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Biomedical subjects

L Van der Hauwaert

Publications and source records attributed to L Van der Hauwaert.

14 recordsLinked to original sources
PubMed1995

Serial cardiorespiratory exercise testing in patients with congenital heart disease.

Aerobic capacity of patients with different forms of congenital heart disease was serially evaluated in 79 patients and the evolution was correlated with the lesion and the level of daily activity. The patients were divided into six groups: patients with a small ventricular septal defect (VSD) with mini shunt (n = 14), mild pulmonary valve stenosis with gradient < 40 mm Hg (PS) (n = 12), mild to moderate aortic valve stenosis (gradient 36 +/- 17 mmHg) (AS) (n = 12), patients 4.7 +/- 2.1 years after repair of tetralogy of Fallot (PO-TF) (n = 16), patients 2.2 +/- 2.9 years after closure of a high flow/high gradient VSD (PO-VSD) (n = 13), and patients 2.6 +/- 1.7 years after Fontan repair (Fontan-PO) (n = 12). Aerobic capacity was assessed by determination of the ventilatory anaerobic threshold (VAT). VAT reflects the highest aerobic exercise level prior to a disproportionate increase of CO2 and ventilation relative to O2 uptake; it is independent of patient motivation. Data are expressed as percentage of normal O2 uptake at VAT, determined in 234 age/gender matched controls. The habitual level of physical activity was assessed by a standardised questionnaire. Aerobic capacity in all subgroups of patients, even with very mild defects, was at or below the lower limit of normal. Children left unrestricted from physical exercise (VSD, PS, PO-VSD) had no change over the study period. However, aerobic capacity of patients with medically imposed physical restrictions (AS) and significant residual haemodynamic lesions (PO-TF, Fontan) decreased with age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Reliability of subjective estimates of exercise capacity after total repair of tetralogy of Fallot.

Sixty-nine patients (age 10 +/- 3.5 years, median 9.7 years) operated on for tetralogy of Fallot, underwent exercise testing 5.1 +/- 2.5 years after total correction. Aerobic capacity was assessed by the ventilatory threshold method. After the exercise test, parents completed a validated standardized questionnaire to evaluate the habitual level of physical activity of their child. They were then asked to place their child into one of three groups, describing their child's activity level, compared to normals (below average, average and above average). In the average and above-average groups, 73% and 65% of the patients were misclassified when compared to objective exercise testing. However, in the below-average group, no misclassifications were found. Subjective estimates of activity level, and consequently exercise tolerance, were poorly associated with objective measurements of exercise performance in these patient groups. Our results question the reliability of self-reported estimates of physical activity level and consequently exercise capacity in children after surgical correction of tetralogy of Fallot.

Activities of Daily Living↗
PubMed1993

Apparent Greig cephalopolysyndactyly and sinus node disease.

We present the clinical findings and follow-up data from birth to 10.5 years in a boy with Greig cephalopolysyndactyly who, in addition, presents sinus node disease ("sick sinus syndrome"). The significance of the concurrence of Greig cephalopolysyndactyly syndrome, an autosomal dominant condition mapped at 7p13, and sinus node disease is discussed.

Abnormalities, Multiple↗
PubMed1992

Rheologic genesis of discrete subvalvular aortic stenosis: a Doppler echocardiographic study.

To determine whether morphologic structures or abnormal flow patterns predispose to pathologic proliferation of subvalvular tissue, 26 patients (mean age 19.8 +/- 10.3 years) were studied greater than or equal to 6 months after operation for isolated discrete subvalvular aortic stenosis. The aortic root diameter and the mitral-aortic separation were measured with sector echocardiography. Flow patterns in the left ventricular outflow tract of these patients and control subjects were evaluated with a color flow mapping system optimized for the detection of turbulence. All control subjects had laminar flow throughout systole in the left ventricular outflow tract. By contrast, turbulence originating well below the site where the shelf had previously been resected was observed in 20 (77%) of the 26 patients. In 16 of these 20 patients turbulence was caused by a ridge, which in 13 patients could be identified as the offshoot of a ventricular band. In four patients the turbulence was caused by malalignment of the muscular and membranous septum, resulting in protrusion of the muscular septum into the outflow tract. Except for the latter four patients, the aortic root diameter was 84 +/- 10% of values predicted by body surface area, with values in six patients falling below the third percentile (p less than 0.01). The mitral-aortic separation was 9.7 +/- 3.5 mm, values in 21 patients falling above the 97th percentile (p less than 0.001). These data support the theory that discrete subvalvular aortic stenosis may be caused by a chronic flow disturbance, preferably in a small and long outflow tract. Left ventricular bands, if reaching the outflow tract, may be a factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Abolishment of chronic volume overload. Implications for diastolic function of the systemic ventricle immediately after Fontan repair.

BACKGROUND: In patients with a univentricular heart, the chronic ventricular volume overload is acutely abolished by the creation of a Fontan circuit. This results in an immediate reduction of the ventricular cavity size but also in an inappropriate degree of ventricular wall thickness, at least in the early postoperative period. The implications for the diastolic properties of the ventricle are poorly understood. METHODS AND RESULTS: A chronic volume overload through a modified Blalock-Taussig shunt was created in 10 mongrel dogs. Six weeks later, the shunt was occluded percutaneously with a detachable balloon. The left ventricular end-diastolic dimension and posterior wall thickness were measured with transcutaneous echocardiography. Digitized high-fidelity pressure tracings were used to determine the time constant of isovolumic pressure decay, tau. The isovolumic relaxation time (A2-MVO) and time to minimal left ventricular pressure (A2-LVPmin) were recorded. All variables were followed up to 1 month after occlusion of the shunt. One hour after occlusion, there was an incomplete return to baseline values of the echocardiographic left ventricular dimension (+12 +/- 8% of baseline value, p < 0.01). Despite a 31 +/- 14% (p < 0.001) increase of the posterior wall thickness after removal of the volume overload, tau or ventricular relaxation showed no change from control values. In contrast, the early filling wave was blunted, suggesting diminished ventricular suction. A2-MVO (p < 0.01) and A2-LVPmin (p < 0.05) lengthened well above baseline values for up to 1 week after occlusion of the shunt. Over the following month, the volume-induced hypertrophy regressed, and indexes of early ventricular filling resumed control values. CONCLUSIONS: We conclude that early after removal of a chronic volume overload, the resultant increase of wall thickness is not associated with impaired relaxation but that viscosity and inertia caused by the increased mass-to-volume ratio will impair early ventricular filling.

Animals↗
PubMedDate not supplied

Results from an international survey of Kawasaki disease in 1979-82.

Kawasaki disease is a febrile illness of unknown etiology affecting mainly children younger than five years, 20% of whom develop coronary artery aneurysms. The disease was first reported in Japan, but case reports have come from several countries; epidemics apparently occur every two to three years. A committee of the International Society and Federation of Cardiology (ISFC) collaborated on an international, retrospective survey in mid-1983 through 1984, asking about Kawasaki disease cases seen in 1979-82 and their outcomes. Responses were received from 53 countries; reports from 20 countries indicated that no cases were seen in the years surveyed. Kawasaki disease did not always follow the Japanese pattern. An indication of 'epidemic' increases was found in some years in some countries. Recognition of Kawasaki disease varies considerably, but further educational efforts are likely to uncover additional cases, and intensive epidemiological efforts would be possible in a number of countries.

Child, Preschool↗
PubMedDate not supplied

The Noonan syndrome.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

Total correction of tetralogy of Fallot following palliation.

Fifty three patients with Tetralogy of Fallot were totally corrected following palliation. Intracardiac repair was not adversely influenced by a Blalock Taussig shunt or a Waterston shunt which did not produce kinking of the RPA. The results were less satisfactory after correction following a Potts shunt or a Waterston shunt with kinking at the site of the anastomosis.

Adolescent↗