Biomedical subjects

S J Lacina

Publications and source records attributed to S J Lacina.

6 recordsLinked to original sources

PubMed1990

Spontaneous pneumothorax in common pulmonary vein atresia.

Common pulmonary vein atresia is a rare congenital anomaly that is rapidly fatal unless immediately recognized and corrected by surgical intervention. This article describes three neonates who died with the diagnosis soon after birth. In the constellation of presenting clinical features in each case, the occurrence of early spontaneous pneumothorax was particularly noteworthy. This sign may well be a helpful physiologic marker within the context of suspected congenital heart disease associated with severe pulmonary venous obstruction.

Female↗

PubMed1989

Doppler evaluation of homograft valved conduits in children.

To assess the flow characteristics of homograft valved conduits in the immediate postoperative period, 69 children with 71 homograft conduits underwent 2-dimensional and Doppler echocardiographic examination at 1 to 40 days (mean 8) after surgery. Of the 71 conduits studied, 19 were aortic and 52 were pulmonary homograft valved conduits. Two aortic homograft valved conduits were inserted in the aortic position, whereas all remaining homografts were placed in the pulmonary position. On the immediate postoperative echocardiogram, 25 (35%) of the conduit valves had no regurgitation and 44 (62%) had 1+ (mild) regurgitation. Two pulmonary valved conduits (3%) in the pulmonary position had 2+ (moderate) regurgitation and right ventricular dimensions greater than 95% for body surface area. The peak velocity across the homograft valve was normal (less than 1.3 m/s) in 58 valves (82%). In the remaining 13 valves, peak velocity ranged from 1.4 to 2.6 m/s. No homograft valve had a peak velocity greater than 2.6 m/s in the immediate postoperative period. To assess the fate of homograft valved conduits in the intermediate-term follow-up period, 38 children with 38 conduits had a repeat echocardiogram at 6 to 25 months (mean 15 +/- 6) after surgery. Of the 38 conduits examined, 10 (26%) had no regurgitation, 25 (66%) had 1+ regurgitation and 3 (8%) had 2+ regurgitation. Progression of the amount of regurgitation occurred in 11 (29%) patients. At the follow-up examination, peak velocity was less than or equal to 1.4 m/s across 34 conduit valves, between 1.4 and 2.6 m/s across 3 valves and greater than 2.6 m/s across 1 valve.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗

PubMed1989

Balloon valvuloplasty for recurrent aortic stenosis after surgical valvotomy in childhood: immediate and follow-up studies.

The immediate and intermediate-term effects of balloon valvuloplasty were assessed at cardiac catheterization in nine children with recurrent stenosis after a previous surgical aortic valvotomy. At valvuloplasty the patients ranged in age from 0.35 to 16 years and had undergone surgical valvotomy 0.3 to 12.5 years previously. Balloon valvuloplasty immediately reduced the peak systolic aortic stenosis gradient by 53%, from 88 +/- 9 (mean +/- SEM) to 41 +/- 6 mm Hg (p = 0.004). The left ventricular systolic pressure was reduced from 189 +/- 8 to 157 +/- 8 mm Hg (p = 0.001) and the left ventricular end-diastolic pressure from 17 +/- 1 to 14 +/- 2 mm Hg (p = 0.025). The heart rate and cardiac index remained unchanged. Before valvuloplasty, one patient had 1 + and two patients had 2+ aortic insufficiency. In six of nine patients, balloon valvuloplasty caused no change in the degree of valvular insufficiency. Two patients had a 1 + increase (from 0 to 1 + insufficiency in both), and one patient with no insufficiency developed 2+ aortic insufficiency. Elective follow-up catheterization was performed 0.8 to 2.5 years (mean 1.5 +/- 0.2) after valvuloplasty. At follow-up, the peak aortic stenosis gradient remained significantly reduced from the gradient before valvuloplasty (37 +/- 5 versus 85 +/- 10 mm Hg, p = 0.002). The gradient had not changed significantly from that measured immediately after valvuloplasty (37 +/- 5 versus 38 +/- 5 mm Hg, p = 0.75). At follow-up, aortic insufficiency had decreased from that immediately after valvuloplasty in three patients and had increased in two.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1986

The congenital long QT syndrome. An unusual cause of childhood seizures.

The congenital long QT syndrome is an unusual disorder characterized by Q-T interval prolongation on electrocardiogram that predisposes the heart to ventricular tachycardia and fibrillation. We describe herein four patients with the congenital long QT syndrome who initially presented with generalized seizures. Three of these children were initially misdiagnosed as having a primary seizure disorder. The causal relationship of complex ventricular arrhythmias to seizure activity was documented in each child. This experience emphasizes the importance of obtaining an electrocardiogram in all children with a seizure disorder of unknown origin.

Arrhythmias, Cardiac↗

PubMed1986

Persistent left superior vena cava communicating with the left atrium through a systemic-pulmonary venous malformation.

A 14 year old white girl who presented with a brain abscess was discovered to have a left pulmonary vascular malformation on a chest roentgenogram. Angiograms revealed a left superior vena cava that drained into a venous malformation within the left lung, then communicated with the left atrium by way of the left superior pulmonary vein. The right superior vena cava was functionally absent and was anatomically an atretic cord. There was mild systemic arterial hemoglobin desaturation, but no evidence of cyanosis. The embryology, physiology and surgical repair of this rare lesion and the complication of a postoperative superior vena cava syndrome are discussed.

Adolescent↗

PubMedDate not supplied

Angiographic evidence of absent ductus arteriosus in severe right ventricular outflow obstruction.

The angiocardiograms of 5 newborn infants with autopsy and/or surgically-proven congenital absence of the ductus arteriosus (ADA) and right ventricular outflow obstruction (Group A), and of 14 neonates with pulmonary atresia complex and patent ductus arteriosus (Group B) were reviewed. Aortic size was similar in both groups; however, the diameters of the right and left pulmonary arteries were much smaller in Group A than in Group B (right pulmonary artery: 2.6 vs 4.5 mm, P less than 0.005; left pulmonary artery: 2.5 vs 4.3 mm, P less than 0.005). Extensive bronchial collaterals were observed in Group A but not in Group B. Tricuspid aortic valve stenosis was present in 2 patients in Group A but in none in Group B. The diagnosis of ADA may be made in newborn infants with severe right ventricular outflow obstruction if the angiocardiograms reveal hypoplasia of the pulmonary arteries, extensive bronchial collaterals, and nonvisualization of the ductus arteriosus. Other suggestive features include aortic valve stenosis and/or right aortic arch with aberrant left subclavian artery.

Angiocardiography↗