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Biomedical subjects

I W DuBrow

Publications and source records attributed to I W DuBrow.

16 recordsLinked to original sources
PubMed1983

Pathologic measurements in aortic atresia.

Detailed autopsy measurements were performed in 13 infants with hypoplastic left ventricle and aortic atresia. Emphasis was placed on the evaluation of changes in the right ventricle, since its function may be important in determining surgical survival. Other important aspects were the ascending aortic and transverse aortic arch diameter, the presence of left atrial obstruction, and the size of the left atrium. The development of improved 2DE and Doppler imaging will permit preoperative and sequential evaluation of these parameters. Measurements performed in this study may serve as a basis for selection of infants for palliative surgery; these procedures are being undertaken more frequently in this hitherto fatal lesion. The measurements may also serve as a basis for noninvasive serial studies of these infants postoperatively.

Aortic Valve↗
PubMed1982

Prostaglandin E1 infusion in newborns with hypoplastic left ventricle and aortic atresia.

Prostaglandin E1 (PGE1) infusion was used in 7 infants with hypoplastic left ventricle and aortic atresia. Of 5 non-operated patients, 4 died shortly after the onset of PGE1 infusion and 1 survived for 30 hours. Of the infants who had surgery, 1 died during the operation and 1 survived for 38 days. In 6 infants, a transient metabolic and/or circulatory improvement could be demonstrated following PGE1 infusion. The lack of response of other infants may be related to the advanced deterioration of their clinical status at the time of study. In the light of recent surgical developments for infants with aortic atresia, support with PGE1 may nevertheless play an important role in their management if started early.

Abnormalities, Multiple↗
PubMed1979

Interrupted aortic arch operation in the first week of life: hemodynamic and angiographic evaluation one year later.

Operation for interrupted aortic arch (IAA) was successful in 2 infants during the first week of life. Both had postoperative hemodynamic and angiographic evaluation at one year of age. The first infant had a type A IAA, and prostaglandins were infused to prevent ductal closure prior to the insertion of a graft between the two ends of the interrupted aorta. The second infant had a palliative operation for type B IAA (pulmonary artery banding and graft from main pulmonary artery to descending aorta). These patients represent the ninth and tenth successful operations for IAA in this age group and are reported with long-term reevaluation.

Age Factors↗
PubMed1978

Right and left ventricular volume characteristics in common atrioventricular canal.

Right (RV) and left (LV) ventricular volume characteristics were determined from biplane cineangiography in 29 patients with atrioventricular canal (AVC). The patients were classified into two groups: group I (N = 19), uncomplicated AVC; group II (N = 10), AVC associated with RV obstruction. In group I, LV end-diastolic volume (EDV) [177 +/- 9 (SEM)% of normal] and RVEDV (125 +/- 9%) both were greater than normal (P is less than 0.001 and less than 0.01, respectively). LV ejection fraction (EF) was decreased (0.59 +/- 0.02, P is less than 0.001) but RVEF was normal (0.58 +/- 0.03). LV stroke volume index (SVI) was increased (48 +/- 3 ml/m2, P is less than 0.005), and RVSVI was normal (34 +/- 3 ml/m2). One patient had a markedly small RVEDV (45%). In group II, LVEDV and RVEDV were not different from normal (119 +/- 11% and 97 +/- 15%, respectively). LVEF was depressed (0.52 +/- 0.04, P is less than 0.001) and RVEF was normal (0.55 +/- 0.05). LVSVI was normal (38 +/- 5 ml/m2) and RVSVI was slightly decreased (29 +/- 4 ml/m2, P is less than 0.025). Two patients had a markedly small RVEDV (31%, 55%). EDV correlated with the pulmonary-to-systemic flow ratio (LV, r = 0.71; RV, r = 0.68). The data show that in most patients with AVC, LV and RV are enlarged in the uncomplicated form but not in the form with RV obstruction. LV function is more compromised than RV in both groups. RV hypoplasia is rare but was documented in both uncomplicated forms and forms with RV obstruction.

Heart Septal Defects, Ventricular↗
PubMed1978

Correlation of angiographic and autopsy left ventricular dimensions in children.

To evaluate controlled pressure coronary artery perfusion fixation of hearts as a means of obtaining meaningful cardiac measurements at autopsy, left ventricular (LV) autopsy measurements were correlated with in vivo end-diastolic (D) and end-systolic (S) angiographic (angio) values from biplane cineangiograms in the same patients. Mitral (MV) and aortic valve (AV) circumferences, LV equatorial circumference (Circ), spatial inflow and outflow lengths, wall thickness (W) and LV volume (Vol) were measured in 34 children with congenital heart disease. All dimensions showed significant correlation of angiographic and autopsy data from which linear regression equations were derived. The r values obtained were: MV 0.74; AV 0.85; D Circ 0.83; S Circ 0.82; D inflow 0.92; S inflow 0.90; D and S outflow 0.96; W 0.78; D Vol 0.92; S Vol 0.86. Mean angio and autopsy values were not significantly different for AV, S inflow, and S Vol. Autopsy values were lower than all D angio values and MV (P less than 0.001 for all), and higher than angio W and S outflow (P less than 0.001 for both). The data show that changes of LV morphology with this fixation method are predictable, making estimation of in vivo values from autopsy measurements possible using the derived linear regression equations.

Angiocardiography↗
PubMed1976

Bradycardia preceding apneic attacks in low-birthweight infants. The relationship and management.

Two premature infants had frequent episodes of prolonged apnea. The apneic spells were not due to the more commonly known causes of apnea in infancy, but were consistently preceded by severe bradycardia. Atropine or ephedrine produced favorable therapeutic results. Since severe bradycardia may be a cause of sudden death in infants, its recognition and treatment is important in the management of apneic infants.

Animals↗
PubMed1976

The influence of age on cardiac refractory periods in man.

As age is a determinant of cardiac refractory periods, this communication describes changes of refractory periods in an age continuum of infants, children and adults, 7 months through 77 years. Seventy patients with evidence of normal A-V conduction on scalar electrocardiogram were included. The patients were divided into six age groups: less than 2 years, 3-5 years, 6-10 years, 11-15 years, 16-30 years, and greater than 30 years. Extrastimulus technique was used to determine refractory periods in sinus rhythm or at longest cycle length assuring atrial capture, then at shorter cycle lengths. Cycle lengths (CL) for each age group were divided into ranges: CL1, 1,000-600 msec; CL2, 599-460 msec; CL3, less than 459 msec. Refractory periods at the three CL's within each age group were determined. Full recovery times of the A-V node within groups of children were determined. Statistical significance of the data was found by analysis of variance. The younger group tended to have shorter values than the older groups (F less than 0.05-0.001).

Adolescent↗
PubMed1975

Comparison of ejection phase indices of left ventricular performance in infants and children.

Ejection phase indices of left ventricular myocardial performance, mean velocity of circumferential fiber shortening (mVcf), mean systolic ejection rate (mSER), and ejection fraction (EF) were determined in 248 pediatric patients, utilizing left ventricular projections of cineangiograms. Heart rate significantly affected mVcf and mSER values in the normal group (r=0.74, 0.79, respectively). A method for heart rate compensation was presented, utilizing a ratio of actual value to expected normal value (A/E) for that heart rate. All indices were significantly lower in the myocardial disease group (12 patients) than in the normal (NI) group (55 patients), but only mVcf (A/E) gave complete separation. There was complete or nearly complete overlap of right ventricular volume and pressure load and left ventricular (LV) pressure load groups (20, 38, and 28 patients each) with NI. For LV volume load (95 patients) mVcf, and mVcf (A/E) mean values were low (P less than 0.025, less than 0.001, resp.). Patients with patent ductus arteriosus had high mVcf and mSER values (P less than 0.05, less than 0.025). MVcf (A/E) was superior to the other indices in identifying patients with depressed myocardial performance.

Adolescent↗
PubMedDate not supplied

Effect of palliative and corrective surgery on ventricular volumes in complete atrioventricular canal.

The effect of pulmonary artery banding (PAB) and intracardiac repair on ventricular volumes was studied in 35 patients with uncomplicated complete atrioventricular canal (CAVC). Right ventricular (RV) and left ventricular (LV) end-diastolic volumes (EDV), determined from biplane cineangiograms using Simpson's rule, were expressed as a percent of normal mean (% Nl) for body surface area; normal range (mean +/- 1SD) is equivalent to 75%-125% Nl. In preoperative studies (RV 26, LV 33), EDV averaged 149 +/- 51% and 184 +/- 50% Nl, respectively, P vs Nl less than 0.001 for both. In one of 26 patients, RV was very small (45% Nl), and one of 33 had a small LV (70% NI). In 13 patients studied post-PAB, RVEDV and LVEDV were lower than in the preoperative group (P less than 0.001) and averaged 114 +/- 40% and 126 +/- 52% Nl, respectively. In three of 13, RV was small (67% and 71% Nl) or very small (56% Nl). Three others had a small (71% and 67% Nl) or very small (56% Nl) LV. In serial pre- and post-PAB studies (RV 9, LV 11), EDV was increased or normal in all preoperatively. In seven of nine, RVEDV decreased, falling below normal range in three. In eight of 11, LVEDV decreased, falling below normal in three. Following repair, RV and LVEDV averaged 80 +/- 20% Nl and 126 +/- 23% Nl, respectively, in seven patients. Four of the seven had RVEDV below normal range. Two patients with a small ventricle had intracardiac repair and did well.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗