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Biomedical subjects

S Milo

Publications and source records attributed to S Milo.

At least 19 recordsLinked to original sources

Three anomalies of the coronary arteries co-existing in a case of pulmonary atresia with intact ventricular septum.

A female infant, who died 17 hours after spontaneous birth, was found to have three distinct coronary arterial anomalies in association with pulmonary atresia with intact ventricular septum. These anomalies were first, an aneurysmal left coronary artery with a fistulous communication into the right ventricle; second, an anomalous origin of the right coronary artery from the pulmonary artery; and third, a supernumerary coronary artery arising from the right ventricle. Although the coronary arterial system was entirely connected to the right ventricle, the perfusing blood originated from the left ventricle and there was no clinical or histological evidence of significant myocardial ischaemia.

Coronary Vessel Anomalies

Unusual drainage of the inferior caval vein in left atrial isomerism.

Two of the 26 cases of left atrial isomerism in our clinical material had an unusual drainage of the inferior caval vein. In one, the inferior caval vein crossed from left to right infradiophragmatically and then drained into the right-sided morphologically left atrium. In the second case, there was azygos continuation to both right and left superior caval veins. These variations have major surgical significance.

Child, Preschool

Right ventricular pressure dynamics after operation for pulmonary stenosis.

Right ventricular pressure dynamics were monitored during the first 24 hours after operation for relief of pulmonary stenosis in 9 patients with dysplastic pulmonary valves who underwent total valvectomy. Rather than the expected immediate drop in pressure after total removal of the obstruction, right ventricular pressures required 18 to 24 hours to decrease to physiological values. In 7 patients, the pressures decreased steadily, but in 2, there was an increase in pressure immediately postoperatively, followed by a gradual decrease.

Adult

Hour-glass deformity of the pulmonary valve: a third type of pulmonary valve stenosis.

In the 12 years from 1975 to 1987, 55 patients had open pulmonary valve surgery for isolated congenital stenosis of the pulmonary valve. Three types of pulmonary stenosis were seen: (a) dome-shaped pulmonary stenosis (34 patients); (b) dysplastic pulmonary valves with thick cauliflower-like cusps (12 patients), and (c) hour-glass deformity of the pulmonary valve, with "bottle-shaped" sinuses (nine patients). This third type has not been described before. Preoperative identification of the valve structure is important because the choice of treatment (balloon dilatation for some dome-shaped valves and excision for dysplastic and hour-glass valves) depends on the type of stenosis.

Adolescent

Successful repair of concomitant tear of the interventricular septum and right ventricular free wall after acute myocardial infarction.

Early repair of acute rupture of the ventricular septum after myocardial infarction is now the procedure of choice accepted by most centers. Rupture of the right ventricular free wall is rare and usually is accompanied by tamponade. The finding of coincidental right ventricular free wall rupture and acute ventricular septal defect following myocardial infarction and their successful repair are discussed in the following report.

Aged

Echocardiography and valve replacement in the critically ill patient with acute rheumatic carditis.

In 4 critically ill patients with acute rheumatic carditis, valve incompetence, and severe life-threatening cardiac failure, medical treatment consisting of bedrest, oxygen, digitalis, diuretics, and steroids produced little or no clinical improvement. Echocardiography showed that in each patient myocardial function was relatively well preserved despite active rheumatic carditis and the critical clinical state. Emergency valve replacement was performed, and a good clinical result was achieved in all 4 patients.

Acute Disease

Selection of saphenous vein bypass gradt diameter to support patency of the stenosed coronary artery.

Injudicious selection of a saphenous vein graft can adversely affect the the late postoperative patency of the proximal coronary artery which it bypasses. The purpose of this investigation was to deduce an upper bound for graft diameter, at small angle of distal anastomosis, below which the stenosed artery will remain patent, from a mathematical model of aortocoronary bypass haemodynamics.

Coronary Artery Bypass

Parachute deformity of the tricuspid valve.

A parachute deformity of the tricuspid valve occurred in a heart with atrioventricular concordance, double outlet right ventricle, and straddling mitral valve. Although to the best of our knowledge parachute deformity of the tricuspid valve has not previously been reported, in this case its presence was insignificant in relation to the other lesions.

Heart Septal Defects, Ventricular