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Li W, Feng W, Chang C, Liu Y, Li X, Wang M, Gan L, Zhang J. Innovative cardiovascular casting technique features the complex malformation of berry syndrome. BMC Pregnancy Childbirth 2024; 24:194. [PMID: 38475705 DOI: 10.1186/s12884-024-06340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
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.
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Affiliation(s)
- Wei Li
- Hubei Provinical Clinical Research Center for Accurate Fetus Malformation Diagnosis, Department of gynaecology and obstetrics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Wei Feng
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Caihong Chang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Ya Liu
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Xue Li
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Mofeng Wang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Ling Gan
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Jiaqi Zhang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China.
- Department of Ultrasound, Hubei University of Medicine, Xiangyang No.1 People's Hospital, No 15, Jiefang Avenue, Xiangyang, 441000, Hubei, China.
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Haranal M, Srimurugan B, Dinh DM, Sivalingam S. Berry syndrome-a rare congenital cardiac anomaly. Indian J Thorac Cardiovasc Surg 2021; 37:526-532. [PMID: 34511759 DOI: 10.1007/s12055-021-01206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022] Open
Abstract
Berry syndrome is a rare congenital cardiac anomaly, characterized by distal aortopulmonary window, hypoplasia or interruption of the aortic arch, intact ventricular septum, and aortic origin of the right pulmonary artery and patent ductus arteriosus. Anatomic depiction of each component is important for the diagnosis. Single-stage surgical repair is challenging but feasible with good survival outcomes. The available literature on this anomaly is limited. Hence, this paper aims at reviewing the literature on Berry syndrome.
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Affiliation(s)
- Maruti Haranal
- Department of Cardiac Surgery, National Heart Institute, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
| | - Balaji Srimurugan
- Department of Pediatric Cardiac Surgery, Amrita Institute of Medical Sciences, Kerala Kochi, India
| | - Duyen Mai Dinh
- Department of Cardiac Surgery, National Heart Institute, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
| | - Sivakumar Sivalingam
- Department of Cardiac Surgery, National Heart Institute, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
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Habibie YA, Busro PW, Roebiono PS, Fakhri D. Berry syndrome; a successful one-stage repair in neonate periods, evaluation result after 9 years, a case report. Ann Med Surg (Lond) 2021; 64:102200. [PMID: 33732452 PMCID: PMC7941068 DOI: 10.1016/j.amsu.2021.102200] [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] [Received: 01/30/2021] [Accepted: 02/28/2021] [Indexed: 11/17/2022] Open
Abstract
Backgroud IAA with an intact ventricular septum is distinctly unusual. Combination with an Aortopulmonary Window (APW), ascending aortic origin of the right pulmonary artery and PDA may be present which is called as Berry syndrome, a rare combination of cardiac anomalies, reported to be 0.046%, lethal combination and die shortly after birth. Case Report We report a 9 days-old male neonates weighing 3.85 kg was referred by local hospital to our center and was ventilated with history of respiratory distress and severe infection since he was born. Admitted to our PCICU, 2D echo showed an IAA type A associated with a huge APW type II and restrictif PDA. A PGE1 infusion was started, during the following days the baby experienced several epileptic episodes. After improvement of the clinical condition, surgery was performed on the 20th days of life on year 2011. A successful one-stage repair of such anomalies in which cutting of PDA that arised from PA trunk and distally becoming into descending aorta, extended end to end anastomosis to conduct the ascending aortic blood flow into the descending aorta and intra arterial baffle was used. A 4-0 Gore-Tex baffle was used both to close the APW and separated the RPA from aortic origin with a good result, as his recently grown up as a cheerful 9 year old child who is growing actively and has entered elementary school in grade 2. Conclusion Berry syndrome is a rare but well‐identified and surgically correctable anomaly. Early diagnosis and surgical treatment to avoid irreversible pulmonary hypertension is mandatory. Berry syndrome, a rare combination of cardiac anomalies, reported to be 0.046%, lethal combination and die shortly after birth. But well‐identified and surgically correctable anomaly. Early diagnosis and surgical treatment to avoid irreversible pulmonary hypertension is mandatory. Successful one-stage repair was done in a 20-days-old neonate using an alternative technique without circulatory arrest (performed on year 2011). Currently on year 2021, (after 9 years of evaluation) the patient has grown up as a cheerful 9 year old child who is growing actively and has entered elementary school in grade 2. During this patient last follow up on March 2019 at NCHHK Pediatric Cardiology clinic, echo result showed no residual AP Window, minimal pressure gradient of 18 mmHg across the aortic reconstruction with good LV function of 70%, good RV function, intact inter atrial & ventricular septum with TVG 20 mmHg. The latest echo follow up with the pediatric cardiologist showed good LV function with EF of 70%, no residual pumnonary hypertension was detected.
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Affiliation(s)
- Yopie Afriandi Habibie
- Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Syiah Kuala, The Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
| | - Pribadi Wiranda Busro
- Division of Pediatric and Congenital Cardiac Surgery, Dept of Thoracic and Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Poppy S Roebiono
- Division of Pediatric Cardiology, Dept. of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Dicky Fakhri
- Division of Pediatric and Congenital Cardiac Surgery, Dept of Thoracic and Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
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Bi WJ, Xiao YJ, Liu YJ, Hou Y, Ren WD. Berry syndrome: a case report and literature review. BMC Cardiovasc Disord 2021; 21:15. [PMID: 33407161 PMCID: PMC7788879 DOI: 10.1186/s12872-020-01837-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Berry syndrome, a rare combination of cardiac anomalies, consists of aortopulmonary window (APW); aortic origin of the right pulmonary artery; interrupted aortic arch (IAA) or hypoplastic aortic arch or coarctation of the aorta; and an intact ventricular septum. There is lack of review articles that elucidate the clinical features, diagnosis, treatment, and outcomes of Berry syndrome. This publication systematically reviews the 89 cases published since 1982 on Berry syndrome. CASE PRESENTATION A 38-year-old woman presented with a loud murmur and cyanosis. Transthoracic echocardiography demonstrated a severely dilated aorta and main pulmonary artery with a large intervening defect. Distal to the APW, the ascending aorta gave rise to the right pulmonary artery. Additionally, a type A IAA, an intact ventricular septum, and a large patent ductus arteriosus were revealed. Computed tomography angiography with 3-dimensional reconstruction confirmed above findings. This is the first report of a patient of this age with Berry syndrome who did not undergo surgery. CONCLUSIONS Berry syndrome is a rare but well-identified and surgically correctable anomaly. Patients with Berry syndrome should be followed up for longer periods to better characterize long-term outcomes.
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Affiliation(s)
- Wen-Jing Bi
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Yang-Jie Xiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Yue-Jia Liu
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China
| | - Wei-Dong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, 36# of Sanhao St. Heping District, Shenyang, 110004, China.
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Surgical repair in a patient with Berry syndrome. Gen Thorac Cardiovasc Surg 2020; 68:1475-1478. [PMID: 32002749 DOI: 10.1007/s11748-020-01301-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Abstract
Berry syndrome is a trilogy involving an aorto-pulmonary window, right pulmonary artery from ascending aorta and an interrupted aortic arch. Surgical repair for this anomaly is associated with a high mortality rate and incidence of right pulmonary arterial stenosis. Herein, we present the case of a patient with Berry syndrome, who underwent a rapid two-stage repair involving bilateral pulmonary arterial banding and complete repair. Postoperative computed tomography scan showed well-repaired great vessels free of obstruction.
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Zhang X, Liu XW, Gu XY, Han JC, Hao XY, Fu YW, He YH. Prenatal diagnosis of Berry syndrome by fetal echocardiography: A report of four cases. Echocardiography 2018; 35:563-565. [PMID: 29430703 DOI: 10.1111/echo.13832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Berry syndrome is a rare congenital cardiac malformation. We describe 4 cases of Berry syndrome diagnosed by fetal echocardiography. Based on our experience, the three-vessel view is important for diagnosing the aortopulmonary window and aortic origin of the right pulmonary artery. Furthermore, the true cross-sectional and sagittal views obtained by continuously scanning from the three-vessel-trachea view to the long-axis view of the aortic arch are required to image the interruption or coarctation of the aortic arch. An early and accurate prenatal diagnosis of Berry syndrome is feasible and helps to improve patient outcomes.
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Affiliation(s)
- Xin Zhang
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Heart Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiao-Wei Liu
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Xiao-Yan Gu
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Jian-Cheng Han
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Xiao-Yan Hao
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Yu-Wei Fu
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Yi-Hua He
- Department 2 of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Fetal Heart Disease Maternal Fetal Medicine Research Important Laboratories in Beijing, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
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Hu R, Zhang W, Liu X, Dong W, Zhu H, Zhang H. Current outcomes of one-stage surgical correction for Berry syndrome. J Thorac Cardiovasc Surg 2016; 153:1139-1147. [PMID: 28089641 DOI: 10.1016/j.jtcvs.2016.11.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/09/2016] [Accepted: 11/19/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Berry syndrome is a combination of distal aortopulmonary window (APW), aortic origin of the right pulmonary artery (RPA), intact ventricular septum, and interrupted aortic arch. We present here our current experience of primary repair of this syndrome with the goal of optimizing treatment for this rare condition. METHODS From January 2003 through December 2015, 16 infants with Berry syndrome underwent one-stage repair at Shanghai Children's Medical Center. Three different surgical correction techniques were used to repair the APW and aortic origin of the RPA, including intra-aortic baffle in 5, RPA detachment in 6, and RPA angioplasty with aortic cuff in 5 patients. RESULTS The median age at repair was 90.5 days (range, 8-170 days). The interrupted aortic arch morphology was type A in 14 and type B in 2 patients. The APW morphology was type IIa in 4, type IIb in 10, and type III in 2 patients. Hospital death occurred in 2 patients, and death at follow-up occurred in one other patient. Three patients who previously underwent RPA angioplasty with aortic cuff required reoperation for aortic or RPA stenosis. Freedom from reoperation was 84.8%, 75.4%, and 75.4%, respectively at 1, 5, and 10 years after surgery. CONCLUSIONS One-stage repair of Berry syndrome has achieved acceptable outcomes. Reoperations mainly are related to aortic or RPA stenosis, and the reoperation rate is higher when RPA arterioplasty is performed with an aortic cuff.
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Affiliation(s)
- Renjie Hu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinrong Liu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Dong
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongbin Zhu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haibo Zhang
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Yang SH, Tian XX, Li YY, Yang ZJ. Prenatal diagnosis of Berry syndrome by fetal echocardiography: a case report. Echocardiography 2016; 33:1611-1613. [PMID: 27779342 DOI: 10.1111/echo.13327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We report a case in which Berry syndrome is diagnosed by fetal echocardiography. Fetal echocardiography showed that the ascending aorta, main pulmonary artery, left pulmonary artery, and right pulmonary artery were presented as a vascular complexity in the three vessels and pulmonary arterial branches view.
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Affiliation(s)
- Shui-Hua Yang
- Department of Ultrasound, The Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiao-Xian Tian
- Department of Ultrasound, The Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
| | - Yuan-Yuan Li
- Department of Ultrasound, The Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zuo-Jian Yang
- Department of Ultrasound, The Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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