHES, Marina L.; JURASZEK, Amy L.; KROGMANN, Otto N.; MARUSZEWSKI, Bohdan J.; LOUIS, James D. St; SESLAR, Stephen P.; SPICER, Diane E.; SRIVASTAVA, Shubhika; STELLIN, Giovanni; I, Christo Tchervenkov; WANG, Lianyi; FRANKLIN, Rodney C. G.The definition and classification of ventricular septal defects have been fraught with controversy. The International Society for Nomenclature of Paediatric and annually for the past 9 years in an effort to unify by consensus the divergent approaches to describe ventricular septal defects. These efforts have culminated in acceptance of the classification system by the World Health Organization into the 11th Iteration of the International Classification of Diseases. The scheme to categorize a ventricular septal defect uses both its location and the structures along its borders, thereby bridging the two most popular and disparate classification approaches and providing a common language for describing each phenotype. Although the first-order terms are based on the geographic categories of central perimembranous, inlet, trabecular muscular, and outlet defects, inlet and Congenital Heart Disease is a group of international specialists in pediatric cardiology, cardiac surgery, cardiac morphology, and cardiac pathology that has met outlet defects are further characterized by descriptors that incorporate the borders of the defect, namely the perimembranous, muscular, and juxta-arterial types. The Society recognizes that it is equally valid to classify these defects by geography or borders, so the emphasis in this system is on the second-order terms that incorporate both geography and borders to describe each phenotype. The unified terminology should help the medical community describe with better precision all types of ventricular septal defects. (C) 2018 by The Society of Thoracic Surgeons
- Expert Consensus Statement: Anatomy, Imaging, and Nomenclature of Congenital Aortic Root Malformations(2023) TRETTER, Justin T.; SPICER, Diane E.; FRANKLIN, Rodney C. G.; BELAND, Marie J.; AIELLO, Vera D.; COOK, Andrew C.; CRUCEAN, Adrian; LOOMBA, Rohit S.; YOO, Shi-Joon; QUINTESSENZA, James A.; TCHERVENKOV, Christo I.; JACOBS, Jeffrey P.; NAJM, Hani K.; ANDERSON, Robert H.Over the past 2 decades, several categorizations have been proposed for the abnormalities of the aortic root. These schemes have mostly been devoid of input from specialists of congenital cardiac disease. The aim of this review is to provide a classification, from the perspective of these specialists, based on an understanding of normal and abnormal morphogenesis and anatomy, with emphasis placed on the features of clinical and surgical relevance. We contend that the description of the congenitally malformed aortic root is simplified when approached in a fashion that recognizes the normal root to be made up of 3 leaflets, supported by their own sinuses, with the sinuses themselves separated by the interleaflet triangles. The malformed root, usually found in the setting of 3 sinuses, can also be found with 2 sinuses, and very rarely with 4 sinuses. This permits description of trisinuate, bisinuate, and quadrisinuate variants, respectively. This feature then provides the basis for classification of the anatomical and functional number of leaflets present. By offering standardized terms and definitions, we submit that our classification will be suitable for those working in all cardiac specialties, whether pediatric or adult. It is of equal value in the settings of acquired or congenital cardiac disease. Our recommendations will serve to amend and/or add to the existing International Paediatric and Congenital Cardiac Code, along with the Eleventh iteration of the International Classification of Diseases provided by the World Health Organization.
- Atrioventricular septal defect with coexisting tricuspid atresia(2011) AIELLO, Vera Demarchi; AFIUNE, Jorge Yussef; MENAHEM, Samuel; ANDERSON, Robert H.We describe two infants having an atrioventricular septal defect in the setting of a double inlet atrioventricular connection, but with patency of the left-sided valvar orifice and an imperforate right-sided valvar component, and a further case with atrioventricular septal defect and an imperforate Ebstein's malformation, all producing the haemodynamic effect of tricuspid atresia. We make comparisons with the arrangement in trisomy 16 mice, in whom deficient atrioventricular septation is seen at times with the common atrioventricular junction exclusively connected to the left ventricle, a situation similar to that seen in two of our infants. We also review previous reports emphasising the important theoretical implication of the findings despite their rarity.
- Human subpulmonary infundibulum has an endocardial network of specialized conducting cardiomyocytes(2020) ALMEIDA, Marcos C. De; STEPHENSON, Robert S.; ANDERSON, Robert H.; BENVENUTI, Luiz A.; LOUKAS, Marios; AIELLO, Vera D.BACKGROUND The right ventricular outflow tract is the most common source of ventricular arrhythmias in nonstructural heart disease. Most of these arrhythmias are of endocardial origin, but their morphologic substrate is mostly unknown. OBJECTIVE The purpose of this study was to identify potential morphologic substrates for such arrhythmias originating within the right ventricular outflow tract. METHODS Three adult human hearts that had been fixed in 4% formaldehyde were examined. In 2 of the hearts, which were obtained subsequent to necropsies, the base of the anterior papillary muscle of the tricuspid valve was removed at the site of its fusion with the moderator band. The block of removed myocardium was submitted to routine histologic processing and sectioned at 5-mu m thickness. The free-standing subpulmonary infundibulum also was removed as a series of macroscopic preparations, which were sectioned in their short axis at 5-mu m thickness. The third heart was assessed using microcomputed tomography after it had been stained with 7.5% I2KI contrast agent for 14 days, with the contrast agent refreshed on the seventh day. RESULTS Specialized conducting cardiomyocytes from the base of the anterior papillary muscle to the supraventricular crest and subpulmonary infundibulum were identified and tracked using histology in 2 hearts and microcomputed tomography in the other. Transitional cells were also found at these sites. CONCLUSION The existence of such specialized cardiomyocytes within the infundibulum is of clinical significance because they could be the morphologic substrate for arrhythmias known to originate from these sites.
- The independence of the infundibular building blocks in the setting of double-outlet right ventricle(2017) AIELLO, Vera D.; SPICER, Diane E.; ANDERSON, Robert H.; BROWN, Nigel A.; MOHUN, Timothy J.It has long been contentious as to whether the presence of bilateral infundibulums, or conuses, is a prerequisite for the diagnosis of double-outlet right ventricle. As the use of such a criterion would abrogate the so-called ""morphological method"", which correctly states that one variable entity should not be defined on the basis of another entity that is itself variable, it is now accepted that double outlet can exist in the setting of fibrous continuity between the leaflets of the atrioventricular and arterial valves. Although this debate has now been resolved, there are other contentious areas still requiring clarification in the setting of hearts unified because of the presence of this particular ventriculo-arterial connection - for example, it is questionable whether the channel between the ventricles should be described as a ""ventricular septal defect"", whereas it is equally arguable that the mere presence of fibrous continuity between the leaflets of the arterial valves does not necessarily place the channel in a doubly committed location. In this review, we describe a series of autopsied hearts in which the anatomical features serve to illuminate these various topics. We then discuss recent findings regarding cardiac development that point to the individuality of the building blocks of the ventricular outflow tracts, specifically the outlet septum, the inner heart curvature, or ventriculo-infundibular fold, and the septomarginal trabeculation, or septal band.
- Lost treasures: a plea for the systematic preservation of cadaveric heart specimens through three-dimensional digital imaging(2015) SESLAR, Stephen P.; SHEPARD, Charles W.; GIROUD, Jorge M.; AIELLO, Vera D.; COOK, Andrew C.; SPICER, Diane E.; LOUIS, James D. St.; FRANKLIN, Rodney C. G.; JACOBS, Jeffrey P.; ANDERSON, Robert H.
- Expert Consensus Statement: Anatomy, Imaging, and Nomenclature of Congenital Aortic Root Malformations(2023) TRETTER, Justin T.; SPICER, Diane E.; FRANKLIN, Rodney C. G.; BELAND, Marie J.; AIELLO, Vera D.; COOK, Andrew C.; CRUCEAN, Adrian; LOOMBA, Rohit S.; YOO, Shi-Joon; QUINTESSENZA, James A.; TCHERVENKOV, Christo I.; JACOBS, Jeffrey P.; NAJM, Hani K.; ANDERSON, Robert H.Over the past 2 decades, several categorizations have been proposed for the abnormalities of the aortic root. These schemes have mostly been devoid of input from specialists of congenital cardiac disease. The aim of this review is to provide a classification, from the perspective of these specialists, based on an understanding of normal and abnormal morphogenesis and anatomy, with emphasis placed on the features of clinical and surgical relevance. We contend that the description of the congenitally malformed aortic root is simplified when approached in a fashion that recognizes the normal root to be made up of 3 leaflets, supported by their own sinuses, with the sinuses themselves separated by the interleaflet triangles. The malformed root, usually found in the setting of 3 sinuses, can also be found with 2 sinuses, and very rarely with 4 sinuses. This permits description of trisinuate, bisinuate, and quadrisinuate variants, respectively. This feature then provides the basis for classification of the anatomical and functional number of leaflets present. By offering standardized terms and definitions, we submit that our classification will be suitable for those working in all cardiac specialties, whether pediatric or adult. It is of equal value in the settings of acquired or congenital cardiac disease. Our recommendations will serve to amend and/or add to the existing International Paediatric and Congenital Cardiac Code, along with the Eleventh iteration of the International Classification of Diseases provided by the World Health Organization.& COPY; 2023 The Authors. The article has been co-published by Elsevier Inc. (on behalf of The Society of Thoracic Surgeons) and Cambridge University Press & Assessment. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
- The morphology of the coronary sinus in patients with congenitally corrected transposition: implications for cardiac catheterisation and re-synchronisation therapy(2016) AIELLO, Vera D.; FERREIRA, Flavia C. N.; SCANAVACCA, Mauricio I.; ANDERSON, Robert H.; D'AVILA, AndrePatients with congenitally corrected transposition frequently benefit from re-synchronisation therapy or ablation procedures. This is likely to require catheterisation of the coronary sinus. Its anatomy, however, is not always appreciated, despite being well-described. With this caveat in mind, we have evaluated its location and structure in hearts with congenitally corrected transposition in order to reinforce the guidance needed by the cardiac interventionist. We dissected and inspected the coronary sinus, the oblique vein of the left atrium, and the left-sided-circumflex venous channel in eight heart specimens with corrected transposition and eight controls, measuring the orifice and length of the sinus and the atrioventricular valves. In two-thirds of the malformed hearts, the sinus deviated from its anticipated course in the atrioventricular groove, ascending obliquely on the left atrial inferior wall to meet the left oblique vein. The maximal deviation coincided in all hearts with the point where the left oblique vein joined the left-sided-circumflex vein to form the coronary sinus. We describe a circumflex vein, rather than the great cardiac vein, as the latter venous channel is right-sided in the setting of corrected transposition. The length of the sinus correlated positively with the diameter of the tricuspid valve (p=0.02). Compared with controls, the left oblique vein in the malformed hearts joined the circumflex venous channel significantly closer to the mouth of the sinus. The unexpected course of the coronary sinus in corrected transposition and the naming of the cardiac veins have important implications for venous cannulation and interpretation of images.