PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “PULMONARY VALVE STENOSIS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources

Total anomalous pulmonary venous connection: helical computed tomography as an alternative to angiography.

BACKGROUND: Echocardiographic evaluation of the pulmonary veins is inadequate at times. Cardiac catheterization, especially in sick neonates, may be a high-risk procedure. Helical computed tomography with three-dimensional reconstruction is noninvasive but remains an underutilized modality. METHODS AND RESULTS: Between January 2002 and February 2003, 7 computed tomography scans of children 3 weeks to 5 years of age were performed to evaluate the drainage of the pulmonary veins in suspected total anomalous venous drainage. Helical computed tomography (GE High speed Advantage) was performed using 2 mm sections, and rapid bolus hand injections of 2 ml/kg body-weight of nonionic intravenous contrast. Sagittal and coronal reformats, and three-dimensional reconstructions were performed, and reviewed by the radiologist. The findings were discussed with the pediatric cardiologist and surgeon involved in the case. The diagnoses included complex congenital heart disease (n = 5), isolated infradiaphragmatic total anomalous pulmonary venous connections (n = 1), and transposition of the great arteries with total anomalous pulmonary venous connections (n = 1). Cardiac computed tomography accurately demonstrated infradiaphragmatic total anomalous pulmonary venous connections in 4, and supracardiac drainage in 3 patients, in addition to the other cardiac findings. The findings on computed tomography scan correlated with surgical (n = 5) and/or angiographic findings (n = 2) in 7 patients. CONCLUSIONS: In sick, high-risk patients, cardiac computed tomography can be considered as an alternative to cardiac catheterization for the evaluation of pulmonary venous drainage.

Angiography↗

[Transcatheter treatment of combined congenital heart anomalies in an adult cyanotic patient].

Contemporary catheterization techniques allow effective percutaneous transcatheter treatment of congenital heart defects as an attractive alternative to open heart surgery. This case report describes transcatheter treatment of congenital pulmonary valve stenosis and secundum atrial septal defect which were diagnosed in a 31 year old woman who presented with cyanosis. This illustrates difficulties in the diagnosis of congenital heart disease in adult patients and demonstrates that transcatheter techniques in the treatment of these congenital anomalies are effective.

Adult↗

Sites of right ventricular outflow tract obstruction in tetralogy of Fallot--a retrospective study.

Fifty one angiographically proved cases of tetralogy of Fallot (TOF) in the age group of 5-50 years were analysed retrospectively for the level(s) of right ventricular outflow tract (RVOT) obstruction. Mean age was 18.1 +/- 11 yrs. Subvalvular stenosis was found to be the commonest site of RVOT obstruction in 49 (96.1%) patients. Evidence of valvular pulmonary stenosis was seen quite commonly (42/51, 83.9% cases), mostly in association with obstruction at other sites. Supravalvular stenosis was also seen in 17 (33.3%) cases. Higher incidence of pulmonary valvular involvement in patients with TOF, in higher average age of patient population may represent valvular involvement to be an acquired phenomenon.

Adolescent↗

[Ebstein's anomaly. Clinical aspects and surgical therapy].

OBJECTIVE: We reviewed the clinical findings and surgical results of Ebstein's anomaly in adult and adolescent age. DESIGN: Retrospective analysis on clinical data, surgery and follow up. SETTING: Patients (pts) studied in the Cardiology and Cardiothoracic Surgery Departments of the Santa Marta Hospital, Lisbon. PATIENTS: All pts in whom Ebstein's anomaly was diagnosed by cardiac catheterization or echocardiography or both, between 1875 and 1989 were included. RESULTS: There were 8 cases (4 female and 4 male). The age varied from 15 and 53 years. Cyanosis and dyspnoea were the presenting features in 7 pts. One of the youngest pts had asymptomatic murmurs. Late appearance of cyanosis had no relation with prognosis. Three pts had pulmonary tuberculosis. One woman had no deterioration in cardiac function during two pregnancies. Clinical findings were variable and ranged from absent murmur with third and fourth sounds to systolic murmurs of high intensity. The ECG was abnormal in all pts. A case with delta wave and normal PQ interval was noted. On the chest X-ray we found cardiomegaly in all pts. Echocardiograms were recorded in 6 pts. The delay of tricuspid valve closure on mitral closure was not always diagnostic. Uncomplicated catheter studies were done in 6 pts. Two pts had associated cardiac lesions: ventricular septal defect (VSD) with pulmonary hypertension and mild pulmonary valve stenosis. Right ventricular angiographies were diagnostic in all cases. During medical follow up from 1 year to 10 years (mean-4) one death occurred in one pt with VSD. In the remaining 4 cases no deterioration in cardiac function or cyanosis was noted. Three pts were operated. The indications for surgery were: severe heart failure and/or increasing cyanosis. Two pts had tricuspid valve replacement with biological prosthesis. One pts had Danielson's tricuspid annuloplasty. During surgical follow up from 2 to 15 years (mean-7) functional class improved and cyanosis disappeared in 2 pts and it decreased in the other. CONCLUSION: In our series of pts with Ebstein's anomaly clinical findings were variable. The indications for surgery were heart failure and cyanosis. The 3 pts operated are alive and have mild symptoms.

Adolescent↗

Ebstein's anomaly: unusual presentation and surgical repair.

Ebstein's anomaly is the most significant congenital anomaly involving the tricuspid valve. This lesion may present in a simple form or may be complicated by other lesions. Patients with this anomaly may vary from mildly symptomatic to severely debilitated. The role of surgical treatment is not uniformly agreed upon, and the optimal procedure for correction or palliation is not clearly defined. Because of the wide spectrum of morphologic abnormalities which may be present in Ebstein's anomaly, no one particular operation may always be satisfactory. We and other groups continue to search for optimal procedures and feel strongly that individualization must be carried out to optimize the result in each patient. We encountered a patient with Ebstein's anomaly in an almost atretic tricuspid valve. In addition, there was severe right ventricular outflow tract obstruction and pulmonary valve stenosis. In this patient the "Fontan Principle" was successfully applied in his management.

Child↗

Myocardial performance after repair of congenital cardiac defects in infants and children. Response to volume loading.

The hemodynamic response to increasing left atrial pressure by volume loading was evaluated in 70 children during the first 24 hours after repair of congenital cardiac defects. The children were grouped into four diagnostic categories: atrial septal defect or pulmonary valve stenosis (n = 8), ventricular septal defect (n = 36), complete transposition after Mustard's operation (n = 13), and tetralogy of Fallot (n = 13). Within 2 hours of bypass, both cardiac index and left ventricular stroke work index were adequate and increased appropriately with volume loading in all four diagnostic groups. The atrial septal defect group demonstrated a similar response to volume loading 4 and 24 hours after bypass. However, the other three diagnostic groups had a higher filling pressure, lower cardiac index and stroke work index, and a depressed response to increasing preload 4 hours postoperatively, which indicated a deterioration in cardiac performance. The deterioration was maximal between 4 and 12 hours after bypass, and performance tended to recover 24 hours postoperatively. The transposition group had a more profound depression in cardiac performance than the other two groups. Within the ventricular septal defect group, smaller children (body surface area less than 0.36 m2) had a more profound depression in performance than larger children. These results demonstrate a significant alteration in cardiac performance during the first 24 hours after repair of congenital cardiac defects in children. These changes should be considered when postoperative management is being planned.

Cardiac Output↗