Biomedical subjects

A Beitzke

Publications and source records attributed to A Beitzke.

120 records · Page 7Linked to original sources

PubMedDate not supplied

Perinatal manifestations of idiopathic long QT syndrome.

A neonate who had presented with sustained irregular heart rate during labor was found to have QT prolongation and repetitive polymorphic ventricular tachycardia (torsades de pointes) postnatally. Propranolol and propafenone successfully controlled the ventricular arrhythmias. Follow-up electrocardiograms and Holter records show persistent QT prolongation, bizarre T waves, and intermittent episodes of T wave alternans. On propranolol monotherapy the boy is thriving and completely free of ventricular arrhythmias. In the rare case of long QT syndrome in the neonate, early detection and therapy are mandatory to prevent ventricular arrhythmias and sudden death.

Anti-Arrhythmia Agents↗

PubMedDate not supplied

Extralobar sequestration with unusual arterial supply and venous drainage.

We present a case of extralobar pulmonary sequestration between the left lower lobe and diaphragm with an unusual arterial blood supply and venous drainage. Angiography revealed a large systemic artery arising from the left subclavian artery. The venous return paralleled this anomalous artery and drained into the left subclavian vein. This case illustrates the wide anatomic variability of such complex bronchovascular anomalies. Careful preoperative evaluation of both the arterial supply and venous drainage is important to avoid intraoperative complications. Angiography provides clear definition of these abnormal vascular structures, which is essential for appropriate therapeutic management.

Bronchopulmonary Sequestration↗

PubMedDate not supplied

Catheter-directed thrombolysis with recombinant tissue plasminogen activator for acute pulmonary embolism after fontan operation.

We report the case of a 3-year-old girl who presented with near-lethal pulmonary thrombembolism 3 weeks after an uneventful Fontan operation. Complete occlusion of the left lower lobe pulmonary artery had occurred together with a cerebral infarction. Recombinant tissue plasminogen activator (rt-Pa) was used for thrombolysis because of its short half-life and its clot-selective properties. To further minimize the systemic effects of rt-PA, local catheter-directed lysis was performed. A prolonged course of low-dose rt-PA therapy achieved complete lysis without side effects.

Catheterization↗

PubMedDate not supplied

Dissection of the descending aorta after balloon angioplasty of native coarctation.

A 12-year-old girl underwent successful balloon angioplasty for a waist-like native coarctation. The balloon size/coarctation diameter ratio was 3.3. Postdilatation angiography showed a small aneurysm at the coarctation site. On frequent review the patient remained symptom-free and normotensive. Recatheterization was performed 14 months after balloon aortoplasty, when angiography revealed a massive aortic dissection extending from the origin of the left subclavian artery to both iliac arteries. She underwent partial replacement of the thoracic aorta. Balloon angioplasty of a narrow waist-like native coarctation may lead to extensive wall dissection and should be considered critically.

Aortic Dissection↗

PubMedDate not supplied

Atypical Bland-White-Garland syndrome with stenosis of the origin of the left coronary artery: catheter intervention after mammary artery bypass stenosis and residual fistula to the pulmonary trunk.

A 16-year-old boy with anomalous origin of the left coronary artery from the pulmonary artery, Bland-White-Garland syndrome, underwent a mammary artery bypass grafting to the left coronary artery (LCA) together with closure of the stenosed origin of the left coronary artery. A residual LCA to pulmonary artery fistula and stenosis of the shunt at the implantation site developed that resulted in a dominant perfusion of the LCA from the right coronary artery. Interventional catheterization was performed with stenting of the LCA mammary artery anastomosis and subsequent coil occlusion of the residual fistula. After this intervention the LCA was exclusively perfused by the mammarian bypass with no residual leak to the pulmonary artery.

Adolescent↗

PubMedDate not supplied

[Coronary aneurysm in Kawasaki syndrome: incidence and prognosis].

Out of 10 pediatric patients with coronary aneurysms after Kawasaki-syndrome 9 were reinvestigated 1 to 9 years after their initial illness. Out of 21 aneurysms of all types and sizes 2 showed early and 1 late, silent thrombosis leading to myocardial infarction. 8 aneurysms regressed spontaneously and another 8 became smaller. The tendency to regress or to decrease in diameter war greatest in the group of patients with a low Asai-Score and initially small aneurysms. Myocardial infarction was only seen in the group of giant aneurysms (over 8 mm of diameter). A simple prophylaxis with anti-platelet agents does not seem to be adequate especially in over-sized aneurysms. Those should be prevented now by gamma-globulin therapy. If they occur, however, thrombosis should be prevented by the use of anticoagulants.

Angiocardiography↗

PubMedDate not supplied

[Trans-catheter closure of patent ductus arteriosus in childhood--an alternative to surgical ligature].

Transcatheter closure of a persistently patent ductus arteriosus (PDA) was successfully performed in four children using a Rashkind double disk umbrella device. Mean age was 5.1 +/- 1.5 (2.8 to 6.3 years) and weight 18.8 +/- 3.8 kg (14.1 to 22.3 kg). In all children the PDA was the only cardiac lesion and was diagnosed clinically and by means of continuous wave and color-coded doppler echocardiography. After angiographic measurement of PDA size the correlating device was implanted. The ductus was closed immediately in two children, whereas there was a residual angiographic shunt in the others. Echocardiography performed within 24 hours showed a minimal shunt only in one of these cases. The shunt had disappeared at the one month follow up study. We experienced none of the reported possible complications. Transcatheter closure of the PDA after the neonatal period seems to be a safe and effective alternative to surgical ligation as our early experience shows, and should become the procedure of first choice in these patients.

Angiocardiography↗

PubMedDate not supplied

[Purulent pericarditis during abscess-forming pneumonia].

The case is described of a 6 months old infant who developed purulent pericarditis during the course of pneumonia. Pericarditis probably developed in this condition by contiguous spread from the pleura. Diagnosis of impending cardiac tamponade was masked by the occurrence of massive unilateral empyema. The management of this condition is discussed by open surgical drainage. Real-time two-dimensional echocardiography is useful for diagnosis and surveillance in this disease.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Diagnosis of congenital AV fistula in childhood--report of a clinical case].

Pulmonary AV fistulas are rarely diagnosed in children. In the absence of cardiac malformations or chronic lung disorders, cyanosis is the most reliable symptom. The diagnosis is confirmed by a series of complementary investigations such as measurement of arterial blood gases, contrast echocardiography, cardiac radionuclid ventriculography and cardiac catheterization studies. These diagnostic procedures serve as a reliable background for any therapeutic decisions.

Arteriovenous Fistula↗

PubMedDate not supplied

[Pulmonary agenesis in partial trisomy 2 p and 21 q].

A case with bilateral cheilognathopalatoschisis, and dysplastic features agenesis of the left lung is reported. Complete absence of one lung is a very rare malformation and was due to our knowledge not reported in partial trisomy 2 p or 21 q.

Chromosomes, Human, 1-3↗

PubMedDate not supplied

[Incidence and etiologic factors of persistent ductus arteriosus in relation to the severity of idiopathic respiratory distress syndrome].

Out of 332 patients with a confirmed diagnosis of RDS, 214 were mechanically ventilated more than 48 hours and 118 less than 48 hours. The incidence of a hemodynamically active persistent ductus arteriosus (PDA) revealed a significant difference for both groups. (54% versus 4,2%). The distribution of PDA did not seem to correlate with birthweight but rather with the severity of RDS, defined by the duration of artificial ventilation. Between three selected groups of 214 patients with longterm ventilation (1. RDS-PDA with surgical ligation - 2. RDS-PDA with spontaneous closure - 3. RDS without PDA) we found significant differences only in the values of inspiratory pressures on mechanical ventilation. No significant differences were found in the time of exposure to high levels of oxygen, the fluid balance, and the application of furosemide.

Body Weight↗

PubMedDate not supplied

Continuous arteriovenous hemofiltration in infants.

Renal replacement therapy is sometimes necessary in small infants with acute renal failure or severe metabolic disorders. Of the available methods hemodialysis and peritoneal dialysis are not always feasible in small infants. We used continuous arteriovenous hemofiltration as renal replacement therapy in five small infants. This report describes the technique and efficiency of this new extracorporal treatment modality. Azotemia and hypervolemia can be controlled easily by spontaneous or suction supported arteriovenous hemofiltration. Furthermore it allows adequate parenteral nutrition in anuric infants and eliminates toxic products in amino acid disorders. Arteriovenous hemofiltration is well tolerated by small infants and can be performed in every pediatric intensive care unit.

Acute Kidney Injury↗