SlideShare une entreprise Scribd logo
1  sur  16
Segmental Approach to
congenital heart
diseases
RAMACHANDRA
THREE CARDIAC SEGMENTS

ATRIA

VENTRICLE

GREAT
ARTERIES
Sequential segmental analysis using
Clinical examination
Chest Radiogrghy
12 Lead Electrocardiography
Echocardiography
Cardiac position and apex orientation
 Atrial arrangement
 Atrioventricular connection
 Ventriculoarterial connections
 Associated malformations and function of segments
HISTORY OF IT
• Richard Van Praagh
1960 • America
• Maria Victoria de la Cruz
1960 • Mexico city

• Echocardiography brought the term “sequential segmental
analysis”
1970
Background
All hearts can be considered in three segments: the atrial
chambers, the ventricular mass and the great arteries. Sequential
segmental analysis means to identify the component parts of the heart
by their morphology and describe the interconnections in a sequential
manner.
ATRIAL ARRANGEMENT
TYPES OF AV CONNECTION
AV VALVES
HAND
Ventricular topology
Ventricular topology describes the spatial relationship of one ventricle
to the other. There are two topologic patterns that are mirror images of
each other. Right and left hand topology. Right hand topology is the
normal pattern. Determination of ventricular topology requires first
identification of the morphologic right ventricle. If the palmar surface
of right hand can be placed on the septal surface, thumb in the inlet
and the fingers toward the outlet and the wrist is at the apex, then
this is the right –hand pattern[D-looped]. If only the left hand palm
can be placed on the septal surface of the right ventricle in the same
manner, then this will be described as left hand topology(L-looped
ventricle). Ventricular topology allows analysis of the atrioventricular
junction in hearts with isomeric arrangement of atrial appendages
UNIVENTRICULAR HEART
VENTRICULOARTERIAL
COMMUNICATION
GREAT ARTERIES TO EACH OTHER
INFUNDIBULUM TO GREAT ARTERIES
External Link

http://www.ncbi.nlm.nih.gov/pubmed/20300266
http://www.wikiecho.org/wiki/File:Segmental_Analysis2.JPG

Contenu connexe

Tendances

Asd echo assessment
Asd echo assessmentAsd echo assessment
Asd echo assessmentMashiul Alam
 
Coronary anatomy and angiographic views
Coronary anatomy and angiographic viewsCoronary anatomy and angiographic views
Coronary anatomy and angiographic viewsthanigai arasu
 
Truncus arteriosus
Truncus arteriosusTruncus arteriosus
Truncus arteriosusAliaa Shaban
 
Echo assessment of Aortic Regurgitation
Echo assessment of Aortic RegurgitationEcho assessment of Aortic Regurgitation
Echo assessment of Aortic RegurgitationMashiul Alam
 
Aortic stenosis Echo
Aortic stenosis Echo Aortic stenosis Echo
Aortic stenosis Echo madhusiva03
 
Echo assessment of cardiomyopathy pdf
Echo assessment of cardiomyopathy pdfEcho assessment of cardiomyopathy pdf
Echo assessment of cardiomyopathy pdfNizam Uddin
 
Noncompaction cardiomyopathy
Noncompaction cardiomyopathyNoncompaction cardiomyopathy
Noncompaction cardiomyopathyKunal Mahajan
 
Ebstein anomaly
Ebstein anomalyEbstein anomaly
Ebstein anomalyAmit Verma
 
Management of cc tga
Management of cc tgaManagement of cc tga
Management of cc tgaIndia CTVS
 
ECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATION
ECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATIONECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATION
ECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATIONPraveen Nagula
 
Right Ventricle Anatomy, Physiology & ECHO Assessment by Dr. Vaibhav Yawalka...
Right Ventricle Anatomy, Physiology  & ECHO Assessment by Dr. Vaibhav Yawalka...Right Ventricle Anatomy, Physiology  & ECHO Assessment by Dr. Vaibhav Yawalka...
Right Ventricle Anatomy, Physiology & ECHO Assessment by Dr. Vaibhav Yawalka...vaibhavyawalkar
 

Tendances (20)

Sinus of valsalva aneurysm
Sinus of valsalva aneurysmSinus of valsalva aneurysm
Sinus of valsalva aneurysm
 
Asd echo assessment
Asd echo assessmentAsd echo assessment
Asd echo assessment
 
Coronary anatomy and angiographic views
Coronary anatomy and angiographic viewsCoronary anatomy and angiographic views
Coronary anatomy and angiographic views
 
aortic arch anamolies
aortic arch anamoliesaortic arch anamolies
aortic arch anamolies
 
Truncus arteriosus
Truncus arteriosusTruncus arteriosus
Truncus arteriosus
 
Echocardiography of CHD in Adults
Echocardiography of CHD in AdultsEchocardiography of CHD in Adults
Echocardiography of CHD in Adults
 
Echo assessment of Aortic Regurgitation
Echo assessment of Aortic RegurgitationEcho assessment of Aortic Regurgitation
Echo assessment of Aortic Regurgitation
 
Echocardiography in mitral stenosis
Echocardiography in mitral stenosisEchocardiography in mitral stenosis
Echocardiography in mitral stenosis
 
Aortic stenosis Echo
Aortic stenosis Echo Aortic stenosis Echo
Aortic stenosis Echo
 
Echo assessment of cardiomyopathy pdf
Echo assessment of cardiomyopathy pdfEcho assessment of cardiomyopathy pdf
Echo assessment of cardiomyopathy pdf
 
Noncompaction cardiomyopathy
Noncompaction cardiomyopathyNoncompaction cardiomyopathy
Noncompaction cardiomyopathy
 
Ebstein anomaly
Ebstein anomalyEbstein anomaly
Ebstein anomaly
 
Management of cc tga
Management of cc tgaManagement of cc tga
Management of cc tga
 
Cc tga
Cc tgaCc tga
Cc tga
 
Cardiac dyssynchrony ppt by dr awadhesh
Cardiac dyssynchrony ppt   by dr awadheshCardiac dyssynchrony ppt   by dr awadhesh
Cardiac dyssynchrony ppt by dr awadhesh
 
Cath hemodynamics vir
Cath hemodynamics virCath hemodynamics vir
Cath hemodynamics vir
 
ECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATION
ECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATIONECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATION
ECHOCARDIOGRAPHIC EVALUATION OF AORTIC REGURGITATION
 
Right Ventricle Anatomy, Physiology & ECHO Assessment by Dr. Vaibhav Yawalka...
Right Ventricle Anatomy, Physiology  & ECHO Assessment by Dr. Vaibhav Yawalka...Right Ventricle Anatomy, Physiology  & ECHO Assessment by Dr. Vaibhav Yawalka...
Right Ventricle Anatomy, Physiology & ECHO Assessment by Dr. Vaibhav Yawalka...
 
Coronary angiogram
Coronary angiogramCoronary angiogram
Coronary angiogram
 
Asd ppt
Asd pptAsd ppt
Asd ppt
 

Similaire à Segmental Approach to Congenital Heart Diseases

Embriologyandcardiacheartdisease
EmbriologyandcardiacheartdiseaseEmbriologyandcardiacheartdisease
Embriologyandcardiacheartdiseasegisa_legal
 
Coronary-artery Circulation Overview Observations about Kugel's artery anatom...
Coronary-artery Circulation Overview Observations about Kugel's artery anatom...Coronary-artery Circulation Overview Observations about Kugel's artery anatom...
Coronary-artery Circulation Overview Observations about Kugel's artery anatom...MinaNous
 
MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar
MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar
MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar Dr. Muhammad Bin Zulfiqar
 
Aortic arch anomalies
Aortic arch anomaliesAortic arch anomalies
Aortic arch anomaliesSanket Nale
 
Comparios coronarias cerdo hombre
Comparios coronarias cerdo hombreComparios coronarias cerdo hombre
Comparios coronarias cerdo hombrefagoto
 
Abnormal branching pattern of the axillary artery
Abnormal branching pattern of the axillary arteryAbnormal branching pattern of the axillary artery
Abnormal branching pattern of the axillary arteryRamendra Raman
 
Anatomy of cardiac structures & conducting system in
Anatomy of cardiac structures & conducting system inAnatomy of cardiac structures & conducting system in
Anatomy of cardiac structures & conducting system inRamachandra Barik
 
Radiological diagnostics of Cardiovascular System
Radiological diagnostics of Cardiovascular SystemRadiological diagnostics of Cardiovascular System
Radiological diagnostics of Cardiovascular SystemEneutron
 
SEMINAR CHEST & MEDIASTINUM ANATOMY.pptx
SEMINAR CHEST & MEDIASTINUM ANATOMY.pptxSEMINAR CHEST & MEDIASTINUM ANATOMY.pptx
SEMINAR CHEST & MEDIASTINUM ANATOMY.pptxDr Danish Khan
 
An unusual origin of brachiocephalic and left common carotid arteries 2018
An unusual origin of brachiocephalic and left common carotid arteries 2018An unusual origin of brachiocephalic and left common carotid arteries 2018
An unusual origin of brachiocephalic and left common carotid arteries 2018Dr.Srikanth pawar
 

Similaire à Segmental Approach to Congenital Heart Diseases (20)

Levo atrio-cardinal vein
Levo atrio-cardinal veinLevo atrio-cardinal vein
Levo atrio-cardinal vein
 
Heart 2
Heart 2Heart 2
Heart 2
 
Embriologyandcardiacheartdisease
EmbriologyandcardiacheartdiseaseEmbriologyandcardiacheartdisease
Embriologyandcardiacheartdisease
 
Coronary-artery Circulation Overview Observations about Kugel's artery anatom...
Coronary-artery Circulation Overview Observations about Kugel's artery anatom...Coronary-artery Circulation Overview Observations about Kugel's artery anatom...
Coronary-artery Circulation Overview Observations about Kugel's artery anatom...
 
MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar
MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar
MDCT Anatomy of Heart Dr. Muhammad Bin Zulfiqar
 
Aortic Arches A REVIEW E POSTER
Aortic Arches A REVIEW E POSTERAortic Arches A REVIEW E POSTER
Aortic Arches A REVIEW E POSTER
 
Heart 1
Heart 1Heart 1
Heart 1
 
the normal heart
the normal heartthe normal heart
the normal heart
 
Coronary CT
Coronary CTCoronary CT
Coronary CT
 
Aortic arch anomalies
Aortic arch anomaliesAortic arch anomalies
Aortic arch anomalies
 
Comparios coronarias cerdo hombre
Comparios coronarias cerdo hombreComparios coronarias cerdo hombre
Comparios coronarias cerdo hombre
 
Abnormal branching pattern of the axillary artery
Abnormal branching pattern of the axillary arteryAbnormal branching pattern of the axillary artery
Abnormal branching pattern of the axillary artery
 
Guia de trabajo de anatomia
Guia de trabajo de anatomiaGuia de trabajo de anatomia
Guia de trabajo de anatomia
 
Cardiology 101 back to the basics
Cardiology 101 back to the basicsCardiology 101 back to the basics
Cardiology 101 back to the basics
 
Anatomy of cardiac structures & conducting system in
Anatomy of cardiac structures & conducting system inAnatomy of cardiac structures & conducting system in
Anatomy of cardiac structures & conducting system in
 
4-170711202454.pdf
4-170711202454.pdf4-170711202454.pdf
4-170711202454.pdf
 
Radiological diagnostics of Cardiovascular System
Radiological diagnostics of Cardiovascular SystemRadiological diagnostics of Cardiovascular System
Radiological diagnostics of Cardiovascular System
 
Chapter19 heartmarieb
Chapter19 heartmariebChapter19 heartmarieb
Chapter19 heartmarieb
 
SEMINAR CHEST & MEDIASTINUM ANATOMY.pptx
SEMINAR CHEST & MEDIASTINUM ANATOMY.pptxSEMINAR CHEST & MEDIASTINUM ANATOMY.pptx
SEMINAR CHEST & MEDIASTINUM ANATOMY.pptx
 
An unusual origin of brachiocephalic and left common carotid arteries 2018
An unusual origin of brachiocephalic and left common carotid arteries 2018An unusual origin of brachiocephalic and left common carotid arteries 2018
An unusual origin of brachiocephalic and left common carotid arteries 2018
 

Plus de Ramachandra Barik

Intensive care of congenital heart disease.pptx
Intensive care of congenital heart disease.pptxIntensive care of congenital heart disease.pptx
Intensive care of congenital heart disease.pptxRamachandra Barik
 
Management of Hypetension.pptx
Management of Hypetension.pptxManagement of Hypetension.pptx
Management of Hypetension.pptxRamachandra Barik
 
CRISPR and cardiovascular diseases.pdf
CRISPR and cardiovascular diseases.pdfCRISPR and cardiovascular diseases.pdf
CRISPR and cardiovascular diseases.pdfRamachandra Barik
 
Pacemaker Pocket Infection After Splenectomy
Pacemaker Pocket Infection After SplenectomyPacemaker Pocket Infection After Splenectomy
Pacemaker Pocket Infection After SplenectomyRamachandra Barik
 
A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...
A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...
A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...Ramachandra Barik
 
Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...
Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...
Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...Ramachandra Barik
 
Anticoagulation therapy during pregnancy
Anticoagulation therapy during pregnancyAnticoagulation therapy during pregnancy
Anticoagulation therapy during pregnancyRamachandra Barik
 
Intracoronary optical coherence tomography
Intracoronary optical coherence tomographyIntracoronary optical coherence tomography
Intracoronary optical coherence tomographyRamachandra Barik
 
A roadmap for the human development
A roadmap for the human developmentA roadmap for the human development
A roadmap for the human developmentRamachandra Barik
 
Left ventricular false tendons
Left ventricular false tendonsLeft ventricular false tendons
Left ventricular false tendonsRamachandra Barik
 

Plus de Ramachandra Barik (20)

Willens's syndrome.pptx
Willens's syndrome.pptxWillens's syndrome.pptx
Willens's syndrome.pptx
 
Intensive care of congenital heart disease.pptx
Intensive care of congenital heart disease.pptxIntensive care of congenital heart disease.pptx
Intensive care of congenital heart disease.pptx
 
Management of Hypetension.pptx
Management of Hypetension.pptxManagement of Hypetension.pptx
Management of Hypetension.pptx
 
CRISPR and cardiovascular diseases.pdf
CRISPR and cardiovascular diseases.pdfCRISPR and cardiovascular diseases.pdf
CRISPR and cardiovascular diseases.pdf
 
Pacemaker Pocket Infection After Splenectomy
Pacemaker Pocket Infection After SplenectomyPacemaker Pocket Infection After Splenectomy
Pacemaker Pocket Infection After Splenectomy
 
Piccolo Duct Occluder.pdf
Piccolo Duct Occluder.pdfPiccolo Duct Occluder.pdf
Piccolo Duct Occluder.pdf
 
MISPLACED ECG LEADS.pptx
MISPLACED ECG LEADS.pptxMISPLACED ECG LEADS.pptx
MISPLACED ECG LEADS.pptx
 
A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...
A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...
A Case of Device Closure of an Eccentric Atrial Septal Defect Using a Large D...
 
Arrythmia-IV.pptx
Arrythmia-IV.pptxArrythmia-IV.pptx
Arrythmia-IV.pptx
 
Arrythmia-III.pptx
Arrythmia-III.pptxArrythmia-III.pptx
Arrythmia-III.pptx
 
Arrythmia-II.pptx
Arrythmia-II.pptxArrythmia-II.pptx
Arrythmia-II.pptx
 
Arrythmia-I.pptx
Arrythmia-I.pptxArrythmia-I.pptx
Arrythmia-I.pptx
 
Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...
Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...
Trio of Rheumatic Mitral Stenosis, Right Posterior Septal Accessory Pathway a...
 
Anticoagulation therapy during pregnancy
Anticoagulation therapy during pregnancyAnticoagulation therapy during pregnancy
Anticoagulation therapy during pregnancy
 
Coronary guidewire
Coronary guidewireCoronary guidewire
Coronary guidewire
 
Intracoronary optical coherence tomography
Intracoronary optical coherence tomographyIntracoronary optical coherence tomography
Intracoronary optical coherence tomography
 
Brugada syndrome
Brugada syndromeBrugada syndrome
Brugada syndrome
 
A roadmap for the human development
A roadmap for the human developmentA roadmap for the human development
A roadmap for the human development
 
Intra aortic balloon pump
Intra aortic balloon pumpIntra aortic balloon pump
Intra aortic balloon pump
 
Left ventricular false tendons
Left ventricular false tendonsLeft ventricular false tendons
Left ventricular false tendons
 

Dernier

Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Miss joya
 
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowKolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowNehru place Escorts
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformKweku Zurek
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girlsnehamumbai
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbaisonalikaur4
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Miss joya
 
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowRiya Pathan
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 

Dernier (20)

Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
 
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
 
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowKolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
 
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Servicesauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 

Segmental Approach to Congenital Heart Diseases