[The coronaries after arterial switch].
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Child↗
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Results for “TRANSPOSITION OF GREAT VESSELS”
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[ORIGIN OF BOTH GREAT VESSELS FROM THE RIGHT VENTRICLE].
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Heart Defects, Congenital↗
Radionuclide scintiphotography in defining postoperative pulmonary vasoconstriction. Succesful results after tolazoline administration in a four-month-old infant with congenital heart disease.
99mTechnetium macroaggregated albumin has successfully been used to define severe postoperative pulmonary vasoconstriction in a four-month-old boy with D-transposition of the great vessels who had undergone a Blalock-Hanlon surgical atrial septectomy. Radionuclide imaging documented clinically suspected pulmonary vasoconstriction and led to the successful use of tolazoline (Priscoline) to reverse the vasoconstriction with improved pulmonary blood flow patterns.
Heart Septum↗
[Cerebral complications of congenital cardiopathies].
In children with congenital heart disease, cerebral vascular accidents may have a variety of causes. Beside subacute endocarditis, complications of heart surgery, emboli and hypertensive accidents in some rare non-cyanotic cardiopathies, emphasis must be laid on the complications of chronic anoxia in cyanotic cardiopathies, anoxic spells, ischaemic cerebral accidents and abscesses of the brain. The latter have become rare and should mostly be feared in older children with inoperable cyanotic cardiopathy. Cerebral vascular accidents proper are a greater cause for concern, since they are not uncommon--especially in young children with Fallot's tetralogy or complete transposition of the great vessels awaiting surgery--, have serious sequelae and occur without warning. Their mechanism, and therefore their prevention, differs according to age. They are particularly dangerous in infants and in children below the age of 4. The only effective prevention is early and complete surgical correction of the cardiopathy.
Brain Abscess↗
Treatment of a persistent postoperative chylothorax with somatostatin.
Chylothorax is a rare but potentially serious complication of pediatric cardiac operations. We report the case of a 4-month-old boy who underwent a Senning procedure for correction of D-transposition of the great vessels. A persistent postoperative chylothorax developed, necessitating continuous drainage, despite conservative treatment over 3 weeks. Thereafter, continuous somatostatin infusion for 14 days led to the reduction and finally cessation of chyle production. This treatment allowed early enteral feeding and avoided further surgical intervention.
Chyle↗
Tricuspid and pulmonic valve echoes in tricuspid and pulmonary atresia.
An echocardiographic pattern of normal tricuspid valve motion in a patient with tricuspid atresia, and pulmonic valve motion in a patient with transposition of the great vessels and pulmonary atresia were documented. The recordings of the valve motion resulted in an initial erroneous diagnosis. Although M-mode echocardiography is very useful for the initial diagnostic evaluation of critically ill newborn infants with complex congenital heart diseases, on occasion recording of valvular echoes may result in conflicting clinical and pathologic correlation.
Echocardiography↗
[Contribution of magnetic resonance imaging in the neonatal diagnosis of congenital cardiopathies. Apropos of 10 cases].
The aim of this study was to evaluate potential indications of Magnetic Resonance Imaging (MRI) in the diagnostic workup of congenital heart disease in the newborn in comparison with two other means of investigation: Doppler-echocardiography and angiography. The imaging permitted to make the diagnosis in the 10 cases. MRI was superior than echocardiography in one newborn with a double aortic arch. MRI detected small muscular ventricular septum defects in two newborns with transposition of the great vessels. There was good agreement between MRI and angiographic images. Neither age nor prematurity proved to pose a limit on the diagnosis of MRI. MRI proved to be a good investigative tool which should be used after echocardiography, eventually making it possible to avoid angiography.
Angiography↗
Left ventricular preparation with an extrathoracically adjustable balloon occluder.
We developed a hydraulic occluder that could be adjusted percutaneously through a subcutaneous reservoir. Because of the potentially high pressures that may occur in preparing patients with transposition of the great vessels for an atrial switch procedure, the band on that hydrauler was modified to withstand arterial pressure and was subjected to studies involving banding of the aorta. Data indicate the suitability of this hydraulic occluder to withstand and maintain pressure in the systemic circulation.
Animals↗
Intramural coronary artery in transposition of the great arteries.
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Coronary Vessels↗
[Complete surgical correction of congenital cardiopathies in infants].
The results of total correction of congenital heart defects in the first year of life are presented. Overall surgical mortality in these generally highly symptomatic infants was 35%. The surgical risk is mainly related to the type of defect: mortality is low (10%) in uncomplicated septal defects and in transpositions of the great vessels, higher in the coarctation syndromes (30%), and considerable in complex heart defects. The weight of the infant seems to be another factor, surgical mortality being high when the patient's weight is less than 4.5 kg. Indications for palliative operation or total repair are discussed on the basis of the presented results.
Aortic Coarctation↗
Successful term pregnancy after Mustard operation for transposition of the great arteries.
Transposition of the great arteries is a complex cardiac malformation with poor prognosis without surgical correction. Since the introduction of surgical procedures such as the intra-auricular reorientation of the venous return (Mustard procedure), an increasing number of patients may reach adulthood and experience pregnancy. Because long-term complications after the Mustard operation include systemic heart failure, arrhythmias, venous return stenosis and pulmonary edema, hemodynamic changes during pregnancy and delivery may potentially engender life-threatening complications in these patients. We report the case of a 24-year-old primigravida who underwent a Mustard procedure at the age of 2 years for transposition of the great vessels, and who carried out a full-term pregnancy. The pregnancy was uneventful until the 34th week, when the woman developed signs of moderate right ventricular failure and frequent episodes of accelerated junctional rhythm. Digitalisation improved symptoms and elicited return to normal sinus rhythm. The patient delivered at term by elective cesarean section, under close hemodynamic monitoring.
Adult↗
Pediatric echocardiography: a review of its clinical utility.
Echocardiography is a new noninvasive tool which provides real-time motion visualization of intracardiac structures for the evaluation of anatomy and physiology in patients with congenital heart disease. This paper is presented to acquaint the pediatrician with the utilization and potential of this technique as practiced by pediatric cardiologists. A discussion of principles of physics and instrumentation in echocardiography is followed by a description of normal echocardiographic anatomy. Specific malformations which can be diagnosed reliably by this technique include: hypoplastic left heart syndrome, transposition of the great vessels, tetralogy of Fallot, idiopathic hypertrophic subaortic stenosis, mitral valve prolapse, and pericardial effusion. In addition, the evaluation of patients with atrial septal defects and patent ductus arteriosus is discussed. New advances in instrumentation and their potential impact in pediatric cardiology are reviewed.
Aorta↗
Surgical repair of cyanotic cardiac defects in young adults. The Fontan procedure and use of the extracardiac valved conduit.
Improvement in the health status of young adults with complex cyanotic congenital cardiac defects has been realized with recent advances in cardiovascular surgical techniques. The Fontan procedure and its modifications have allowed physiologic correction of tricuspid atresia by separating the pulmonary and systemic circulations and creating a direct connection from right atrium to pulmonary artery. The extracardiac valved conduit has been successfully used in the repair of pulmonary atresia with ventricular septal defect, and the triad of transposition of the great vessels, ventricular septal defect, and pulmonary stenosis. Nursing implications for the care of these patients in the postoperative period and their long-term management has been addressed. Advances in surgical techniques have brought these anomalies into the realm of surgical repair and have increased the life expectancy of these patients, and thus more patients with these cardiac defects will be seen in adult cardiology settings.
Adult↗
CT of anomalies of the mediastinal vessels.
Computed tomographic (CT) studies of the thorax were performed on 12 patients with congenital anomalies of the mediastinal great vessels. CT correctly identified 11 of 12 abnormalities including left superior vena cava, right aortic arch with aberrant left subclavian artery, L- and D-transposition of the great vessels, pulmonary valvular stenosis, and truncus arteriosus. CT obviated further invasive procedures in those anomalies not associated with intracardiac defects and supplemented the angiographic findings in some patients with intracardiac defects requiring catheterization.
Adolescent↗
[Intravascular radiologically-guided surgery in the treatment of congenital heart defects].
The article discusses the experience of the Bakulev Institute of Cardiovascular Surgery, USSR AMS, in catheter endovascular radiologically-guided surgery of some congenital heart diseases in the period from 1967 to 1990. A total of 505 operations were performed at the department of radiologically-guided examination and treatment of the heart and vessels: 307 Rashkind's and 35 Park's operations in total transposition of the great vessels, 110 balloon dilatations in valvular stenosis of the pulmonary trunk and 13 in valvular stenosis of the aorta, 7 embolizations in coronary-cardiac fistulas, 2 balloon dilatations in constrictions of Blalock-Taussig anastomosis, 14 balloon dilatations in peripheral stenoses of the pulmonary arteries, etc. The methodical aspects and the results of endovascular interventions are discussed in detail. The data of foreign researchers on the promising methods of radiologically-guided surgery are also shown.
Adolescent↗
Corrected transposition. Another approach for repair of associated intracardiac malformations.
A variety of surgical approaches have been used for repair of cardiac lesions associated with corrected transposition of the great vessels. These techniques have met with variable success and generally high surgical mortality rates. In an effort to simplify the surgical approach to repair of ventricular septal defect and replacement of left atrioventricular valve in a 4-year-old youngster, we chose to correct the defects through a left posterolateral thoracotomy and through the left atrium utilizing profound hypothermia and circulatory arrest. Ease of intracardiac assessment and repair and postoperative results to date have been most gratifying.
Child, Preschool↗
Open heart surgery in first year of life using profound hypothermia (core cooling) and circulatory arrest. Experience with 134 consecutive cases.
Between April 1970 and December 1977, 134 infants aged 2 days to 12 months underwent open heart surgery using profound hypothermia and total circulatory arrest. The technique of bypass (core) cooling is described. Results are reviewed for 4 principal diagnoses: 'simple' transposition of the great vessels, total anomalous pulmonary venous connection, ventricular septal defect, and Fallot's tetralogy. A mortality of 44 per cent in 32 cases during the first 3-year period has been reduced to 22 per cent in 102 cases during the subsequent 5 years. The overall mortality for the entire period was 28 per cent. The policy for the management of each diagnostic group is outlined.
Cardiac Surgical Procedures↗
Facial nerve paralysis following pediatric cardiac surgery.
A newborn female diagnosed with transposition of the great vessels with restrictive ventricular septal defect presented left facial peripheral nerve paralysis following anatomical surgery correction (arterial switch) by cardiopulmonary bypass. We have not found any causal factor either in the anesthesia or postoperative period. The electromyogram presented signs of peripheral nerve impairment, and the cerebral echography and electroencephalogram were normal. The facial nerve paralysis was almost recovered seven weeks after surgery. This is the first pediatric patient reported with peripheral facial nerve paralysis after cardiac surgery.
Facial Paralysis↗