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J L Andrade

Publications and source records attributed to J L Andrade.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Pulmonary artery pressure evaluation in adults by Doppler echocardiography].

PURPOSE: To assess the role of pulsed Doppler echocardiography (PDE) in the indirect assessment of pulmonary artery (PA) pressure (P), analysing the pulmonary velocity blood flow curves (PVBFC) profile. PATIENTS AND METHODS: Sixty-one adults with several kinds of heart disease were submitted to heart catheterization to obtain PAP (systolic, diastolic, mean), and other hemodynamic variables. A PDE examination was performed in all to obtain the PVBFC at the level of the pulmonic annulus. Qualitative features of the curve were analysed (morphological pattern, presence of pulmonic regurgitation) as well as quantitative data (acceleration time = AT, right ventricle ejection time = RVET index, AT/RVET index AT corrected for heart rate = ATC), which were compared to the invasive measurements. RESULTS: An abnormal rapid acceleration of the PVBFC, with triangular configuration, was noted in patient with pulmonary hypertension (PH), in contrast to the dome-like shape of the PVBFC in normal PAP. Pulmonary regurgitation was more frequent (p less than 0.05) in patients with severe PH (mean PAP greater than or equal to 40 mmHg), comparing with patients with PAP less than 40 mmHg. Inverse linear correlations were observed between AT and mean PAP, particularly when sinus rhythm was present (r = 0.89; p less than 0.05) excluding patients with atrial fibrilation (19 cases). CONCLUSION: PDE is an useful and noninvasive method for indirect evaluation of PAP in adults, especially during stable sinus rhythm, in heart rate range from 60 to 115 bpm.

Adolescent↗
PubMed1991

[Systemic-pulmonary shunts in congenital heart diseases with decreased pulmonary blood flow: critical analysis of the surgical techniques and immediate results].

PURPOSE: To evaluate immediate postoperative results in children with congenital heart disease and decreased pulmonary blood flow who underwent a systemic to pulmonary shunt. PATIENTS AND METHODS: Sixty-four patients underwent surgery, 46.8% (30) of them males with ages from 1 day to 17 years old. They were divided in three groups: I--13 pts (20.3%) who underwent classical Blalock-Taussig (BT) shunt; II--46 pts (71.8%) who underwent modified BT shunts, 34 of them with polytetrafluoroetylene (PTFE) and 12 of them with umbilical vein shunts; III--5 pts (7.8%) with central anastomosis that were made with three different types of graft; 3 PTFE, umbilical vein and bovine mammary artery in one each. The simultaneous procedures were: section and suture of PDA--2, closure of systemic-pulmonary collaterals--3, pulmonary valvotomy--3, right ventricular outflow patch--3, pulmonary branch stenosis (enlargement)--2. RESULTS: In group I there were 4 (30.7%) closures, with two immediate reoperation and a total mortality of 30.7%. In group II there were 4 closures (8.6%) and two reoperations with a mortality of 15.2% (7 cases). In group III there was one graft closure and an overall mortality of 80% (4 pts). When analysing deaths due to the shunt itself the mortality rate was respectively 15.3%, 8.6% and 40.0%. CONCLUSION: Modified BT operation was performed most frequently in our service; it was associated with less closure and mortality than the other types of shunt. It is considered our first alternative for a systemic-pulmonary shunt.

Adolescent↗
PubMed1990

[Developement and quality control of a radioimmunoassay for measurement of endogenous digoxin].

It has been suggested that sodium renal excretion is regulated, at least partially, by a factor with natriuretic properties called digoxin-like factor (DLF). As this substance crossreacts with digoxin antibodies, it was measured with a radioimmunoassay used to determine exogenous digoxin. Methodological conditions and quality control to determine DLF in plasma and urine have been established. Good correlation coefficients in specificity as well as dilution studies were obtained. Within--and between--assay coefficients of variations indicate good reproducibility. Moreover, changes in plasma DLF levels were detected in patients with cirrhosis or with renal failure, diseases which thrive on alterations in salt and water metabolism. In conclusion, this radioimmunoassay method for measuring DLF may be useful to investigate the role of this factor in several physiological and pathological conditions.

Adolescent↗
PubMed1989

[Fascicular block of the His bundle: critical approach for its identification].

The correct identification of the left and right fascicles blocks of the His bundle will permit to explain different patterns of the ECG and VCG. The differentiation between the right peripheral bundle branch and the left bundle branch division is not only important in anatomic and physiologic grounds, but also in a clinic viewpoint. So, trying to refine the diagnostic criteria and improve the recognition of these intraventricular conduction disturbances, we developed this study. Eighty five patients were evaluated and divided into two groups. Group I included 65 patients with cardiac disease; group II consisted of 20 normal subjects taken as a control. Some classic ECG and VCG criteria were tested as well as new ones. We confirmed the significance of the S2/S3 relation to distinguish the right superior divisional block (RSDB) from the left anterior hemiblock (LAH), and added some new criteria: 1) C morphology in horizontal plane (HP) to the right divisional block (RDB); 2) assessment of aVL lead to separate RSDB from LAH--qR pattern in the last, and different one to RSDB; 3) the qR' pattern in L2, L3 and aVF leads associated with left ventricular hypertrophy (LVH) pattern screened the left posterior hemiblock (LPH). We found no significance in R3/R2 relation to the right inferior divisional block (RIDB). Similarly to what happened to the left bundle branch block in the 70's decade, we expect that an adequate assessment of the RDB can permit a better understanding of its real clinical value.

Bundle-Branch Block↗
PubMed1987

Aortic and mitral discontinuity with congenital subaortic aneurysm and normally connected great arteries: echocardiographic diagnosis in life.

A newborn with preductal coarctation and ventricular septal defect had a subaortic aneurysm which protruded into the left atrium causing intractable pulmonary oedema. The subaortic aneurysm was congenital. It was clearly identified by cross-sectional echocardiography which, in serial studies, showed it to be increasing in size. Predisposing to its development was the wide area of aortic and mitral discontinuity in association with the concordant ventricular connexion of the great arteries. The child remained in worsening pulmonary oedema after relief of the coarctation and banding of the pulmonary trunk and died after attempted relief of the left atrial obstruction.

Aortic Aneurysm↗
PubMed1986

Echocardiographic routine analysis of the coronary sinus by an apical view: normal and abnormal features.

The echocardiographic aspects of the coronary sinus have not received much attention in the literature. In the few published articles about anomalous venous connection to the coronary sinus, the parasternal long axis view has been suggested as ideal for its visualization. More recently, it has been suggested that the coronary sinus in normal hearts is best visualized from the apical transducer position. The purpose of this study was to assess the appearance of the coronary sinus from an apical view in a group of 400 consecutive patients with ages varying from 5 days to 80 years. In ten patients with persistent left superior vena cava, the coronary sinus was markedly dilated throughout its extension. All cases were confirmed either by angiography or surgery. In another three patients with Ebstein's anomaly studied postoperatively, it was observed that the coronary sinus was abnormally draining into the right ventricle below the prosthesis plane. These findings were confirmed by the surgical reports. The routine evaluation of the coronary sinus was better performed by an apical view, which provided detailed information not only of normal, but also abnormal anatomy of this segment of the heart. We speculate that it could be especially useful in diagnosing coronary sinus atresia and thrombosis, and coronary ostium atresia, as well as total anomalous intracardiac pulmonary venous drainage.

Journal Article↗
PubMed1983

Classification of the site of ventricular septal defect by 2-dimensional echocardiography.

Sixty-three consecutive patients aged 2 months to 27 years with simple ventricular septal defect (VSD) or the syndrome of Fallot's tetralogy were prospectively investigated with 2-dimensional (2-D) echocardiography to assess the accuracy of the method in defining the anatomic site of the VSD. Twenty-two patients were referred for surgery without invasive investigation. The anatomy was confirmed in all patients at operation. Two-dimensional echocardiography was reliable in identifying subaortic, inlet, small, moderate, and large subtricuspid, large subpulmonary, and most large central and apical muscular VSDs. Mistakes were made initially in distinguishing doubly committed subarterial defects from subaortic VSD because of difficulty in imaging the right ventricular outflow in short axis at the aortic root level, small subpulmonary defects obscured by prolapsed aortic cusp tissue, and small apical or outlet muscular VSDs because of difficulty in distinguishing true "dropout" from trabeculations. Other VSDs particularly muscular, were sometimes overlooked after another large VSD had been identified. Thus, identification of the anatomic site of VSDs by 2-D echocardiography is a reliable method that can replace invasive investigation in assessing the uncomplicated VSD before operation. Ventricular septal defects are classified as muscular or subvalvular and subdivided according to the valve to which the defect is related.

Adolescent↗
PubMed1983

Two-dimensional echocardiographic assessment of surgically closed ventricular septal defect.

One hundred twenty patients operated on for closure of a ventricular septal defect (VSD) had postoperative assessment by 2-dimensional echocardiography. The presence of persistent "drop-out" between ventricular septum (VS) and the periphery of the "patch" was considered a sign of detachment and residual shunt. Echocardiographic findings of intact VS or residual VSD were correlated with angiographic findings in 30 patients and with clinical signs in 90 patients. Minute shunts with increased flow ratios less than 1.5:1 were occasionally missed. Persistent small drop-out was sometimes wrongly diagnosed as residual shunt when the patch was in an angled position and in the early postoperative weeks when peripatch edema of the VS suggested drop-out. Thus, 2-dimensional echocardiography is a reliable method for assessing significant persistent ventricular shunts and intact VS after surgical closure of a VSD.

Echocardiography↗
PubMed1983

Aorto-left ventricular communication after closure. Late postoperative problems.

The long-term follow-up of six patients operated on for aorto-left ventricular communication has been reviewed in detail. All had residual aortic regurgitation after the initial repair of the defect. It was severe in four and required repeated reoperation in three with ultimate aortic valve replacement. The failure of early repair to solve the haemodynamic problem has provoked a reconsideration of the basic anatomy, of the surgical approach, and of the postoperative physiology of this anomaly. The so called "tunnel" is not a tunnel with length but should be considered as a localised breach at the insertion of the right coronary cusp. The localised aortic root dilatation at the site is a weakness that remains after closure of the tunnel leaving a poorly supported aortic valve and a weak root. Thus, the initial repair of the aorto-left ventricular communication must not only close the communication but reinforce, strengthen, and support the right aortic sinus in order to maintain cusp competence.

Adult↗
PubMedDate not supplied

Dobutamine stress echocardiography in anomalous left coronary artery.

The evaluation of left ventricular function with dobutamine stress echocardiography is described for the first time in a patient with anomalous left coronary artery from the pulmonary trunk during the preoperative and postoperative periods. This method demonstrated signs of myocardial ischemia that were not seen on the resting echocardiogram during the preoperative period and ventricular function recovery after surgical intervention.

Cardiotonic Agents↗
PubMedDate not supplied

Maintenance of midgut epithelial cells from Dendroctonus valens (Coleoptera: Scolytidae) in vitro.

This article describes the culture of epithelial cells from anterior and posterior midgut regions of adult Dendroctonus valens. Culture conditions were established, and cell adherence was improved by means of a new technique that allowed the cells to grow between two glass coverslips. Cytoplasmic projections occur as anterior midgut cells grow to confluence; these projections were not observed in cells of the posterior midgut. The optimal culture medium for the maintenance of these epithelial cells was Roswell Park Memorial Institute 1640 medium at 25 degrees C. Cells in Grace's medium died in 24 h. Cultures did not require CO(2) atmosphere, but culture development was favored by the microaerophilic environment and the dark conditions in which the cells were grown, between the coverslips.

Animals↗