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Biomedical subjects

C Zamora

Publications and source records attributed to C Zamora.

At least 37 records · Page 2Linked to original sources
PubMed1983

Congenital absence of pulmonary valve leaflets.

Congenital absence of pulmonary valve leaflets is an uncommon condition usually associated with ventricular septal defect and an obstructive pulmonary valve ring. Twenty-one patients with these malformations are described. Twenty had an associated ventricular septal defect with ventriculoarterial concordance, and one also had transposition of the great arteries, ventricular septal defect, and obstructive pulmonary valve ring. The clinical features, cardiac catheterisation findings, and angiocardiographic results are presented. Twelve patients underwent cardiac surgery. Three patients died, one in the early, and the other two in the late postoperative period. The results, according to the surgical technique employed and postoperative cardiac catheterisation findings, showed that patients in whom the bioprostheses were implanted in the pulmonary position had a better late follow-up.

Adolescent↗
PubMed1980

Truncus arteriosus communis, an unusual anatomical variant of type I.

We present a case of type I truncus arteriosus communis characterized by the horizontal origin of the main pulmonary artery from the common trunk and by a winding course up to a total length of 11.5 cm to the point of bifurcation of the pulmonary artery. Other than cyanosis the patient had a normal clinical history, which was followed for 20 years. The length of the main pulmonary artery could be related to the lower site of the incomplete septation of the common trunk, and it seems that hemodynamic factors contributed to this unusual configuration.

Angiocardiography↗
PubMed1979

Qualitative radionuclide angiocardiography in the diagnosis of corrected transposition.

Seven patients with corrected transposition were studied by qualitative radionuclide angiocardiography. In four patients with situs solitus with apex on the left, the pulmonary artery was in a medial and posterior position, to the right of the aorta, with its root attached to the morphological left ventricle positioned on the right. The aorta arose from the ventricle placed on the left and had an anterior position. The ventricle located on the right has a triangular shape. In the case of situs solitus with dextroversion, the pulmonary artery was to the right of the aorta and had a right-to-left direction. The ventricle placed on the right was ovoid. In one single case of situs inversus with levoversion, the pulmonary artery was on the left, emerging from the morphological left ventricle placed on the left, and was ovoid in shape, while the aorta was on the right arising from the morphological right ventricle. In one case of situs inversus with dextrocardia, atrioventricular relationships were the same as in levoversion but the apex was on the right and the morphological left ventricle was triangular. Qualitative radionuclide angiocardiography is a simple and non-invasive method for obtaining morphological data for the precise diagnosis of corrected transposition.

Aorta↗
PubMedDate not supplied

[Diagnostic problems in visceral heterotaxia].

Due to the lack of uniformity in the criteria for formulating the diagnosis of the syndrome of heterotaxy, 12 cases with this abnormality were reviewed. The patients were selected on the following basis: symmetrical liver, changeable P waves in consecutive electrocardiograms, bronchial isomerism, hematological disturbances, anomalous relationship of the inferior vena cava and abdominal aorta, anomalous systemic and pulmonary venous drainage and complex cardiac malformations. The most frequent findings were: symmetrical liver, changeable P waves, anomalous systemic venous return, anomalies of the atrio-ventricular valves, particularly atrioventricular canal, aorto-cava juxtaposition, single atrium, anomalous pulmonary venous return, transposition of the great arteries and pulmonary stenosis. Less frequent anomalies were: atrial and ventricular septal defects, atrial isomerism, truncus arteriosus and partial distortion of the great arteries. The hematological disturbances as well as the radioisotope scanning of the liver and the spleen were of little help. Suggestions are given for the diagnosis of the syndrome and for the evaluation of present diagnostic procedures making necessary to use the data gathered with more precision.

Abnormalities, Multiple↗
PubMedDate not supplied

[Hemodynamics changes in children and adolescents with mitral valve replacement].

The authors analyze the pre and post-operative hemodynamic picture of 30 children and adolescents with mitral valve replacement, which corresponds to a group of 106 patients operated on from 1964 to 1974. At variable time periods, between 9 days and 48 months (average 28 months) from the valve replacement, a new catheterization was done. The majority of the studies were done in the period between 13 and 36 months. Of the 30 cases, 21 were carriers of the Starr-Edwards valve, and the rest of different types. The Starr-Edwards valves produced a lawering of the CVP from 23.0 to 11.0 mm. Hg (average values) whereas with the other types the average pre-operative figure was 21.0 and in the post-operative period it fell to 11.0 mm. Hg. In the group with SE valves, pre-operative SPP was an average of 64.3 and in the post-operative period it was 32.0 mm. Hg. In the cases of SE valves the pre-operative total pulmonary resistances were 12.3 units and post-operatively they fell to 3.7 units. With the other types of valves the pre-opeative average was 10.9 units and post-operatively it was 5.3 units. The hemodynamic results obtained over a period of time with valvular substitution were similar in the distinct types of valves. However in the SE the benefits resulted more constant. The value of radiological and electrocardiographic study in order to predict the early post-operative hemodynamic changes is discussed. These studies serve essentially for a long range evaluation, whereas the hemodynamic, and clinical improvement maintained a strict relationship. This work shows that, in children and adolescents, the presence of severe venous-capillary and arterial pulmonary hypertension, and the elevated pulmonary resistences, are not contraindications for surgical treatment. It equally proves the eficacy of the valvular replacement, when the surgical indication and the control of the patients are handled in the proper way.

Child↗
PubMedDate not supplied

[Persistent atrioventricular canal. Differential diagnosis of its variations].

The authors reviewed 40 cases of endocardial cushion defect, 26 with the complete type and 14 incomplete. In 34 cases the diagnosis was corroborated anatomically and in the rest through angiocardiogram. 2. There is a discussion of proposed classifications and in accordance with the abnormality of the endocardial cushions, they outline the anatomic varieties. 3. They show that the complete and partial forms have notable differences in their clinical picture and in the prognosis. Particularly when there are associated malformations. They also give a detailed account of the essential data for the differential diagnosis. 4. In those cases with the partial type, the electrocardiogram showed typical behavior, whereas, in those with complete type the results were related to the associated malformations. 5. The anatomy of the persistence of endocardial cushion defect is analyzed and taking this into consideration, the problems which occur with mitral valve replacement are discussed. 6. They emphasize the importance of an excellent angiographic study, which besides its diagnostic value, is fundamental in making a decision in regard to surgical selection and technique. 7. They show the high frequency of malformations which may coexist with Endocardial cushion defect and remind us that as long as we continue to wait for classic data, especially of tb electrocardiogram, and ignore the left ventriculogram to establish the diagnosis, an important number of cases will remain undiagnosed. 8. They show that in the incomplete type there habitually exits situs solitus and the associated malformations are rare and simple; on the other hand in the complete, situs ambiguo was proven in 69.2% and solitus in the rest, and in 92.3% there were complex associated malformations. They affirm that with the suspicion or the confirmation of the complete type consider the possibility of it is imperative to heterotaxia. If this exist and there is low pulmonary flow we should suspect the coexistence with tetralogy of Fallot.

Adolescent↗
PubMedDate not supplied

[Anatomo-clinical study of arterioventricular disorders].

The relationship of the great arteries with their respective ventricles in the three toncoconal morphologies depends on the orientation and rotation of the septum of the trunk and cone. In this work we study a case of crossed great arteries and another of partial distortion of the great arteries and one of transposition of the great arteries, all with arterioventricular concordance. In the anatomic and angiocardiographic examples an analysis is made of the arterioventricular relation in each type of arterial pedicle. We say that arterioventricular concordance exists with crossed great arteries when the pulmonary originated from the anterior infundibulum and its direction of right to left or from left to right in the frontal plane shows the spacial position of the anatomically right ventricle. In the transposition of the great arteries or in the partial distortion of the great arteries with arterioventricular concordance the aorta in the frontal plane shows the spacial position of the anatomically right ventricle. In the first group the aorta originates from the anterior infundibulum while in the second, from the posterior infundibulum. We review the examples of arterioventricular discordance diagnosed by necropsy or by laboratory studies. We study 5 cases; 1 with crossed great arteries, 3 with transposition of great arteries and the last with partial distortion of the great arteries. In the arterioventricular discordances with crossed great arteries in the lateral position, we observe that the pulmonary artery originates from the anterior infudnibulum whereas in the transposition, the aorta emerges from the anterior infundibulum. In the partial distortion of the great arteries the vessels are side by side or the aorta a little bit anterior to the pulmonary which is connected with the anterior infundibulum. In the posteroanterior incidence when there exists an arterioventricular discordance with crossed great arteries, the direction of the pulmonary does not indicate the spacial position of the anatomically right ventricle. In the same way, in the transposition and in the partial distortion of the great arteries the aorta does not indicate the spacial position of the anatomically right ventricle. On the basis of the evidence obtained by experimental and descriptive embriology, the morphogenetic processes responsible for the arterioventricular relations are presented. The anatomic specimens of each example is analyzed and the adequate parameter for the diagnosis of the distinct varieties of arterioventricular relations are presented. Finally a review is made of the few cases found in the literature and the differential diagsis between the concordant and discordant troncoconal malformation is established.

Angiocardiography↗
PubMedDate not supplied

[Atrioventricular conduction disorders following total correction of tetralogy of Fallot. Analysis of the electrogram of the bundle of His].

A study was made of the electric activity of the atrioventricular (AV) conduction system in basal conditions and with atrial stimulation in order to discover the type, severity and prognosis of the AV disturbance in cases of total correction of tetralogy of Fallot. The authors studied thirteen patients from the Paediatric Department of the National Institute of Cardiology who had undergone such surgery, 7 males, 6 females from 3 to 22 years old. All presented advanced RBBB and sinus rhythm; in the immediate postoperative period, one presented complete transitory A-V block which required a stand by pacemaker; in 2 cases there was a first degree AV block; in two other, LAH and LPH. In 5 cases atrial stimulation was made with single charges and progressive frequency. Measurements were taken at the customary intervals. In basal conditions, prolongation of the AH interval was only found in 2 patients, both with first degree AV block in the peripheral EKG; both patients were taking digitalis. The HV interval was longer than normal in 3 cases, with one of these showing also a lengthened AH interval. The atrial stimulation showed prolonged ventricular activation in 2 cases, one of them with normal basal HV interval. The authors conclude that this procedure permits: 1) The discovery of alterations in the AV conduction system which could not be found in a peripheral EKG. 2) Localization of the site of the lesion. 3) The finding of disturbances of the ventricular conduction by atrial stimulation. 4) Identification of those patients who, after a complete correction of tetralogy of Fallot, show a potential high risk of developing complete complete AV block or of sudden death. 5) The establishment of a real prognosis in these patients.

Adolescent↗
PubMedDate not supplied

[Study of ventricular function by means of echocardiographic quantification of the thickness/radius (h/r) ratio of the left ventricle in healthy subjects].

We studied 72 healthy subjects; 31 of them were adults and 41 children. By means of two-dimensional echocardiography we obtained a short axis view at the papillary muscle level of the ratio of the thickness (h) of the ventricular wall and the radius (r) of the cavity. We analysed ventricular performance determinants (pre-load, after-load and contractility). This non-invasive method gives information similar to pressure-volume curves. Thus, we propose it for the study of left ventricular overloads.

Adolescent↗
PubMedDate not supplied

[High frequency electrocardiography. Study of childhood ventricular repolarization in function of the depolarization process].

On an experimental basis the authors studied the process of repolarization and depolarization in high frequency electrocardiograms of 30 healthy children. The negativity of the T wave in V1 and V2 corresponds with the repolarization of the left ventricle and the positivity with that of the right ventricle. The vectors of repolarization of both ventricles were identified and found to be situated on a horizontal plane. In all tracings the electrical systole of the right ventricle was found to be greater than that of the left ventricle. The number of components of high frequency tracings in the intrinsecoid deflexion was greater on the right ventricle. The authors suggest that the high frequency electrocardiogram is a valuable procedure in clinical investigation.

Adolescent↗
PubMedDate not supplied

[Congenital intrapericardial parietal aneurysm of the left atrium. The electrocardiogram and echocardiogram as methods of diagnostic value].

A case of congenital intrapericardial aneurysm of the left atrium associated with functional mitral insufficiency is described; it was resected successfully. Clinical, radiographic, vecto-electrocardiographic, ecocardiographic and angiocardiographic findings are shown. Those are compared with those of other nine similar cases. The finding of qR or QS complexes in L-I and a VL in the electrocardiogram as a sign of left atrial enlargement and eco-fre space posterior to the left ventricular endocardium in the ecocardiogram is mentioned as useful data in the diagnosis of left atrial aneurysmal dilatation not previously reported. Considering that the surgical result is always good, it is concluded that the congenital intrapericardial aneurysm of the left atrium is a rare malformation which needs to be resected irregardless of the presence or absence of arrhythmias, embolisms or heart failure.

Child↗