bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissecting aneurysm of the pulmonary arteries—an unusual complication of congenital heart disease
Authors: Farrell Thomas M. , Cottrill Carol M. , O'Connor William N. , Boucher Dede , Noonan Jacqueline A. 
Published: August 2008

SummaryDissection of a pulmonary arterial aneurysm due to underlying pulmonary hypertension from congenital heart disease is uniformly fatal, but fortunately rare. Two such cases are presented, along with review of 24 other known cases published in the literature. Clinical presentation, guidelines tomanagement, and possible surgical intervention in the acutely dissecting patient are discussed.
The effect of left-to-right intracardiac shunting on the distribution of pulmonary arterial axial velocities determined by an intraluminal pulsed Doppler technique
Authors: Henry G. William , Criado Enrique , Lucas Carol L. , Ferreiro José I. , Ha Belinda , Carroll Sheri L. , Wilcox Benson R. 
Published: August 2008

AbstractThe distribution of axial velocities in the pulmonary artery must be determined to describe accurately the flow in the pulmonary artery. Previous studies in our laboratory have demonstrated the complexity of the velocity profile in the pulmonary trunk and the branch pulmonary arteries with normal and altered pulmonary blood flow. These findings have demonstrated a skewed, parabolic mean velocity profile in the pulmonary trunk under normal hemodynamic conditions. To determine the effect of left-to-right intracardiac shunting on the distribution of axial velocities in the pulmonary artery, an animal model of atrial and ventricular shunting was used. In both models, the distribution of mean axial velocities remained skewed and parabolic with the higher mean velocities recorded toward the anterior wall.
The morphology of aortopulmonary windows with regard to their classification and morphogenesis
Authors: Ho Siew Yen , Gerlis Leon M. , Anderson Christine , Devine William A. , Smith Audrey 
Published: August 2008

AbstractWe examined 25 heart specimens with aortopulmonary windows in order to review the variety of the lesion and its associated malformations. Unlike common arterial trunk, the aortopulmonary window involves a deficiency of the wall of the ascending aorta and that of the pulmonary trunk. The window was in proximal position in three specimens, intermediate position in three specimens, distal position in 16 specimens and was confluent in three specimens. The size of the window varied from 27 to 100% of the total length of the pulmonary trunk but size did not bear any apparent relationship to the position of the defect. The shape of the window was tunnel-like in one case. Of the 16 specimens with distal windows, the orifice of the right pulmonary artery arose from the aorta in seven specimens and was overriding the plane of the window in one specimen. The window occurred as an isolated lesion in four specimens. It was associated with interruption of the aortic arch at the isthmus in eight specimens and between the left carotid and left subclavian arteries in three specimens. A further three specimens had isthmal stenosis. Among the other associated defects were complete transposition (two specimens), tetralogy of Fallot (one specimen), and double outlet right ventricle (one specimen). A ventricular septal defect was present in six of the 25 specimens. The associated lesions found with aortopulmonary window are seldom encountered with common arterial trunk, suggesting these two arterial lesions have different pathogenesis and are not variants of the same entity.
Magnetic resonance imaging and transesophageal echocardiography—a comparative study in patients with congenital heart disease
Authors: Fletcher Scott E. , Fyfe Derek A. , Wiles Henry B. , McKellar Lisa F. 
Published: August 2008

AbstractTransesophageal echocardiography and magnetic resonance imaging have proved useful as noninvasive imaging modalities in postoperative patients with congenital heart disease, or patients with suboptimal transthoracic echocardiograms. Each modality has specific advantages. When both are of equal efficacy, magnetic resonance imaging is recommended because it is less invasive and more comfortable for the patient.
Reconstruction of the aortic arch in an adolescent female with complex congenital heart disease
Authors: Verma Rajiv , Danilowicz Delores , Colvin Stephen 
Published: August 2008

AbstractCoarctations of the aortic arch are rare, and when found, they are often associated with other complex congenital heart disease. An adolescent female with multiple coarctations of the aortic arch and ventricular septal defects underwent complete repair, entailing replacement of the aortic arch with a homograft and closure of the ventricular septal defects. The postoperative course was complicated by a tear in the homograft, possibly related to sepsis. After its resolution, her hemodynamic results remain excellent.
Double orifice mitral valve associated with subaortic stenosis—echocardiographic and anatomic findings
Authors: Johnson Thomas B. , Fyfe Derek A. , Swanger Stephen J. 
Published: August 2008

SummaryWe describe an infant with complex congenital heart disease, including double orifice of the mitral valve associated with complex subaortic stenosis. Transthoracic and intraoperative transesophageal echocardiography were used to define three distinct anatomic abnormalities, all potentially contributing to the subaortic obstruction. Stepwise surgical repair with transesophageal echocardiographic monitoring of hemodynamic function ensured optimal initial surgical results. Overwhelming postoperative complications ensued, however, and the patient died. Postmortem findings are also presented.
Accessory tissue tags arising from the mitral valve—an unusual cause of ventricular flow obstruction
Authors: Knight-Mathis Vicki , Cottrill Carol M. , Salley Robert K. 
Published: August 2008

SummaryAccessory atrioventricular valvar tissue is uncommon and, on occasion, has been identified as a cause of ventricular outflow obstruction. Accessory tricuspid valvar tissue has been reported to cause subpulmonary obstruction but infrequently has accessory tissue arising from the mitral valve been associated with obstruction. This paper reports two cases of subvalvar obstruction; the first in association with a ventricular septal defect causing subaortic obstruction and the other in association with congenitally corrected transposition and a ventricular septal defect, causing subpulmonary obstruction.
Balloon dilation recanalization of completely occluded modified Blalock-Taussig shunt
Authors: Galal Omar , Qureshi Shakeel A. 
Published: August 2008

SummaryA two-month-old boy, with complex pulmonary atresia, became increasingly cyanosed 10 days after a modified 5 mm right Blalock-Taussig shunt. There was no shunt flow on auscultation or Doppler echocardiography. Despite anticoagulation with heparin, the shunt remained occluded. After demonstration of the occluded shunt at angiography, a guide wire was easily passed through the occlusion and into the pulmonary artery. Balloon dilation was then successfully accomplished with a 6 mm diameter angioplasty balloon resulting in a patent shunt. The shunt was still widely patent at cardiac catheterization six months later.
‘Absent pulmonary valve’ syndrome associated with muscular ventricular septal defect and aneurysmal dilation of the ascending aorta
Authors: Kececioglu Dennis , Galal Omar , Abbag Fuad 
Published: August 2008

SummaryA rare association of ‘absent pulmonary valve’ syndrome, midmuscular ventricular septal defect and aneurysmatic dilation of the ascending aorta without pathology of the aortic valve is described in a 10-month-old infant. The diagnosis was established by echocardiography and angiography.
Absence of the arterial duct in a neonate with tricuspid atresia
Authors: Bubolz Beth , Case Christopher L. , Sade Robert M. 
Published: August 2008

SummarySummary Absence of the arterial duct has been reported in association with tetralogy of Fallot, with pulmonary stenosis or atresia, other complex cyanotic congenital heart diseases, and anomalies of the aortic arch but not, as far as we are aware, with tricuspid atresia. We report the clinical, surgical, and autopsy findings of a patient with tricuspid atresia whose initial clinical course was influenced by the absence of thearterial duct.
Coronary arterial patterns in complete transposition—;classification in relation to the arterial switch procedure
Authors: Amato Joseph J. , Zelen Jonathan , Bushong Joanne 
Published: August 2008

AbstractThe arterial switch operation has become the standard of surgical repair for total correction of complete transposition (concordant atrioventricular and discordant ventriculoarterial connections). A standard nomenclature for classification of the numerous anatomic relationships the coronary arteries may assume, however, has yet to be universally adopted. Inconsistent use of varied nomenclatures remain an obstacle to effective communication between physicians and surgeons. In this review we offer a unified nomenclature incorporating five important relationships: the configuration of the sinuses; their location; the configuration of the arterial orifices; the pattern of branching of the major coronary arteries; and the course of each artery.
Surgical treatment of ruptured aneurysm of the sinus of Valsalva
Authors: Qiang Guo Jia , Dong Zhu Xiao , Xing Xie Gan , Xiang Cao Jian , Di Xiao Ming , Lin Shen Zhong , Yu Wu Qing , Guo Li Zheng , Wei Shi Cheng , Hua Shang 
Published: August 2008

SummaryThis study reviews the results of the surgical management of 154 cases of ruptured aneurysm of the sinus of Valsalva. Of the patients0 73% were male, with an average age of 28 years. An associated ventricular septal defect was found in 40% and 23% had aortic valvar regurgitation. The aneurysms originated from the right coronary sinus in 79% and from the non-coronary sinus in the remainders. The aneurysms ruptured into the right ventricle in 73%, into the right atrium in 27% and into the left ventricle in less than 1%. Operative mortality was 4.5%. Long-term follow-up was achieved in 80% of patients, with a mean duration of 5.7 years and a range from two months to 29 years. Preoperative aortic regurgitation and preoperative functional class (NYHA III or IV) were both predictive of a worse long-term outcome. The optimal surgical approach was closure of the distal end of the fistula by direct suture together with reinforcement of the aortic sinus with a Dacron patch.
The modified Fontan operation in hearts associated with atrioventricular valvar atresia or common atrioventricular valve—neoseptation of the atriums using a right atrial flap
Authors: Sarioglu Tayyar , Paker Tufan , Türkoglu Halil , Akçevin Atif , Sarioglu Ayse , Yalçinbas Yusuf , Akpinar Belhan , Aytaç Aydin 
Published: August 2008

SummarySummary Between June 1988 and December 1992, six patients with dominant left and rudimentary right ventricles underwent orthoterminal correction with a modified Fontan operation in which the atriums were neoseptated using a flap constructed from the right atrial wali. Four patients had anomalous systemic venous connections. The operations were performed under direct caval cannulation, standard cardiopulmonary bypass, moderate hypothermia and cardioplegic arrest. After opening the right atrium with a longitudinal incision, the atrial septum was completely resected and the coronary sinus was cut back. The upper wall of the right atrial incision was brought down in such a way that the pulmonary venous atrium was drained into the dominant ventricle via the right-sided or common atrioventricular valve. This was followed by direct connection of the right atrium with its anterior wall reconstructed with pericardium to the pulmonary arteries. In one patient, a left superior caval vein draining to the left atrium was divided and anastomosed to left pulmonary artery. One patient died on the 12th postoperative day with pulmonary infection and sepsis, though he had no hemodynamic problem, and another died on the sixth day due to high pulmonary vascular resistance. The remaining four patients are progressing well at a mean of 23.4 months postoperatively with functional capacity of NYHA I-IT and sinus rhythm. Echocardiographic and angiocardiographic examinations during follow-up showed unobstructed pulmonary and systemic venous pathways in all. This modification of the Fontan operation seems a good alternative technique which creates a contractile left atrium with large enough dimensions and an unobstructed pathway for pulmonary venous flow.
The role of transesophageal echocardiography in the diagnosis and management of children and young adults with valvar diseases of the left heart
Authors: Leung Maurice P. , Yung Tak-Cheung , Chan Bobby , Chiu Clement , Lee Jan , Mok Che-Kueng 
Published: August 2008

SummaryThe role of transesophageal echocardiography in the diagnosis and management of left-sided cardiac valvar disease in children and young adults was assessed in terms of whether additional information (over transthoracic echocardiography) could be obtained, and whether the added information contributed to the better management of the patients. Between January 1991 to August 1992, 27 consecutive patients were studied. Their age ranged from 2.5 to20 years (mean 12.7), with body weights ranging between 12 and 60 kg (mean 35.6). Twelve of the children suffered from atrioventricular valvar disease, 13 had predominant aortic valvar lesions and two had mixed valvar pathologies. Additional information was obtained by transesophageal over that of transthoracic echocardiography in 18 children (67%). Transesophageal echocardiography clarified the etiologies or mechanism of valvar regurgitation in eight and seven children with atrioventricular and aortic pathologies, respectively. The technique correctly diagnosed severe mitral regurgitation underestimated by conventional technique, detected a missed eccentric aortic regurgitant jet and convincingly excluded bacterial vegetations in one case each. The investigation contributed to the better management of three children (11%) by providing information that allowed the appropriate choice of therapy. Transesophageal echocardiography, therefore, is a useful technique for the diagnosis and management of valvar disease of the left heart in children and young adults.
Absent right atrioventricular connection with the left atrium connected to a left-sided dominant right ventricle—anatomical and functional aspects in four cases
Authors: Ebaid Munir , Cavalini José Fernando , Aiello Vera Demarchi 
Published: August 2008

SummaryAbsent right atrioventricular connection, with the left atrium connected to a dominant left-sided morphologically right ventricle, is a rare situation. We report four cases, demonstrating the anatomical correlations and the clinical aspects needed to make the diagnosis. We also discuss the nomenclature of this important combination.
Cardiac masses in infants and children
Authors: Picarelli Dante , Nozar José Victor , Leone Rubén , Duhagón Pedro , Peluffo Carlos , Montenegro José Luis , Zuñiga Carlos 
Published: August 2008

SummaryWe discuss the management of 10 children with cardiac masses produced bytumors, thrombus or vegetations. The ages of the patients ranged from five days to nine years, only two being more than five years old. In all cases, the diagnosis was made by cross-sectional and Doppler echocardiography. Themasses were detected in the chambers of the right heart in five patients, in the left heart in four and on both sides in one patient. Five patients had predisposing factors. The clinical features were variable, but cardiac failure was the most common sign. All the patients underwent emergency surgery. Two patients died during the period of hospitalization and two in the late postoperative period. The six surviving patients are now asymptomatic.
Placement of endovascular stents for systemic venous obstruction after the Mustard operation
Authors: Abdulhamed Jassim M. , Yousef Saad Al , Ali Khan Mohamed A. , O'Laughlin Martin 
Published: August 2008

AbstractThree patients aged five years, five years four months and 14 years with obstruction of the systemic venous baffle following the Mustard operation were treated with balloon dilation and implantation ofstents. Balloon dilation of the baffle obstruction was performed initially in the first two cases. In the third case, the obstruction was complete and was punctured with atranseptal needle via a 6 French transeptal sheath followed by a balloon dilation. in all three patients, a Palmaz stent (Johnson & Johnson, Summerville, New Jersey, USA) was loaded onto the balloon catheter and delivered into the stenotic area. There was complete relief of obstruction in allcases. The first case developed supraventricular tachycardia at the time ofcatheterization, the morning following implantation of the stent and thentwo weeks after that. There were no complications with catheterization and noshort-term side effects in the other cases. These cases illustrate the use of endovascular stents in the treatment of baffle obstruction.
Congenital stenosis of pulmonary veins—failure to modify natural history by intraoperative placement of stents
Authors: Cullen Seamus , Ho Siew Yen , Shore Darryl , Lincoln Christopher , Redington Andrew 
Published: August 2008

AbstractCongenital pulmonary venous stenosis is a rare but important cause of pulmonary hypertension in infancy. The prognosis is uniformly poor, despite surgery and attempted balloon dilation of the narrowed veins. We performed intraoperative stenting of congenital pulmonary venous stenoses in two infants with initial clinical and hemodynamic improvement. Both patients subsequently died due to progressive pulmonary hypertension. Stenting of the pulmonary veins in this condition does not alter the natural history.
Successful surgery for a tuberculous left ventricular aneurysm in a child
Authors: Palweni Chapman W. , Harrisberg Jeffrey R. , Levin Solomon E. 
Published: August 2008

SummaryAn 18-month-old black child became ill one month prior to admission to our center. She was shown to be Mantoux positive, with evidence of cardiomegaly on x-ray. Echocardiography revealed a progressive enlarging left ventricular aneurysm—a finding confirmed at cardiac catheterization. She underwent successful resection of the aneurysm. Histology proved it to be tuberculous in origin. To our knowledge, this is the youngest patient reported with such an aneurysm, and the first to have survived surgical correction.
Double outlet right atrium and complete atrioventricular septal defect with abnormal findings of the biopsied lung
Authors: Suzuki Kiyoshi , Kikuchi Toshio , Mimori Shigekazu 
Published: August 2008

SummaryWe describe a rare type of atrioventricular septal defect with common atrioventricular orifice and malaligned atrial septum, the latter feature resulting in severe obstruction of the left atrial egress. Excision of the atrial septum and banding of the pulmonary trunk was performed at the age of thirteen months. Lung biopsy demonstrated marked medial hypertrophy with severe intimal fibrosis in the small pulmonary arteries and mild thickening of the pulmonary veins, considered contraindications for corrective surgery.
Pitfalls in the diagnosis of pulmonary arteriovenous malformations
Authors: Schiemmer Michael , Tulzer Gerald , Wimmer Maria 
Published: August 2008

SummaryA homogeneous opacity of the right upper lobe was found radiographically in a 15-month-old male child during investigation of an upper respiratory tract infection. Based on computerized tomography, the diagnosis was made of a solid tumor of the lung. At thoracotomy, dilated serpentine vessels were found on the surface of the right upper lobe, and the diagnosis of a large arteriovenous malformation was considered. Use of enhanced computed tomography without contrast and failure to note a reduced arterial oxygen saturation were two diagnostic pitfalls. The diagnosis of an arteriovenous malformation was confirmed by pulmonary angiography, and a right upper lobectomy was successfully performed.
Intrauterine thrombosis of the arterial duct
Authors: Uzun Orhan , Da Costa Philip E. , Gibbs John L. 
Published: August 2008

AbstractA hydropic neonate, born at 28 weeks gestation, died 45 minutes after birth. Autopsy showed an abnormally long and tortuous arterial duct which wasoccluded by laminated thrombus. The right heart chambers and the left ventricle were dilated, but there was no other structural cardiac abnormality. Apart from the abnormal ductal morphology, there was no evident cause for the intrauterine thrombosis of the arterial duct, which appeared to be the sole cause of fatal heart failure.
Psychological aspects of congenital heart disease
Authors: Gardner Freda V. , Angelini G. D. 
Published: August 2008

AbstractOutcome following the treatment of congenital heart disease continues to improve and interest has focused on reducing morbidity as well as mortality. One important aspect of this is the psychological effect of congenital heart disease and its treatment on both children and their parents. This review addresses the extent and nature of the psychological morbidity associated with this disease, in particular the impact of the diagnosis on the management of patient and family. The etiology of the high level of psychosocial morbidity remains poorly understood. Data from the 1960s concerned with pre-school and school-age children is now of little value given the dramatic changes in the treatment of congenital heart disease, which is now predominantly in the neonatal period. While theory from developmental and pediatric psychology may be usefully applied to this area, further research is required to define effective psychological care for patients and their families.