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Biomedical subjects

E A Kiel

Publications and source records attributed to E A Kiel.

12 recordsLinked to original sources
PubMed2001

Transcatheter closure of patent ductus arteriosus with the Amplatzer duct occluder: short-term follow-up.

BACKGROUND: Transcatheter closure of the patent ductus arteriosus is a well established procedure. The objective of this study was to assess the effectiveness and the safety of the Amplatzer duct occluder. METHODS AND RESULTS: Occlusion of the patent ductus arteriosus was attempted in 23 patients. The median weight was 11.7 Kg (range, 5 kg - 42.4 kg) with a mean ductus diameter of 3.7 mm (range, 1.6 - 7.2 mm). The immediate closure rate was 86% with a closure rate of 100% at 6 months, 1 year and 2 years following device placement. There was one device embolization that occurred immediately following device placement. No patient had aortic narrowing or pulmonary artery stenosis following the procedure. CONCLUSIONS: The Amplatzer duct occluder is safe and effective in the closure of a patent ductus arteriosus up to 7.2 mm in diameter. Selecting a device at least 12 mm larger than the minimal ductal diameter can minimize embolization.

Alloys↗
PubMed1995

Emergent radiofrequency ablation of the AV node in a neonate with unstable, refractory supraventricular tachycardia.

Supraventricular tachycardia due to accessory atrioventricular connections in infants is usually well-tolerated. Rarely an infant can have supraventricular tachycardia that is incessant and refractory to medical therapy. We describe a patient with supraventricular tachycardia detected prenatally that caused severe cardiac dysfunction and hemodynamic instability after birth.

Atrioventricular Node↗
PubMed1987

Double-outlet right ventricle and severe systemic outflow tract hypoplasia.

Double-outlet right ventricle and severe systemic outflow tract hypoplasia comprises a subset of patients in whom total correction or palliation requires complex surgical procedures in the neonatal period. Our experience with 3 patients illustrates the difficulties associated with treatment and suggests possible surgical options for this otherwise lethal variant of the Taussig-Bing syndrome.

Aorta, Thoracic↗
PubMed1985

Cardiac decompensation following verapamil therapy in infants with supraventricular tachycardia.

Three infants with supraventricular tachycardia and congestive cardiac failure were given verapamil intravenously. In two of the infants, the rhythm was converted to sinus, but the third infant required direct current cardioversion. However, each infant demonstrated hemodynamic decompensation shortly after verapamil administration and required cardiopulmonary resuscitation. All three patients were stabilized and their tachycardia was controlled with digoxin. All three were doing well at the time of follow-up evaluation, and there was no evidence of structural heart disease. The risk of cardiac decompensation in infants with supraventricular tachycardia and congestive cardiac failure should be kept in mind prior to administration of verapamil. Alternative methods for conversion of supraventricular tachycardia should be considered.

Electric Countershock↗
PubMed1984

Prevalence of T-lymphocyte abnormalities in infants with congenital heart disease.

Thirty-two infants younger than 6 months with catheterization-proved congenital heart disease were prospectively examined for T-lymphocyte immunodeficiency (compared with adult and normal newborn controls). Cardiac lesions were separated into two groups: (1) "high-risk" lesions previously associated with T-cell abnormalities in DiGeorge's syndrome, and (2) the remaining "low-risk" lesions. Cardiac patients as a whole did not have significant abnormalities in T-cell rosette (TCR) percentages (mean +/- SE, 50.0% +/- 22%) or response to phytohemagglutinin (PHA) (72,243 +/- 38,388 counts per minute). However, a greater percentage of patients with high-risk cardiac lesions had abnormal TCR and PHA results than either the control or low-risk group, due to the inclusion of three infants with DiGeorge's syndrome. These findings suggest that newborn infants without evidence of DiGeorge's syndrome have normal T-lymphocyte function. Infants with high-risk cardiac lesions deserve a careful immunologic evaluation to avoid significant morbidity and mortality.

Cardiac Catheterization↗
PubMed1983

Cardiovascular manifestations in the Larsen syndrome.

The Larsen syndrome consists of a skeletal dysplasia with multiple joint dislocations and a characteristic facies. The basis of the abnormalities is felt to be a generalized mesenchymal disorder involving connective tissues. More than 80 cases have been reported in the literature with isolated reports of congenital cardiac septal defects and acquired abnormalities of the aorta and mitral valve. A case with marked aortic dilation and insufficiency as well as an aneurysm of the ductus arteriosus is presented. The aortic lesions are similar to those described in other connective tissue disorders, particularly the Marfan syndrome. Previous reports of ductal aneurysms have not revealed an association with connective tissue disorders, but have described a significant morbidity. In summary, patients with the Larsen syndrome are likely to have cardiac lesions similar to those classically associated with the Marfan syndrome; these patients deserve a careful investigation for cardiac anomalies. These aortic lesions may be as prognostically significant as cardiac lesions in the Marfan syndrome.

Aortic Valve Insufficiency↗
PubMedDate not supplied

Right heart pigtail catheter for selective angiocardiography.

The use of a modified pigtail catheter for right heart angiocardiography provides a safe method of obtaining good quality contrast studies of right heart lesions in infants and children. The catheter is also useful in left ventriculography in complete atrioventricular canals or other complex cardiac lesions.

Angiocardiography↗
PubMedDate not supplied

Arterial blood oxygen desaturation in infants and children during upper gastrointestinal endoscopy.

Arterial blood oxygen desaturation and abnormal electrocardiographic changes have been reported in adults undergoing upper gastrointestinal endoscopy. We studied 32 infants and children less than 12 years of age using pulse oximetry and continuous electrocardiography before, during, and after upper gastrointestinal endoscopy performed under intravenous sedation. Sinus tachycardia was the most common electrocardiographic change, and no clinically significant electrocardiographic abnormalities were induced by the procedure. Desaturation to less than or equal to 90% was found in 37.5% of the patients and was most commonly noted during the endoscopy procedure and in patients with cardiopulmonary disease. The desaturation was unpredictable because there was no correlation between desaturation and medication, tolerance to the procedure, weight, or age of the child. Some patients who subjectively appeared to tolerate the procedure well had significant desaturation. The use of pulse oximetry should be considered for all children undergoing upper gastrointestinal endoscopy.

Child↗