[Exploration of the left heart by retrograde arterial approach (Seldinger's method) in children and infants. 114 cases].
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Biomedical subjects
Publications and source records attributed to A M Worms.
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The differential diagnosis of the tetralogy of Fallot includes three main types of condition: 1) Malformations which differ from Fallot in their extent, such as interventricular communications of type IV and pulmonary atresia with an open septum. 2) Malposition of the large vessels with pulmonary stenosis (double opening in the right ventricle, complete or corrected transposition). 3) Malformations associating an intraventricular shunt and another type of pulmonary stenosis (double chambered ventricle, interventricular membranous and muscular communication, common atrioventricular canal, single ventricle). An analysis of the findings in angiographic images can provide precise differential diagnosis of these pseudo-Fallots.
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The "elfin facies", described by Williams and Beuren, is usually associated, beside mental retardation, with a supravalvular aortic stenosis and, more broadly, with multiple arterial stenoses. Other types of cardiac defects were described in this context, but the case reported by the authors is the first one with a tetralogy of Fallot. The hypothesis of widerspread histodysplastic lesions is discussed: the process may be early enough to alter the morphogenesis of the cardiac conus and to produce, more lately, the classical stenotic lesions of the arterial wall.
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