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Biomedical subjects

C Kratz

Publications and source records attributed to C Kratz.

At least 19 recordsLinked to original sources
PubMed1990

The evolving pattern of pediatric endocarditis from 1960 to 1985.

A diagnosis of endocarditis was made in 37 patients (three days to 21 years old) on the basis of the following: histology in 11; at least two positive blood cultures in patients with underlying cardiac disease in 22; less than two positive blood cultures, vegetations seen at echocardiography and a suggestive clinical syndrome in four. Twenty-six patients had primary endocarditis (17 with pre-existing cardiopathy, nine with normal hearts). The 11 others developed secondary endocarditis following heart surgery (early onset in six, late onset in five). The mean delay before diagnosis was prolonged 35.8 days. The clinical and laboratory findings included weakness in 36 patients, fever in 35, new or modified heart murmur in 14, positive blood cultures in 30, anemia in 12, high white blood cell count in 15, increased sedimentation rate in 14, and positive echocardiogram in 11. Etiologic agents isolated were: streptococci in 17, staphylococci in seven, miscellaneous germs in eight, and aspergillus in two. Mortality was greater in patients less than one year old, infected with aspergillus or without underlying heart disease. The present study suggests that childhood endocarditis remains uncommon but presents a poor prognosis with a mortality of 27% and a morbidity of 85.7%.

Adolescent↗
PubMed1988

Echocardiographic and anatomic findings in atrioventricular discordance with ventriculoarterial concordance.

Atrioventricular (AV) discordance with ventriculoarterial (VA) concordance is a rare form of congenital heart disease that consists of 5 different anatomic types. The salient therapeutic consideration uniting these 5 different anatomic entities is that anatomic correction can be achieved by an atrial switch procedure with closure of any associated septal defect. Three patients who had AV discordance with VA concordance are presented, with emphasis upon 2-dimensional echocardiographic diagnosis and surgical management. One of these patients had ventricular inversion with inverted normally related great arteries in situs solitus (i.e., [S,L,I]), thus representing a form of congenital heart disease that until now has not been documented anatomically. Although these are complex defects, multiple-plane imaging with 2-dimensional echocardiography was found to be extremely reliable in ascertaining the anatomy when a comprehensive, segmental analysis is applied. This approach includes determination of visceroatrial situs, ventricular loop and great arterial position and alignment. A surgical approach to closure of the ventricular septal defect through the left-sided infundibulum in isolated ventricular inversion afforded excellent exposure of the defect and avoided AV conduction block.

Aorta↗
PubMed1988

[Cardiac pacemakers in children. 15 years' experience].

Between 1971 and 1986, 85 pacemakers were implanted at the St Justine Hospital, Montreal, in 57 young patients (25 girls, 32 boys) then aged from one day to 23 years (mean 10.3 years). The patients were followed up for periods ranging from 15 days to 13.5 years (mean 4.5 years); 119 epicardial electrodes were positioned by thoracotomy in 52 patients and by sternotomy in 5 patients; the 85 pacemaker cases were placed in the left retroperitoneal cavity. The pacemakers were programmed in modes VVI (28), AAI (1) and DDD (28). The indications for pacemaker implantation were: complete atrioventricular block in 39 cases (postoperative 16, congenital 22, acquired 1), sinus node disease in 17 cases (postoperative 13, cardiomyopathy 3, normal heart 1) and Romano-Ward syndrome in 1 case. Operated heart diseases which required pacemaker implantation were: D-transposition of the great arteries in 17 cases (complete atrioventricular block 7, sinus node disease 10), tricuspid valve atresia in 3 cases (sinus node disease 3) and tetralogy of Fallot in 3 cases (complete atrioventricular block 3). Twenty-four patients underwent a total of 33 reoperations: 21 changes of battery, 12 changes of electrodes (6 for fibrosis, 6 for breakage). Only one patient developed infection of the pacemaker case. Altogether, the incidence of complications (infection and/or breakage) was low in this series, regardless of the pacing mode. Pacing in children is now an acceptable treatment with low risk provided the indications are well selected.

Adolescent↗
PubMed1979

Echocardiographic manifestations of persistence of the right sinus venosus valve.

The echocardiographic features of a neonate born with a persistent right sinus venosus valve are presented. Because surgical correction of this serious anomaly may be possible, the diagnosis should be made soon after birth. An echocardiogram suggesting a right atrial myxoma, an unlikely finding in a neonate, should be an important clue to the diagnosis of this anomaly.

Echocardiography↗
PubMed1978

Bringing it home.

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Community Health Nursing↗
PubMed1978

Medical nursing?

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Community Health Nursing↗
PubMed1978

[Hypoplastic syndrome of the left heart. Anatomo-echocardiographic correlations].

The findings on echocardiography and their anatomical correlations are reported in a group of 15 neonates with the syndrome of hypoplasia of the left side of the heart. The lesions which make up this syndrome could be defined precisely using echocardiography. In the major forms of this syndrome (10 cases), the correlation between the clinical and the echocardiographical findings was sufficient to establish the diagnosis, and to avoid the necessity for cardiac catheterisation without prejudice to the treatment plan. Characteristic findings in the major types were: --an aortic diameter less than or equal to 5 mm; --a left ventricle which was absent or had a diameter of less than 11 mm with an LV/RV ratio of less than 0.6; --a mitral valve which was absent or had a very abnormal form with multiple echoes. The differential diagnosis on echocardiography and the limitations of the method are discussed.

Diagnosis, Differential↗