bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coil embolization of aortopulmonary collateral arteries as an emergency in infants and children
Authors: Vairo Ugo , Ballerini Luigi , di Carlo Duccio , Pasquini Luciano , Di Donato Roberto , Marcelletti Carlo 
Published: August 2008

SummaryEmbolization of major aortopulmonary collateral arteries by coils introduced via catheterization is a well-established procedure for the control of excessively high pulmonary blood flow in patients with tetralogy of Fallot and pulmonary stenosis or atresia. Under special circumstances, this procedure can be life-saving. Between October 1987 and February 1992, four patients with tetralogy of Fallot and pulmonary atresia and one patient with pulmonary stenosis rather than atresia underwent transcatheter embolization of major aortopulmonary collateral arteries as an emergency. Their ages ranged from 41 days to 13 years, with a mean of 45 months. Two patients had recently undergone surgical repair of tetralogy of Fallot while one had been palliated by enlarging the right ventricular outflow tract without closing the ventricular septal defect. All three had been dependent on mechanical ventilation in the postoperative period with signs of pulmonary congestion or intraparenchymal hemorrhage. Eight embolizations were attempted with 0.025 or 0.038 inch coils; seven collateral arteries were completely occluded and one was partially occluded. Thirteen coils were used in total. The systemic saturation rose in one postsurgical patient, with radiological evidence of decreased pulmonary congestion and regression of hemorrhage. In the other cases, the systemic saturation was unchanged. Peak pulmonary arterial pressures dropped in two patients but remained unchanged in three. Our experience suggests that embolization of major aortopulmonary collateral arteries can be beneficial in critical patients, thus avoiding the risks of surgical reexploration.
Neonatal postductal coarctation of the aorta—Doppler characteristics of aortic and ductal blood flow
Authors: Cullen Seamus , Champion Michael , Redington Andrew 
Published: August 2008

AbstractDoppler echocardiography revealed a characteristic pattern of flow in four neonates with postductal coarctation of the aorta. There was a continuous left-to-right shunt at the level of the patent arterial duct with simultaneous measurement of a large gradient across the site of coarctation with a pandiastolic gradient and prolonged pressure half-time. Infusions of prostaglandin produced no hemodynamic improvement, and urgent surgical correction was performed.
Residual patency of the arterial duct subsequent to surgical ligation
Authors: Zucker Nili , Qureshi Shakeel A. , Baker Edward J. , Deverall Philip B. , Tynan Michael 
Published: August 2008

SummaryClinical and Doppler echocardiography were performed in 65 patients who had undergone ligation of the arterial duct between January 1978 and December 1991. Of the patients, 12 (18%) patients had residual patency as demonstrated by color Doppler, while three (4.6%) of these had continuous murmurs. There was no association between residual patency and the age at surgery, the weight at surgery or the follow-up interval.
Isomerism of the left atrial appendages associated with bronchoatrial discordance and unusual systemic venous drainage
Authors: Jewel Francis M. , Joffe Hyam S. , Wilde Peter 
Published: August 2008

AbstractA complex case of congenital heart disease is presented which features isomerism of the left atrial appendages combined with bronchoatrial discordance and an anteriorly placed non-interrupted inferior caval vein draining to the left-sided atrium. This combination of anomalies has, as far as we are aware, not been described before. It emphasizes the importance of direct confirmation of atrial arrangement by atrial angiography or transesophageal echocardiography.
Echocardiography of the prominent Eustachian valve—associations and complications with cyanosis and right heart obstruction
Authors: Brook Michael M. , Silverman Norman H. 
Published: August 2008

SummaryWe reviewed the echocardiographic features of 16 children with prominent Eustachian valves, six of whom had associated pathology of the right heart, while eight had other anomalies, primarily atrial and ventricular septal defects. The hearts of two patients were structurally normal. Prolapse of the membrane through the orifice of the tricuspid valve or through the atrial septum was present in seven patients, two of whom were symptomatic. One presented with severe cyanosis which resolved after surgical removal on the basis of the echocardiographic findings. The other presented with atrial arrhythmias which did not improve with removal. The size or behavior of the membrane, including prolapse, did not correlate with either age or presence of pathology of the right heart. The echocardiographic appearance of prominent Eustachian valves is variable. Rarely, when prominent, the valves can cause symptoms associated with obstruction to the right heart, particularly cyanosis or an arrhythmia.
Smith-Magenis syndrome (interstitial deletion of chromosome 17p) and congenital heart disease
Authors: Abuelo Dianne N. , Corwin Robert D. 
Published: August 2008

SummaryA syndrome with characteristic facial and skeletal features resulting from a specific deletion of material on the short arm of chromosome 17 was first described by Smith et al in 1982.1 The common findings are brachycephaly, hypoplasia of the middle face, and short broad hands associated with mental retardation. More than 50 cases have been reported, and about one third have congenital heart disease. We report here a patient with atrial and ventricular septal defects together with pulmonary valvar stenosis.
The role of balloon dilation of native aortic coarctation in neonates, infants and children
Authors: Galal Omar , Halees Zohair Al , Qureshi Shakeel , Gometza Begonia , Fawzy Mohammed Eid , Fadley Fadel Al , Dunn Bruce , Duran Carlos 
Published: August 2008

AbstractIn 38 children with aortic coarctation between the age of three weeks and 16 years, 44 balloon dilation procedures were attempted. At initial catheterization (n=38), the mean gradient dropped from 49.6±21.2 mm Hg prior to dilation, to 15.3±15.8 mm Hg after the procedure (p>0.05). Twenty-six patients were recatheterized 3–24 months after the initial procedure. The mean gradient remained low at 12.7±15.2 mm Hg (range 0–64). Six of the 26 (23%) patients required a second dilation because of significant recoarctation. This proved successful in four, but in two patients, the second dilation failed, and they were referred for elective surgery. Thus, good overall results were obtained in 24 of the 26 (92.3%) patients undergoing reinvestigation following balloon dilation. Complications included requirements for blood transfusion in 9/44 (20%), chest pain during balloon inflation in 3/44 (6.8%), rupture of the balloon in 3/44 (6.8%), and femoral arterial thrombectomy in 3/44 (6.8%). At a mean clinical follow-up of 21 months, 21% of the patients had a weaker femoral pulse on the side used for balloon dilation, while 21% had mild hypertension measured in the arms despite the absence of a significant gradient. One patient (2.6%) developed an aortic aneurysm as a complication of the procedure. We conclude that balloon dilation is a safe and effective procedure in the majority of the patients with native aortic coarctation.
Profile of aortopulmonary window in India—a study of twenty cases
Authors: Pinto Robin J. , Bhagwat Ajit R. , Loya Yunus S. , Sharma Satyavan 
Published: August 2008

SummaryTwenty cases of aortopulmonary window are reported with special reference to some unusual modes of presentation and hemodynamics. Patients over 15 years of age accounted for 35% of the group. This delayed presentation may relate to referral patterns and socioeconomic conditions prevalent in India. Curiously, this elderly subset had two modes of presentation—either as large left-to-right shunts with low pulmonary vascular resistance (71.4%), or as Eisenmenger's syndrome (28.6%). The reasons for the low pulmonary vascular resistance in the majority of these older patients remain unclear. The echocardiographic features of these defects can be missed in presence of significant associated cardiac lesions. A careful search should, therefore, be made for an additional aortopulmonary window in all cases with evidence of intercirculatory shunting.
Left isomerism with absence of the spleen and obstructed pulmonary venous drainage—an uncommon association
Authors: Zimarino Marco , Gerboni Salvatore , Picchio Fernando M. 
Published: August 2008

SummaryCardiac and extracardiac anomalies tend to follow characteristic patterns when there is an isomeric arrangement of the heart and lungs. We present a case diagnosed correctly during prenatal life as having isomerism of the left atrial appendages in which some of the associated features were most unexpected, namely absence of the spleen and obstructed totally anomalous pulmonary venous connection. This association proved misleading for us in the management of the patient. We found it difficult to believe our findings in the light of our past knowledge, and this resulted in a delay in the referral for surgery. The final outcome was unfortunately fatal. In the management of isomerism of any type, therefore, a wide spectrum of combinations and “crossover” of cardiac anomalies must be anticipated, emphasizing the need to assess individually the arrangement of the different organs of the body.
An unusual cause of cyanosis after the modified Fontan procedure—closure of venous communications between the coronary sinus and left atrium by transcatheter techniques
Authors: Hayes Alison M. , Burrows Patricia E. , Benson Lee N. 
Published: August 2008

SummaryCommunication of the coronary sinus with the left atrium is an unusual anomaly. Two cases of tricuspid atresia are described where systemic desaturation developed following a modified Fontan procedure. In both, investigation demonstrated a communication between the coronary sinus and the left atrium. Transcatheter closure of these communications was achieved with a ductal device in one case and coil embolization in the other. Following occlusion and elimination of the right-to-left shunt, both patients became fully saturated in room air.
An unusual presentation of isolation of the right subclavian artery
Authors: Smith Julian A. , Hirschklau Michael J. , Reitz Bruce A. 
Published: August 2008

SummaryIsolation of the right subclavian artery from the aortic arch is a rare malformation. When isolated, the artery originates from the right pulmonary artery via a right-sided arterial duct, which may be patent or closed at the time of presentation. Intracardiac or other anomalies of the great vessels are commonly associated with this lesion. We present a case of isolation of the right subclavian artery which was initially diagnosed as persistent patency of a left-sided arterial duct. Surgical correction was eventually achieved by disconnecting the right subclavian artery from the right pulmonary artery and translocating it to the ascending aorta.
The size of the coronary arteries in children with complete transposition before and after the arterial switch operation
Authors: Yatsunami Koichi , Nakazawa Makoto , Seguchi Masashi , Momma Kazuo , Imai Yasuharu 
Published: August 2008

AbstractThe size of the coronary arteries parallels the ventricular mass, thus it may be abnormal in complete transposition beyond infancy and could be influenced by the arterial switch operation. To investigate this possibility, we measured the diameters of the right, left main trunk, anterior descending, and circumflex coronary arteries before and three to seven years (mean 4.8) after the arterial switch operation in 17 patients with a “normal” distribution of the coronary arteries (so-called Shaher type 1). The values were compared with 18 controls who had Kawasaki disease with no apparent coronary arterial disease. The right, left anterior descending, and circumflex arteries were smaller than control values before the operation. The post-/preoperative ratios of the diameter were 1.16±0.11 for the right coronary artery, 1.18±0.16 for the left main trunk, 1.20±0.18 for the left anterior descending artery, and 1.22±0.26 for the circumflex artery. There were no significant differences among these values. After surgery, the right coronary artery was larger, but the left coronary arteries were smaller in the patients than in the controls: 2.5±0.3 vs 2.0±0.2 mm for the right coronary artery; 2.4±0.3 vs 2.7±0.1 mm for the left main trunk; 1.9±0.2 vs 2.4±0.2 mm for the left anterior descending artery; 1.6±0.4 vs 2.2±0.5 mm for the circumflex artery, respectively. The posterior descending coronary artery originated from the right coronary artery in all patients. The total cross-sectional area of the right coronary, left anterior descending, and circumflex arteries was 9.7±2.4 mm2in the patients, and 11.8±2.9 mm2in the controls (p>O. 1), suggesting that the increased size of the right coronary artery compensates for the small left coronary arteries. We conclude that the arterial system in complete transposition, with a large right coronary artery and small left coronary system, remains smaller than normal even at midterm follow-up after anatomic repair despite normalization of left ventricular volume and muscle mass.
Application of ice water to the face during controlled respiration—a measure of basal vagal tone
Authors: Yum Myung Kul , Kim Seung Hwan , Jung Yeoung Geun 
Published: August 2008

AbstractWe examined the effectiveness of the application of ice water to the face during metronome-controlled respiration (15 breaths per minute) for vagalstimulation. We also examined the importance of basal vagal tone and sympathovagal interaction in determining the individual response to the stimulation. Fifty-three boys, aged 12 and 13, were included in this study. Vagal tone and sympathovagal interaction were assessed by power spectral analysis of the variability of the RR interval (heart rate). Basal heart rate, high frequency power, and low-to-high frequency power ratios were 81 ± 13(58–110 beats/min), 791 ± 1061(56–4161 m.sec2) and 1.08±1.22 (0.04–4.85) during controlled respiration. After application of ice water, 23 children developed frequent nodal escape beats due to severe sinus bradycardia. Minimum heart rate, high frequency power, and low to high power ratios changed to 42± 12 (19–72 beats/min), 1890±1882 (211–7258 m.sec2) and 0.64±0.43 (0.12–1.46). The increased ratio of high frequency power, maximum decrement in heart rate, and its percent after stimulation were 5.44±5.62 (0.63–24.26), 39±14 (10–81 beats/mm) and 47±15 (16–81%), respectively. The increased ratio of high frequency power was correlated with basal logarithmic high frequency power (r=−0.60, p=O.0004). Maximum heart rate decrement was correlated with basal logarithmic high frequency power (r=−0.60, p=O.OO18) and low-to-high frequency power ratio (r=0.27, p=O.O4). We conclude that application of ice water to the faceduring controlled respiration induces powerful vagal stimulation and bradycardia similar to, or even greater than, facial immersion in cold water. There is wide variability of individual response which can be explained by the magnitude of absolute basal vagal tone.
Experimental studies on the implantation of intravascular stents in puppies—potential use for aortic coarctation and pulmonary arterial stenosis
Authors: Ino Toshihiro , Shimazaki Shinjiro , Yabuta Keijiro , Okada Ryozo 
Published: August 2008

AbstractWe have investigated angiographically and histologically the vascular response to implantation of intravascular stents in normal puppies. Eight balloon-expandable stents were placed in six mongrel puppies (weight 6.4–10.5 kg) under anesthesia. Four stents were successfully placed in the pulmonary arteries and three in the aorta. In one case, the strut of the stent was hooked by a leaflet of the tricuspid valve at the time of placement and eventually had to be implanted in the inferior caval vein. Two puppies died, one from bleeding from the femoral artery and the other from thrombotic obstruction at the superior mesenteric artery, both after successful implantation. The former was due to repeat arterial puncture and the latter wasdue to failure to use aspirin. Angiographic studies showed satisfactory opacities of the branch arteries in all but one puppy. The diameter of the arteries prior to implantation was 7.5±1.5 mm. The diameters at the middle of the stents immediately after implantation and during the period of follow-up were 6.9±1.7mm and 6.9±2.1 mm, respectively. Histologic studies revealed that neogenic endothelial layers of 30 to 40 pm in thickness had formed over the struts of the stent without formation of thrombusthree weeks after implantation. Scanning electron microscopy revealed that the endothelial cells of the neoendothelial layer had almost identical characteristics to those of normal arteries. These results indicate that clinical application of this stent is feasible but that use of anticoagulants is mandatory during and after implantation in the treatment of selected patients with aortic coarctation or pulmonary arterial stenosis. Relative progression of stenosis may occur, however, and the inability for re-expansion is a major disadvantage of this stent.
Enlargement of a classical Blalock-Taussig shunt by implantation of a stent after failed balloon angioplasty
Authors: McLeod Karen , Blackburn Michael E. , Gibbs John L. 
Published: August 2008

SummaryThe period of adequate palliation from a Blalock-Taussig shunt may be limited by the development of stenosis of the shunt. Balloon dilatation oftenis unsuccessful due to recoil of the vessel. We report the case of a 22-year-old man with a stenosed Blalock-Taussig shunt who was successfully treated by the implantation of a balloon expandable stent.
Normal values for cardiac and great arterial dimensions in premature infants by cross-sectional echocardiography
Authors: Imai Toshiro , Satomi Gengi , Yasukochi Satoshi , Harada Yorikazu , Takeuchi Takamasa , Gotoh Hirohisa , Sakamoto Takahiko 
Published: August 2008

AbstractThe number of neonates who undergo intracardiac repair for congenital heart disease has increased in recent years. In considering appropriate surgical options in such circumstances, normal values for various cardiovascular dimensions are needed. We measured 19 parameters for the heart and great arteries (four valves, pulmonary tree, aortic arch, ascending and descending aorta, ventricular septum, left ventricular internal and posterior wall dimensions) using cross-sectional echocardiography in 55 premature and full-term infants (ranging in gestational age from 23 to 41 weeks, in body weight from 543 to 3966 g). The increase in each dimension correlated closely with body weight (r=0.62 to 0.87) and was found to follow a linear regression. The diameter of the isthmus was found to be smaller, and the size of mitral valve annulus larger, than previously published values.
Cytotoxic effects of cardioplegic solutions and cytoprotective effects of insulin on immature cardiac myocytes during hypothermic preservation
Authors: Orita Hiroyuki , Fukasawa Manabu , Uchino Hideaki , Uchida Tetsuro , Shiono Satoshi , Washio Masahiko 
Published: August 2008

AbstractThe purpose of this study was to evaluate the functional and biochemical effects of cardioplegic solutions on immature cardiac myocytes incubated under hypothermic conditions. In addition, the effects of insulin as an additive were evaluated in each solution. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for four days; 12.5 x 105myocytes/flask were then incubated at 4 °C for three, six and 12 hours in three types of cardioplegic solutions—glucose-potassium solution (glucose: 50 gm/l, NaHCO3: 20 mEq, KCl: 20 mEq), lactated Ringer's solution (KCl: 20 mEq) and St. Thomas' Hospital solution. After each hypothermic incubation, enzymes were measured in the incubation solutions. The myocytes were then cultured for an additional 24 hours at 37 °C to evaluate the recovery of the myocyte beating rate. In the Ringer's group, the recovery ratio of the myocyte beating rate was complete at three hours, then decreased to 48.8 percent of control (beating rate prior to hypothermic incubation) at 12 hours. The glucose-potassium and St. Thomas' groups had significantly lower recovery ratios than the Ringer's group, beginning at three hours (63.4, 72.9, 95.6 percent, respectively). Release of enzymes (CPK and LDH) in the Ringer's group gradually increased and at 12 hours was 29.0 mIU/flask and 260.0 mIU/flask, respectively. The St. Thomas' group, in contrast, had significantly increased values for CPK at 12 hours to 116.0 mIU/flask, and the greatest increases of both enzymes were observed in the glucose-potassium group at 12 hours (CPK: 115.5, LDH: 1163.9). By addition of 20 IU/l insulin, marked improvements were observed in the Ringer's and glucose-potassium groups both functionally and biochemically. Thus, the lactated Ringer's solution had the least cytotoxic effects that might be suitable for a basic solution of various cardioplegic solutions during the neonatal period, and insulin may have beneficial effects on immature myocardium under hypothermic conditions.
Double orifice left atrioventricular valve—diagnosis and management of an unexpected lesion
Authors: Brieger David B. , Ward Cameron , Cooper Stephen G. , Nunn Graham R. , Cartmill Timothy B. , Sholler Gary F. 
Published: August 2008

AbstractDouble orifice left atrioventricular valve is an uncommon condition. This paper describes 10 consecutive patients with the anomaly encountered over 20 months. Diagnosis was assisted by cross-sectional echocardiography and supplementary color Doppler, often requiring non-standard views and a high index of suspicion. There were three anatomical variants—those in which the orifices were equal in size (three of 10 patients), those in which they were unequal and associated with an atrioventricular septal defect (four of 10 patients), and those in which they were unequal in the absence of an atrioventricular septal defect (three of 10 patients). The unequal orifice in both anatomical situations was frequently complicated by valvar regurgitation (six of seven patients). Conservative repair was possible in three of the four patients requiring surgery to the left atrioventricular valve. This condition should be thought of more often in the differential diagnosis of left atrioventricular regurgitation in childhood.
Mycotic aneurysm of the pulmonary trunk in a patient with valvar pulmonic stenosis
Authors: Abbag Fuad , Galal Omar 
Published: August 2008

SummaryA seven-year-old patient with severe valvar pulmonary stenosis developed a mycotic aneurysm of the pulmonary trunk, which was followed closely with echocardiography. The aneurysm increased rapidly in size over a period of three weeks and required surgical removal.