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Biomedical subjects

D G Human

Publications and source records attributed to D G Human.

At least 37 records · Page 2Linked to original sources
PubMed1987

Valve replacement in children.

The performance of the St. Jude prosthetic valve is reviewed in 81 patients aged 3 to 15 years. All 66 mitral (2 re-replacements), 8 aortic and 9 double valve replacements between February 1979 and August 1984 are included. The early mortality was 3.7% and actuarial analysis shows a 90% event free survival up to 5 years. Anticoagulant therapy was used in most patients, but comparison between groups receiving warfarin or aspirin or no therapy reveals no differences in the complication rate. The valve is well suited for use in children since the early degeneration seen with heterograft valves does not occur, and anticoagulation is not essential.

Actuarial Analysis↗
PubMed1987

Frontonasal dysplasia associated with tetralogy of Fallot.

Three children with frontonasal dysplasia associated with tetralogy of Fallot are reported. All cases had true hypertelorism and a median nasal groove with absence of the nasal tip. There was no mental deficiency. The facial anomaly is a sporadic, non-genetic interference of the normal development of the face. This is the first report of frontonasal dysplasia associated with a cardiac defect. Multifactorial inheritance of this syndrome is proposed.

Abnormalities, Multiple↗
PubMed1986

Endomyocardial biopsy technique in infants and small children.

Endomyocardial biopsy is performed when a histological diagnosis is required, e.g. in patients with cardiac failure due to unknown causes, in anthracycline toxicity, and to evaluate cardiac transplant rejection. Right ventricular endomyocardial biopsy has been carried out in 10 infants and small children (average age 14 months); the technical aspects of the procedure are discussed. Performed by a paediatric cardiologist endomyocardial biopsy in infancy is as safe as a routine cardiac catheterization.

Biopsy↗
PubMed1986

Rupture of tendinous chords during acute rheumatic carditis in young children.

Four children (age range 2 3/4-6 1/2 years) presented with acute mitral regurgitation due to rupture of the tendinous chords. All required urgent replacement of their mitral valve. Subsequent histological examination confirmed acute rheumatic carditis in all. Acute rheumatic carditis is a rare cause of ruptured tendinous chords of the mitral valve especially in young children. The difficulties in diagnosis and management are discussed.

Acute Disease↗
PubMed1985

A clinical and anatomical analysis of univentricular hearts.

Between January 1982 and May 1984 37 patients with a univentricular heart who had undergone two-dimensional echocardiography and cardiac catheterization were reviewed. The clinical, electrocardiographic, radiological and anatomical data are analysed and the controversy regarding this condition is discussed. The management and appropriate surgical procedures are presented.

Electrocardiography↗
PubMed1985

Left atrial myxoma in a 13-month-old infant.

The presentation, diagnosis and management of a 13-month-old child with a left atrial myxoma is described. The value of echocardiography in confirming the diagnosis is emphasized.

Echocardiography↗
PubMed1985

Coarctation and coarctation syndrome. A 5-year review.

The management of and results of treatment in 57 children with coarctation of the aorta are presented. In this series, 75% of the patients presented in the 1st year of life and 51% presented as neonates. Among the 50 patients who underwent surgery the total surgical mortality rate was 14%. The higher mortality in young infants is closely related to associated cardiac anomalies. We suggest that neonates with coarctation presenting with heart failure should be operated on early, as this significantly reduces the mortality.

Age Factors↗
PubMed1984

Peri-operative management and administration of anaesthesia in children with congenital complete heart block. A case report and review.

The clinical presentation and natural history of congenital complete heart block (CHB) differ from those of acquired third-degree heart block. Although perioperative prophylactic cardiac pacing is considered mandatory in patients with acquired CHB, it is not usually necessary in children with asymptomatic congenital heart block. The anaesthetist should be able to identify which patients require temporary perioperative pacing, and should modify his anaesthetic technique appropriately for patients who do not. An 8-year-old patient with congenital CHB who required emergency surgery for acute appendicitis is presented and the anaesthetic management, including the indications for pacing, is discussed.

Anesthesia, General↗
PubMed1984

Critical congenital heart disease.

We have reviewed the outcome in 94 infants who underwent diagnostic cardiac catheterization in the 1st month of life during the period 1976-1980. Eighty-three were shown to have congenital heart disease, and in nearly 50% further active intervention was attempted. Mortality directly related to catheterization was only 1%, although hospital mortality after surgery was 44%, and overall mortality was 53%. The prevalence of cardiac abnormalities encountered has remained unchanged over the past 10 years, but there has been a gradual improvement in prognosis. Factors contributing to this are discussed.

Cardiac Catheterization↗
PubMed1984

Treatment choice in acute rheumatic carditis.

A trial was conducted using sequential analysis by pairs to compare the efficacy of corticosteroids and salicylates in the treatment of acute rheumatic carditis. The results show a significantly favourable effect of steroid treatment both in clinical response and in reduction of the erythrocyte sedimentation rate. In addition, patients receiving steroids usually had a shorter hospital stay. The use of steroids in acute rheumatic fever with carditis is recommended.

Acute Disease↗
PubMed1983

Anomalous left coronary artery from the pulmonary artery - a therapeutic dilemma.

An anomalous left coronary artery from the pulmonary artery was diagnosed clinically in 12 patients (and confirmed angiographically in 11 and at autopsy in 1). A classic history of 'infantile angina' was obtained in only 1 patient, while the typical electrocardiographic findings of anterolateral ischaemia or infarction were present in 11 patients (92%). The majority had evidence of left ventricular dysfunction and mitral regurgitation. Three patients underwent surgical reimplantation of the anomalous left coronary artery into the ascending aorta. Two survive, but with persistent electrocardiographic changes and cardiomegaly. Nine patients, of whom 4 survive, were managed medically. Five of the 6 deaths occurred within 1 month of diagnosis. A conservative approach to surgical intervention is recommended, as surgery is unlikely to alter the ultimate prognosis.

Angiography↗
PubMed1982

The prolonged QT syndrome in childhood. Case reports.

Syncopal episodes in 5 children have been shown to be caused by the prolonged QT syndrome. The clinical features, pathogenesis and treatment of this syndrome are discussed, and the poor prognosis without treatment is stressed. The prolonged QT syndrome should be considered and an ECG performed in all cases of recurrent unexplained syncope in the paediatric age group.

Adolescent↗