PubMed · 7234593
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H Abel, G Schoffa, E Hofmann. 1981. Surface mapping in intraventricular blocks.. https://doi.org/10.1159/000391930
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From June 1988 through June 1994, 20 children with symptomatic tetralogy of Fallot, associated with hypoplastic or stenotic pulmonary arteries in 19 cases, were operated on in our institution. Mean age at operation was 49.5 +/- 43 months (ranging from 10 months to 12.5 years). Mean weight was 13.5 +/- 6.5 kg (range 6.2 to 30 kg) and mean body surface area was 0.6 +/- 0.2 m2. Mean preoperative hematocrit value was 47.6% +/- 11.1%, and mean preoperative arterial oxygen saturation ratio was 75.7 +/- 9.5. Six patients (30%) had prior systemic-pulmonary arterial shunts. Pulmonary arterial stenoses were congenital or iatrogenic (or both) and were located principally on the left pulmonary artery (63%), on the pulmonary bifurcation (15%), or separately on the left and right pulmonary arteries (21%). In all children the pulmonary arterial tree was repaired with the patient's own pedicled pericardium. Mean follow-up is 36 +/- 25.2 months (range 1 to 71 months). Hospital mortality rate was 0%. There was one late death, and two children were lost to long-term follow-up. No child required reoperation. Seventeen children returned for evaluation, consisting of physical examination, electrocardiogram, chest roentgenogram, and Doppler echocardiogram, and 11 underwent late catheterization or magnetic resonance imaging of the chest to evaluate the pulmonary arterial repair. All children were in New York Heart Association class I or II. Right ventricular function was normal by echocardiography in 100% with a mean right ventricular systolic pressure of 39.37 +/- 8.4 mm Hg. Mild to moderate pulmonary regurgitation was present in the majority of patients. The results of pulmonary arterial repair were good in 100%. There was no residual stenosis, and we observed uniform enlargement of the repaired pulmonary arteries over a 5-month to 6-year follow-up period. These results are of particular interest inasmuch as other materials previously used for repair of pulmonary arteries do not grow and may even shrink, resulting in residual stenosis.
The changes of regional dry heat loss and skin temperature in 15 healthy preterm babies, 8 with a gestational age (GA) of 33-36 weeks and 7 with a GA of 28-31 weeks, were studied under controlled conditions at environmental temperatures ranging from 29.5 to 34.0 degrees C. In both groups of babies the skin temperature for all body regions followed the changes in operative temperatures. Regional dry heat losses also closely followed the external temperature gradient. In the 33-36 weeks GA neonates the regional changes in thermal conductance (index of cutaneous blood flow) indicated that only the foot responded to low environmental temperature with vasoconstriction while vasodilatation was indicated for the trunk. In the 28-31 weeks GA neonates similar but not significant changes of thermal conductance were calculated. The limited ability to reduce heat loss by reducing the skin conductance over a major part of the body surface area contributes to the vulnerability to low environmental temperature in preterm neonates.
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