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Biomedical subjects

F B Bessinger

Publications and source records attributed to F B Bessinger.

18 recordsLinked to original sources
PubMed1989

Acute angular origin of left coronary artery from aorta: an unusual cause of left ventricular failure in infancy.

An unusual congenital anomaly of the left coronary artery, consisting of ostial stenosis caused by an acute angular origin of the vessel from the aorta in an infant, is presented. This anomaly resulted in progressive myocardial fibrosis and development of left ventricular congestive heart failure. The clinical state mimicked anomalous origin of the left coronary artery from the pulmonary artery.

Coronary Vessel Anomalies↗
PubMed1985

Intravenous KCl supplementation in pediatric cardiac surgical patients.

A total of 31 pediatric cardiac patients (mean age 19 1/2 months) who required surgery for repair of various congenital heart defects were prospectively studied in the postoperative period to determine potassium (K) dose-response characteristics. All patients received supplementary K when the serum K was less than 4.0 meq/liter. A total of 100 administrations of intravenous potassium chloride (KCl) were evaluated. KCl, 0.5 meq/kg, was infused over 2 h by syringe pump. This infusion was repeated as necessary to achieve a serum K greater than or equal to 4.0 meq/liter. The KCl was administered in addition to the K in the patients' maintenance solution. Blood samples for serum K determination were collected 15-30 min before and after the KCl infusion. The mean K dose administered was 0.72 +/- 0.23 meq/kg. This produced a mean rise in serum K of 0.61 +/- 0.48 meq/liter. Of 100 administrations, 11 resulted in no change or a decrease in serum K. Four of 100 administrations resulted in serum K greater than 5.0 meq/liter. Intravenous KCl supplementation in a dose of 0.5 meq/kg administered over 2 h is safe and effective for pediatric postoperative cardiac patients. Serum K should be measured to monitor therapy, due to variable response.

Adolescent↗
PubMed1985

Combined techniques for double valve replacement in the infant.

A 6-month-old female infant was seen with heart failure secondary to severe aortic and mitral regurgitation. As a neonate the infant had undergone an aortic valvotomy for congenital aortic stenosis. Subsequently the infant had aortic and mitral regurgitation with an infarcted papillary muscle. Double valve replacement was carried out with the St. Jude valve. The first approach was by the Manouguian procedure with extension of the aortotomy out between the left coronary cusp and the noncoronary cusp. The posterior mitral apparatus was resected, and a 19-mm St. Jude aortic valve was sewn into the mitral position. Because the enlarged aortic valve annulus was still inadequate to accommodate a 19-mm St. Jude valve, a Konno procedure was carried out to enlarge the aortic ring anteriorly. Atrial, septal, and aortic repair and right ventricular outflow tract reconstruction were carried out with bovine pericardium. Bypass was carried out with standard techniques of hypothermia, aortic cross-clamping, and cardioplegia. Postoperative anticoagulation therapy was initially with aspirin and dipyridamole (Persantine); however, clotting of the mitral prosthesis necessitated treatment with urokinase and heparin, which completely resolved the clot. Sodium warfarin (Coumadin) therapy was then begun. One year postoperatively, the child is developing normally.

Animals↗
PubMed1978

Echocardiographic features of total anomalous pulmonary venous connection to the coronary sinus.

Six infants with anomalous connection of the pulmonary veins to the coronary sinus were studied with single crystal echocardiography. The posterior left atrial wall echo was identified by its continuity with the left ventricular posterior wall echo during a sweep from the left atrium to the left ventricle. In five of the six infants an echo-free space measuring 7 to 9 mm was identified behind the posterior left atrial wall; this space was thought to represent the common pulmonary vein. In four of these five, and also in the remaining infant, a highly mobile linear echo with a double wave form per cardiac cycle was recorded behind the posterior aortic wall and anterior mitral leaflet echoes. Echocardiographic contrast studies after the injection of saline solution into the coronary sinus disclosed that this additional echo was produced by the anterior wall of the coronary sinus. The anatomic connection of the pulmonary veins were established in each patient with pulmonary cineangiography. In four of the six patients all four pulmonary veins were connected to the coronary sinus by way of a common pulmonary vein; in the remaining two patients three of four pulmonary veins were connected to the coronary sinus, while the left upper lobe pulmonary vein was connected to the left innominate vein. The coronary sinus was greatly enlarged in each patient.

Cardiac Catheterization↗
PubMed1978

Echocardiographic differentiation of partial and complete atrioventricular canal.

Retrospective examination of echocardiograms was performed in 34 patients with persistent atrioventricular (A-V) canal who had undergone cardiac catheterization. Characteristic findings in 16 patients with partial A-V canal were lack of continuity of mitral and tricuspid valves, paradoxical interventricular septal motion, definite E and A waves of the mitral valve anterior leaflet (MVAL) echoes and late systolic anterior motion of the mitral valve. Eighteen patients with persistent A-V canal had an interventricular communication and were classified as having the complete form. They characteristically had continuous mitral and tricuspid valves, normal interventricular septal motion, disorganized MVAL echoes, and normal systolic mitral valve motion. Combining these findings allowed differentiation of 31 of the 34 patients (91%) as having partial or complete A-V canal. Determining the presence of a VSD from loss of interventricular septal echoes was unsatisfactory. The severity of mitral insufficiency could not be estimated from echocardiograms of our patients with partial A-V canal.

Echocardiography↗
PubMed1978

Silent unilateral pulmonary venous obstruction. Occurrence after surgical correction of transposition of the great arteries.

An 11-year-old girl was found to have completely obstructed left pulmonary veins eight years following corrective surgery for transposition of the great arteries. The patient was acyanotic and asymptomatic. Retrograde flow of arterial blood from the affected left lung accounted for an angiographic appearance that mimicked occlusion of the left pulmonary artery and resulted from a failure of systemic venous development. Pulmonary venous anatomy could only be demonstrated by pulmonary arterial wedge angiographic studies. This experience emphasizes that complete unilateral pulmonary venous obstruction may occur in an asymptomatic patient and underlines the importance of investigating pulmonary venous anatomy in any patient with gross inequality of the distribution of pulmonary blood flow.

Blood Pressure↗
PubMed1976

Alveolar rhabdomyosarcoma involving the heart. An echocardiographic, angiographic and pathologic study.

A 12-year-old girl, who had had an above-knee amputation of the left leg for a soft tissue sarcoma six years prior to this admission, presented with syncope, angina, and signs of aortic stenosis. Echocardiography demonstrated a mass arising from the interventricular septum with obstruction of the left ventricular outflow tract and aortic valve. Cardiac catheterization and angiography confirmed these findings. At operation, a tumor was found involving the interventricular septum. Histologically, it was an alveolar rhabdomyosarcoma, and it appeared similar to the previous tumor. The patient was treated by partial surgical resection, cytotoxic drugs and localized radiation therapy and has been followed by serial echocardiography.

Cardiac Catheterization↗
PubMed1975

Patent ductus arteriosus complicating respiratory distress syndrome.

PDA was diagnosed in 76 (19%) of 396 patients with RDS. Evidence of excessive pulmonary blood flow and CHF developed in 15 (20%). CHF was not recognized prior to 10 days of age in any patient. All 15 with CHF were initially managed medically. Seven improved; three died of other causes. Five patients who failed medical management were surgically treated; all survived operation, but only two were improved.

Autopsy↗
PubMed1975

Hypertensive pulmonary vascular disease associated with patent ductus arteriosus. Primary or secondary?

In an infant with patent ductus arteriosus and pulmonary hypertension, elevated pulmonary vascular resistance persisted following ligation of the ductus. Histologic examination of a pulmonary biopsy at two years of age and tissue obtained at autopsy at three years of age showed obstructive pulmonary vascular disease. The question as to whether the organic vascular lesions are secondary to the effects of the patent ductus or part of pulmonary hypertension cannot be resolved. The age of the patient favors a primary etiology.

Age Factors↗