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Biomedical subjects

M Vorísková

Publications and source records attributed to M Vorísková.

At least 19 recordsLinked to original sources
PubMed1997

Long-term ventricular performance after intra-atrial correction of transposition: left ventricular filling is the major limitation.

OBJECTIVE: To establish the incidence of systolic and diastolic dysfunction of the right and left ventricle in a large cohort of patients after Mustard or Senning operations and to assess changes in the incidence on long term follow up. DESIGN: Postoperative case-control study using radionuclide ventriculography. Ejection fractions, peak filling rates, rapid filling periods and fractions, slow filling periods and fractions, and atrial contraction periods and fractions were studied. SETTING: Tertiary care centre, ambulatory and hospital inpatient care. PATIENTS: A convenience sample of 153 patients studied at median age of 6.9 years (median 4.4 years after surgery). In 99 cases another study was available at a median age of 15.3 years (median 13 years after surgery and 8.8 years after the first study). RESULTS: Respective incidences of dysfunction in the first and the second study were as follows: ejection fraction-right ventricle 7.8% and 8.1%, left ventricle 7.2% and 10.1%: peak filling rate-right ventricle 0% and 4.2%, left ventricle 14.3% and 29.5% (p < 0.05); rapid filling period-right ventricle 18.3% and 11.6%, left ventricle 30.2% and 30.5%; slow filling period-right ventricle 4.8% and 3.2%; left ventricle 11.9% and 23.2%; atrial contraction period-right ventricle 0.8% and 4.2%, left ventricle 15.1% and 26.3%; rapid filling fraction-right ventricle both 0%, left ventricle 82.5% and 79.0%; slow filling fraction-right ventricle 0.8% and 4.2%, left ventricle 37.3% and 30.5%; atrial contraction fraction-right ventricle both 0%, left ventricle 79.4% and 71.6%. CONCLUSIONS: The incidence of systolic ventricular dysfunction is 8% (right ventricle) and 10% (left ventricle) 13 years after surgery, without a significant increase over the eight year follow up. Diastolic filling is abnormal in up to 80% of patients and left ventricular peak filling rate deteriorates with time.

Adolescent↗
PubMed1990

[Anomalous origin of the right coronary artery from the pulmonary artery. Preoperative diagnostic finding in the aortopulmonary window].

A rare case of the abnormal origin of the right coronary artery is demonstrated in a two-year-old boy with an aortopulmonary window and subvalvular membranous aortal stenosis. The diagnosis was established by angiography before operation by injection of contrast substance into both great arteries. Surgical repair of the complicated defect comprised also derivation of the orifice of the right coronary artery into the aorta. The long-term postoperative follow-up indicates relatively favourable results with signs of impaired myocardial perfusion in the area supplied by the right coronary artery.

Aortopulmonary Septal Defect↗
PubMed1989

Prevalence, treatment, and outcome of heart disease in live-born children: a prospective analysis of 91,823 live-born children.

All 91,823 children born in 1980 in Bohemia (population 6.314 million; area 52,478 square kilometers) were examined at least four times during infancy and at the age of three and four years. All children who died were autopsied and those with heart disease were selected. A total of 779 children (8.223/1000 live births) were suspected by provincial pediatric cardiologists of having a heart disease. All of these were examined at the age of four years at our Center of Pediatric Cardiology. At this age heart disease was proved in 613 alive or deceased children (6.676/1000 live births), congenital cardiac malformations in 589 (6.415/1000 live births), and cardiomyopathies in 24. The most frequent congenital heart defects (CHD) were ventricular septal defect (VSD) (31.41%), atrial septal defect (ASD) (11.37%), aortic stenosis (AS) (7.64%), pulmonary stenosis (PS) (7.13%), coarctation of the aorta (CoA) (5.77%), and transposition of the great arteries (TGA) (5.43%), followed by persistent ductus arteriosus (PDA) (4.75%), atrioventricular septal defect (AVSD) and hypoplastic left heart syndrome (HLHS) (4.07% each), tetralogy of Fallot (TF) (3.56%), and pulmonary atresia (PA) (2.38%). A prevalence of less than 0.1/1000 live births was found for the remaining cardiovascular defects. One hundred fifty-nine (25.9%) patients were admitted to our highly specialized center, 116 (19.7%) catheterized and 85 (13.9%) treated surgically, during the first four years of life. A total of 440 (71.8%) patients survived the fourth year of life. The percentage of deaths was 25.6% among those with congenital heart diseases and 71% with cardiomyopathies. The overall mortality rate was 27% in surgically and 26% in medically treated patients.

Aortic Coarctation↗
PubMed1987

Infants with critical heart disease in a territory with centralized care.

All children with a critical heart disease in a 6.3 million inhabitants territory were referred and all infants who died were autopsied and the protocols sent to the only Center of Pediatric Cardiology and Cardiovascular Surgery. In the first 5 years of the centralized care, 1,122 infants, i.e. 2.36/1,000 live births suffered from a critical heart disease. 639 (57%) were admitted to the Center and the rest died in provincial hospitals with but not always from a heart disease found at autopsy. An additional 43 (6.2%) patients had nonstructural heart disease and 12 (1.7%) had heart diseases not considered to be critical. The total incidence of critical heart disease fluctuated from 2.15 to 2.51/1,000 live births without any well-defined trend. A decrease in the relative frequency throughout the 5-year period was found for common arterial trunk, pulmonary stenosis and atresia while an increase was observed in patency of the arterial duct. The most frequent critical heart diseases in infancy were: ventricular septal defect (18.2%) - mostly in isolation; complete transposition (14.6%); aortic coarctation (10.0%); hypoplastic left heart syndrome (9.1%) and pulmonary atresia (6.3%). The majority (51.4%) of patients became critically ill or died in the neonatal period. The most common conditions seen in neonates were complete transposition (22.5%), hypoplastic left heart syndrome (16.1%) and coarctation of the aorta (9.5%). The highest share of critically ill patients was encountered in complete transposition (100%), pulmonary atresia (98.7%), common arterial trunk (97.4%) and double outlet right ventricle (92.1%). The least dangerous were atrial septal defect (6.6%), pulmonary stenosis (7.0%), aortic stenosis (12.2%) and ventricular septal defect (21.0%). The mean age was 76 (+/- 56) days at admission and 59 (+/- 73) days at death. Urgent cardiovascular surgery was performed in 235 (36.8%) of the 639 patients admitted in infancy, that is 0.5 per 1,000 live born children.

Age Factors↗
PubMed1985

Results of corrective surgery for tetralogy of Fallot.

During a 5-year period (1978-1983) corrective surgery for tetralogy of Fallot was performed in 114 patients, ranging in age from 2 to 24 years (mean 8.4 years). Forty-one of them (35.9%) had previously undergone a palliative operation. Insertion of a transannular patch was necessary in 48 patients (42.1%). Eleven children died in the immediate postoperative period (early mortality 9.6%); no deaths occurred later. 103 survivors were followed-up for periods ranging from 5 months to 5 years mean 2.4 years) after surgery. The condition in 91 patients was excellent (88.7%), in 11 good (10.7%) and in one poor. Residual ventricular septal defect persisted in 9 patients (8.7%). Postoperative ECG revealed complete right bundle branch block in 71 patients (59%), incomplete block in 18 (18%), 5 patients (5%) had complete RBBB with left anterior hemiblock. Postoperative dysrhythmia requiring treatment was found in 7 patients (6%). Of 82 patients thoroughly examined by echocardiography, 37 (45%) had pulmonary regurgitation, 29 (35%) pulmonary plus tricuspid regurgitation, and 3 (4%) isolated tricuspid regurgitation. 83% of the patients had impaired lung function.

Adolescent↗
PubMed1984

Results of radical surgical correction of ventricular septal defect.

This study evaluates results of radical correction of simple and complex ventricular septal defect in 85 children. 35 children were under 3 years of age. Two babies operated at the age of 6 and 8 months in a critical condition died after surgery. Total operation mortality was 2.3%. In 51 patients examined one year and more after surgery, the long-term results are in 90% of the cases excellent and in 10% favourable. In none of the patients did the authors find an unfavourable result of the operation. The authors regard radical surgical correction of ventricular septal defect as a method of choice regardless of the patient's age and weight.

Adolescent↗