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Biomedical subjects

D W Sapire

Publications and source records attributed to D W Sapire.

35 records · Page 2Linked to original sources
PubMed1979

Prolonged atrioventricular conduction in young children and adolescents. The role of increased vagal tone.

Prolonged atrioventricular (A-V) conduction is often an apparently normal finding in children with or without congenital heart disease. The mechanism is probably vagally mediated and appears to be benign in the majority of cases. Eleven children with first-degree and/or second-degree Mobitz type 1 A-V block were studied by intracardiac His bundle electrocardiography with atrial pacing. Six children had congenital heart disease with left-to-right shunts and 5 had normal cardiac anatomy. In all the patients studied, the A-H intervals were longer than normal. Wenckebach periodicity appeared at relatively long cycle lengths, and in 5 of the 6 patients in whom values could be determined, atrioventriculonodal effective and functional refractory periods were prolonged. With atropine and isoproterenol conduction intervals returned to normal. There was no tendency to develop echo beats with atrial extrastimuli, even when A-H intervals became markedly prolonged. The results of this study suggest that vagal tone plays a significant role in the prolongation of A-V conduction, even in congenital heart lesions that are known to be associated with a long PR interval.

Adolescent↗
PubMed1979

Dilatation of the descending aorta: a radiologic and echocardiographic diagnostic sign in arteriovenous malformations in neonates and young infants.

Eleven infants with arteriovenous malformations were admitted to St. Christopher's Hospital for Children between 1970 and 1978. Dilatation of the descending aorta was seen in the chest roentgenogram in 8 of the 11 patients. Echocardiography used in the two most recent cases revealed approximation of the descending aorta to the posterior left atrial and left ventricular wall in association with generalized cardiomegaly. The most frequently reported radiologic findings in infants with arteriovenous malformations are cardiomegaly, increased pulmonary vasculature and a widened superior mediastinum. These findings can accompany other congenital malformations of the heart, but the radiographic and echocardiographic findings of a dilated descending aorta appear to be more specifically associated with arteriovenous malformations in the neonate and infant.

Aorta, Thoracic↗
PubMed1977

Thrombosis of the left coronary artery in a newborn infant.

A unique occurrence of antenatal thrombosis of the left main coronary artery in a term infant is presented. The clinical features are indistinguishable from those of several other forms of congenital heart disease. The etiology of the thrombosis is unknown.

Autopsy↗
PubMed1975

Echocardiographic detection of aneurysms of the interventricular septum associated with ventricular septal defect. A method of noninvasive diagnosis and follow-up.

Spontaneous closure of a ventricular septal defect is frequently accompanied by the formation of an aneurysm of the membranous septum. The exact anatomic basis for such an aneurysm varies. Some arise from redundant tissue from the endocardial cushions or from adherence of the tricuspid septal leaflet to the defect; the origin of others cannot be determined. Echocardiographic studies in 17 patients with the diagnosis of ventricular septal defect revealed in 7 an aneurysm of the membranous septum that was later confirmed by angiography. In no patient was an aneurysm missed or erroneously diagnosed in the echocardiographic study. Echocardiography can be a useful diagnostic and prognostic tool in the long-term management of patients with ventricular septal defect.

Adolescent↗
PubMedDate not supplied

Subclavian-artery-to-innominate-vein fistula presenting with congestive failure in a newborn infant.

Congestive heart failure associated with intrathoracic arterio-venous fistula has not, to our knowledge, been reported previously in a newborn infant. A 2 X 4 mm arterio-venous fistula between the subclavian artery and innominate vein presented on the first day of life with heart failure and required surgical intervention. The uncommon location of the fistula produced potentially misleading radiologic findings. When the infant was 2 days old the fistula and a 12 mm diameter persistent ductus arteriosus were ligated; following this, heart failure regressed.

Arteriovenous Malformations↗
PubMedDate not supplied

True congenital aneurysm of the septum primum not associated with obstructive right- or left-sided lesions: identified by two-dimensional echocardiography and angiography in a newborn.

Aneurysms of the interatrial septum are unusual anomalies that have been demonstrated by (M-mode and 2-dimensional) echocardiography in patients with complex congenital heart defects. They have also been found at autopsy in adults without heart defects. Complications have resulted from these aneurysms in adults. A true aneurysm of the septum primum was an incidental finding identified by 2-dimensional echocardiography and angiography in a newborn with an atrial septal defect.

Cineangiography↗