[The regenerating heart -- hope for children with congenital heart defects].
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It is given an overview about actual strategies of the treatment of children suffering from heart diseases. Partly proven drugs are given in an optimized doses e.g. digoxin and digitoxin where as other new drugs and therapeutic principles are introduced e. g. catecholamines and vasodilator agents, antiarrhythmic drugs or electrotherapy and antiarrhythmic surgery. Various functional disturbances of the cardiovascular system can occur in the newborn period. New diagnostic principles especially echocardiography with doppler sonography, holter monitoring and exercise testing have lead to better therapeutic regimens. Heart catheterizations have new therapeutic tools like the balloon valvuloplasty of a stenotic pulmonic valve. At least the advances of cardiac surgery have lead to a shift of the time of correction to early childhood. Two step interventions are more and more removed and the related children and their families will have a better outcome and a better life quality.
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A comparative analysis of the results of invasive and noninvasive measurement of right ventricular pressure showed a high correlation for systolic (r = 0.97, P less than 0.05, n = 41) and diastolic (r = 0.89, p less than 0.05, n = 41) pressures. The noninvasive technique is applicable only in the presence of tricuspid regurgitation or that of ventricular septal defect ejection. Moreover, in slight or minimal tricuspid regurgitation when the peak of systolic regurgitation is poorly seen, there is a difference between the results of these measurements (7-10 mm Hg). It has been concluded that Doppler echocardiography is an informative noninvasive tool for measuring pressure in the right ventricle and pulmonary artery and offers an opportunity of determining pulmonary hypertension quantitatively before and after surgery.
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