bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of the bidirectional cavopulmonary shunt in patients under one year of age
Authors: Calderón-Colmenero Juan , Ramírez Samuel , Rijlaarsdam Maria , Buendia Alfonso , Zabal Carlos , Zarco-Martínez Ernesto , Attie Fause 
Published: August 2008

SummaryBetween January 1990 and March 1992, a bidirectional cavopulmonary shunt was performed in seven patients under one year of age for palliation of complex cyanotic congenital heart disease. Five cases had tricuspid atresia with a restrictive ventricular septal defect. One case presented with complete mirror imagery, right-sided heart, double inlet and double outlet right ventricle with pulmonary stenosis. Another case had isomerism of the left atrial appendages with common atrioventricular valve and double outlet right ventricle. All had a pulmonary arterial index greater than 250 mm/m2(Nakata index). Age and weights before surgery averaged five months (one to 11 months) and 5.6 kg (range 2.8 to 8.5 kg) respectively. Preoperative mean arterial oxygen saturation measured by cardiac catheterization was 60.05±14% and postoperative mean arterial oxygen saturation on room air was 79.85±6.03% (p<0.05). There were no deaths, although postoperative complications occurred in three patients, namely pleural effusion and pneumothorax. Mean follow-up was 10±4.2 months. The cardiothoracic ratio decreased in all cases. On subsequent echocardiographic studies with pulsed Doppler sampling, low velocity systolic-diastolic forward flow was registered in the pulmonary trunk. The velocity of flow increased clearly during inspiration. The bidirectional cavopulmonary shunt can be considered as primary palliation for complex cardiac malformations with restricted pulmonary flow independent of age and body weight.
Criteria for selection of balloon valvoplasty for treatment of aortic stenosis in neonates
Authors: Donti Andrea , Bonvicini Marco , Gargiulo Gaetano , Frascaroli Guido , Picchio Fernando M. 
Published: August 2008

SummaryIn 10 neonates with critical aortic stenosis who were treated with balloon dilation, we investigated retrospectively the predictive value for mortality of three echocardiographic parameters: early diastolic mitral valvar diameter, left ventricular end-diastolic diameter, and diameter of the aortic root. Valvoplasty was technically successful in each patient and the peak systolic ejection gradient decreased from 85±42 to 22±13 mm Hg, but clinical success was achieved in only six neonates, with four dying. The diameter of the aortic root was similar in survivors and non-survivors. The mitral valvar diameter and the left ventricular end-diastolic diameter, in contrast, were significantly smaller in non-survivors. The mitral valvar diameter and the left ventricular end-diastolic diameter, in contrast, were significantly smaller in non-survivors. The association of a mitral valvar diameter equal to, or less than, 9 mm with a left ventricular end-diastolic diameter equal to, or less than, 14 mm identified clearly all those who did not survive. In the future, we will recommend patients with these anatomical features for primary Norwood palliation. Neonates with a mitral valvar diameter equal to or greater than 12 mm and a left ventricular end-diastolic diameter equal to or greater than 17 mm, in contrast, are good candidates for balloon dilation. All our patients with these anatomical features survived and are doing well at follow-up (30±14.8 months). Simple echocardiographic measurements, therefore, can help in predicting outcome and choosing the best treatment in neonates with critical aortic stenosis.
Prospective study on a new therapeutic strategy for infants and children with aortic coarctation
Authors: Ino Toshihiro , Nishimoto Kei , Akimoto Katsumi , Ohkubo Mataichi , Yabuta Keijiro , Watanabet Mikio , Hosodat Yasuyuki 
Published: August 2008

AbstractThere is little information on the indications for balloon dilation angioplasty for aortic coarctation. To determine the indications for balloon dilation in aortic coarctation, we evaluated prospectively the outcome of children treated according to our therapeutic protocol. The protocol included patients with postoperative recoarctation and isolated native coarctation with risks for surgical repair as conditions for which balloon intervention was absolutely indicated, and native coarctation without a significant arterial duct as a condition possibly qualifying for balloon dilation. Patients with duct-dependent coarctation and diffuse hypoplasia of the aortic arch were not considered to require balloon intervention and were treated surgically. We entered 47 patients into this protocol between January 1988 and December 1993. In 21, dilation was performed successfully and provided significant relief of pressure gradients. The peak systolic pressure gradients across the coarcted site in native coarctation and postoperative recoarctation decreased significantly from 40±19 to 13±10 mm Hg (p<0.0001) and 38±24 to 14±75 mm Hg (p<0.01) immediately after the procedure, respectively. Similarly, the diameters of the coarcted site increased significantly from 3.8±1.8 to 6.6±2.43 mm (p<0.0001) and 4.6±1.9 to 6.0±2.0 mm (p<0.005), respectively. Five patients with native coarctation, and one with postoperative recoarctation, developed restenosis during the period of follow-up and were treated successfully with repeat dilation. It may be possible to change the therapeutic strategy for aortic coarctation with advances in the use of balloon dilation. Our protocol for this technique appears to be reasonable, but further evaluation of its indications is needed.
Configuration of right ventricular pressure curves and infundibular stenosis after balloon pulmonary valvoplasty
Authors: Nakanishi Toshio , Tsuji Tohru , Nakazawa Makoto , Momma Kazuo 
Published: August 2008

AbstractWe evaluated the clinical significance of the configuration of right ventricular pressure curves after balloon valvoplasty in 35 patients with pulmonary valvar stenosis. Right ventricular pressures were measured with a fluidfilled catheter. We divided the subjects into two groups according to the pressure curves seen after balloon valvoplasty. In eight patients, two peaks were found in the curves, with the higher peak occurring at late systole. The remaining 27 patients had a single peak observed during early to mid systole. In all patients in the group with a single peak, the ratio of ventricular pressures decreased by more than half, and no residual narrowing was seen in right ventricular outflow tract, the diameter after valvoplasty increasing by more than half over the diameter before the procedure. In contrast, in five of eight patients in the group with double peaks in the pressure curves, the ratio between ventricular pressures remained higher than 0.5, and the diameter of the right ventricular infundibulum was reduced to less than half the diameter prior to balloon valvoplasty. In three of these patients with double peaked pressure contours, to whom propranolol was administered intravenously, the pressure configuration changed to one with a single peak and the ventricular pressure ratio fell to below 0.5. The degree of obstruction of the right ventricular infundibulum also decreased. These data suggest that a high right ventricular pressure and two peaks in the pressure curve with the higher peak at late systole after balloon valvoplasty indicate, first, the presence of a significant narrowing in the right ventricular outflow tract and, second, effective balloon valvoplasty.
Aortic run-off in children with arterial shunts or persistent arterial duct—characteristics of flow detected by Doppler techniques in the descending aorta
Authors: Ward Cameron J. B. , Sholler Gary F. 
Published: August 2008

AbstractFlow in the descending aorta was studied to characterize aortic run-off in patients with shunts at the arterial level. Pulsed Doppler examination of descending aortic flow was performed with simultaneous estimation of ratios of shunt-to-systemic flow (shunt flow ratio) at cardiac catheterization. We studied 14 patients with shunt-dependent circulations, eight patients with isolated persistence of the arterial duct, 11 normals and five patients immediately after umbrella occlusion of their persistent arterial duct. Parameters of diastolic flow were standardized to systolic parameters. The ratio of diastolic velocity to the time integral (velocity/time integral retrograde diastolic flow ÷ velocity/time integral systolic flow) ranged from 1×10−1−10.8×10−1. Shunt flow ratios ranged from 0.1−3.9. Pandiastolic retrograde flow was seen in 21 of 22 patients with shunts at the arterial level (the ratio was 0.1 in the remaining patient). No normal patient exhibited pandiastolic retrograde flow. Of the five patients undergoing ductal closure, three exhibited persistent pandiastolic retrograde aortic flow following effective occlusion. The ratio of diastolic velocity to the time integral correlated with the ratio of shunt flow (r=0.76, standard error 0.7). A diastolic velocity/time integral ratio of greater than 8.5×10−1 (sensitivity 67%, specificity 94%) selected patients with shunt flow ratio greater than two, and a diastolic velocity/time integral ratio of less than 5×10−1 (sensitivity 100%, specificity 94%) selected shunt flow ratios of less than 0.5.
The impact of severe congenital heart disease on physical and psychosocial functioning in adolescents
Authors: Bjørnstad Per G. , Spurkland Ingrid , Lindberg Harald L. 
Published: August 2008

AbstractA study was made of 26 adolescents, aged from 13 to 18 years, with different types of severe congenital heart disease, assessing their somatic condition and its impact on mental health and psychosocial functioning. Physical capacity was reduced, more pronounced in girls than in boys, along with an increased rate of psychiatric problems. Associations were found between physical capacity and psychosocial functioning, and between psychosocial functioning and chronic family difficulties. On the other hand, half the patients studied achieved fair function, both physically and with regard to their mental health. The degree of reduced physical capacity is an important etiological factor for impaired mental health in patients with congenital heart disease. This knowledge should be taken into account when dealing with this group of patients. A good social network seems to be a protective factor. It will probably be rewarding to give patients and their families not only an optimal medical follow-up, but also psychological, practical and financial support to improve or create such a network.
A morphometric study of the human fetal heart with perimembranous ventricular septal defects
Authors: Alvarez Luis , Aránega Antonia , Saucedo Roberto , Marchal Juan A. , González Amanda R. , Hernández María J. 
Published: August 2008

AbstractMorphometric methods were used to study hearts with perimembranous ventricular septal defects in 22 human fetuses and neonates weighing from one to 3.8 kg (2.221±0.852 kg). All specimens displayed concordant atrioventricular and ventriculoarterial connections, and all had perimembranous ventricular septal defects. A total of 17 interventricular parameters (nine in the right ventricle and eight in the left) were measured in each specimen. The values were compared with patterns of normality established by Rowlatt and her colleagues in hearts from 83 children ranging in age from birth to 15 years. These patterns were found to be less reliable than our own data from fetal and perinatal hearts from children ranging in age from birth to one month. Our morphological data, when appropriately interpreted, have immediate clinical and surgical applications in the treatment of fetal and perinatal cardiovascular disorders.
The combined use of amiodarone and class 1-C antiarrhythmic agents in children with intractable supraventricular tachyarrhythmias
Authors: Balaji Seshadri , Case Christopher L. , Gillette Paul C. 
Published: August 2008

AbstractCombined antiarrhythmic drug therapy is an occasionally necessary but problematic approach to the child with recalcitrant supraventricular tachycardia. There is little experience with the combined use of amiodarone and class 1-C agents (flecainide, propafenone and encainide) in children. To judge the efficacy and safety of this combination, we reviewed the case notes and results of investigation in all nine children with supraventricular tachycardia who received such therapy between 1984 and 1993. These nine children received combined therapy on 12 occasions. Five were infants with either atrioventricular reentrant tachycardia (n=3) or atrial ectopic tachycardia (n=2), and four were older children with atrial flutter seen after a Fontan procedure. Amiodarone was combined with flecainide on eight occasions, with propafenone on three occasions, and with encainide on one occasion. Both infants with atrial ectopic tachycardia were successfully controlled, but only one of three infants with atrioventricular reentrant tachycardia had successful control on combination therapy. In three of the four patients with atrial flutter, the combination was useful in reducing the number of arrhythmic episodes. Three infants suffered side effects. At electrophysiologic study to judge efficacy, ventricular tachycardia was induced in two patients (one infant and one Fontan patient), necessitating a change in the 1-C agent. One patient had skin rash due to flecainide and was placed on propafenone with success. One Fontan patient died of complications after an elective surgical procedure. No deaths occurred attributable to proarrhythmia. Thus, combined therapy with amiodarone and 1-C agents was found to be safe and fairly effective in children with certain types of intractable supraventricular tachycardia.
Ruptured aneurysm of the aortic sinus of Valsalva—difficulties in establishing the diagnosis
Authors: Holdright Diana R. , Brecker Stephen , Sheppard Mary 
Published: August 2008

AbstractAneurysms of the aortic sinus of Valsalva are rare and generally do not produce symptoms unless the aneurysm ruptures. When rupture occurs, the clinical findings depend to an extent on the site of the aneurysm and the cardiac chamber into which the aneurysm ruptures. We report a case of acute rupture of an aneurysm of the right aortic sinus, which was misdiagnosed as a ventricular septal defect. The clinical condition of the patient deteriorated rapidly, and transcatheter closure of the defect with an umbrella was associated with a fatal outcome.
Non-surgical reconstruction of the right ventricular outflow tract in acquired infundibular atresia
Authors: Rosenthal Eric , Qureshi Shakeel A. , Tynan Michael 
Published: August 2008

SummaryA 33-year-old woman known to have tetralogy of Fallot and a straddling tricuspid valve had bilateral systemic-to-pulmonary arterial shunts constructed at the age of six months. She subsequently developed infundibular atresia. Antegrade flow of blood from the right ventricle to pulmonary trunk was re-established by percutaneous laser perforation of the outflow tract, later followed by implantation of a stent.
Co-existence of quadricuspid aortic and pulmonary valves in an adolescent with rheumatic heart disease
Authors: Attie Fause , Zabal Carlos , López-Valle Hilda R. 
Published: August 2008

SummaryWe describe a male adolescent with co-existence of quadricuspid aortic and pulmonary valves and rheumatic heart disease. As far as we know, the presence of quadricuspid aortic and pulmonary valves in the same patient has not previously been described. Furthermore, the presence of rheumatic heart disease in this case makes it a true rarity.
Fistula between the right pulmonary artery and the left atrium—an unusual cause of cyanotic heart disease
Authors: Saatvedt Kjell , Stake Gunnar , Lindberg Harald 
Published: August 2008

AbstractA fistula from the pulmonary artery to the left atrium is a very rare congenital anomaly. The communication, almost exclusively arising from the right pulmonary artery, may give rise to a variety of symptoms with cyanosis as the predominant sign. To our knowledge only seven neonates have been reported with this anomaly, and five of them died postoperatively. We present another two neonates with such a fistula which was closed by simple ligation using a transsternal approach and cardiopulmonary bypass. Both patients had an uneventful postoperative course and are alive and well at the age of two and three years, respectively.
Horseshoe lung associated with anomalous pulmonary venous connection without pulmonary hypoplasia
Authors: Corno Antonio , Rosti Luca , Machado Ivan 
Published: August 2008

SummaryHorseshoe lung is an exceedingly rare congenital malformation, characterized by unilateral pulmonary hypoplasia together with a midline isthmus producing fusion of the tissues of the lower lobes. It is frequently associated with other cardiac and extracardiac anomalies. We report an infant with a variant of the horseshoe lung with partial anomalous venous connection of intracardiac type, ventricular septal defect, and persistent left superior caval vein. There was no pulmonary hypoplasia.
Successful treatment of leakage of serous fluid following construction of a polytetrafluorethylene central shunt
Authors: Masiello Paolo , Panza Antonio , Di Benedetto Giuseppe 
Published: August 2008

AbstractA central polytetrafluorethylene shunt was constructed in a 13-year-old boy after previous placement of a Waterston-Cooley shunt. Because of excessive leakage of serous fluid from the prosthesis, the boy required a second operation when the shunt was wrapped with absorbable collagen hemostat (Novacol FibrillarTM). The leakage stopped suddenly and the boy was discharged home after one week. Follow-up at four months shows no pericardial effusion and good function of the shunt.
Catheter closure of a residual aortopulmonary window after corrective surgery
Authors: Gildein H. P. , Mocellin R. 
Published: August 2008

SummaryApart from its original use for closing an open duct, the Rashkind ductal occluder has been used to close a variety of other defects. We report successful use of this device to close a residual aortopulmonary window persisting after corrective surgery had been carried out at the age of six months.
Recanalization of the arterial duct after initial total occlusion with a Rashkind umbrella
Authors: Bjørnstad Per G. , Smevik Bjarne 
Published: August 2008

AbstractWe report two patients in whom an initially completely closed arterial duct reopened 6–12 months after implantation of the Rashkind USCI®umbrella. We are not aware of any other reports of this occurrence. No obvious reason could be found for the recanalization.
Relation of left ventricular mass, volume and mass/volume ratio in children with aortic stenosis and/or insufficiency
Authors: Li Jennifer S. , Snider A. Rebecca , Zreik Hani , Armstrong Brenda E. , NeSmith James W. , Bengur A. Resai 
Published: August 2008

AbstractTo determine if symptoms and electrocardiographic abnormalities relate to left ventricular mass, volume, and mass/volume ratio in children with aortic stenosis and/or insufficiency, we examined 42 patients (aged 11±6 years) with cross-sectional and Doppler echocardiography. Clinical symptoms included exertional chest pain, shortness of breath, exercise intolerance, congestive heart failure and syncope. Electrocardiographic abnormalities were defined as the presence of both left ventricular hypertrophy and ST-T wave changes. Left ventricular volumes and mass were measured from echocardiograms using paired orthogonal apical views and biplane Simpson's and truncated ellipsoid models, respectively. The peak and mean pressure gradients across the aortic valve, the aortic valvar area, and the degree of aortic insufficiency were determined using echo/Doppler techniques. Eighteen patients (ages 10±7 years) had pure aortic stenosis (peak gradient 52±29 mm Hg, mean gradient 28±18 mm Hg, and valve area 0.86±.46 cm2/m2). Of these 18, seven had symptoms and seven had an abnormal electrocardiogram. Twenty-four patients (aged 12±6 years) had aortic stenosis and aortic insufficiency (peak gradient 36±18 mm Hg, mean gradient 19±9 mm Hg, 18 with 1−2+ aortic insufficiency and six with 3−4+ aortic insufficiency). Of these 24, 10 had symptoms and 10 had an abnormal electrocardiogram. When symptomatic and asymptomatic patients were compared using an unpaired Student's t-test, symptomatic patients with pure aortic stenosis and combined aortic stenosis and insufficiency had left ventricular hypertrophy and inappropriately increased mass/volume ratios. However, due to differences in left ventricular volume, symptoms and electrocardiographic abnormalities occurred at a higher mass/ volume ratio in pure aortic stenosis (2.7±0.6) than in combined aortic stenosis and insufficiency (1.7±0.3).
Modulation of the viability of immature cardiac myocytes by cardiac fibroblasts after hypothermic preservation—its values as a technique for evaluation of storage solutions
Authors: Orita Hiroyuki , Fukasawa Manabu , Uchino Hideaki , Fukui Kana , Kohi Minoru , Washio Masahiko 
Published: August 2008

AbstractWe evaluated the modulation of the viability of immature cardiac myocytes by cardiac fibroblasts after hypothermic preservation using three types of storage solutions—saline, University of Wisconsin solution, and MCDB 107 medium. Cardiac myocytes and fibroblasts were isolated from neonatal rat ventricles, and cultures of myocytes only or co-cultures with fibroblasts (myocyte: fibroblast 2:1) were established. On the fourth day of culture, the cultures were incubated at 4 °C for 6, 12, 18 and 24 hours in the different storage solutions. Enzymes were measured in the storage solutions immediately before and after hypothermic incubation. The cultures were then incubated for an additional 24 hours at 37 °C to evaluate the recovery of the myocyte beating rate. The myocyte beating rate in the co-culture groups showed significantly higher recovery ratios than the corresponding groups in which only myocytes were cultured. Complete recovery was observed in the group co-cultured in MCDB medium 24 hours after hypothermic incubation (83.4% of control—beating rate prior to hypothermic incubation) compared to the other co-cultured groups (15.4, 0%, respectively). Release of enzymes in the co-cultures was significantly suppressed compared to the cultured myocytes, and the greatest suppression was found after 24 hours of incubation in MCDB medium (CPK: 36.6 mIU/flask, LDH: 281.2 mIU/flask) compared to the other two co-cultured groups (CPK: 181.1, 281.1; LDH: 501.7, 773.2). Cardiac fibroblasts diminished myocytic injury after hypothermic preservation using various storage solutions, in which MCDB 107 medium showed the best overall protective effect. Thus, cardiac fibroblasts may play an important role in controlling myocytic viability under various hypothermic conditions.