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At least 145 records · Page 8Linked to original sources
PubMed1990

[Surgery of congenital heart defects in adulthood].

During the period between 1983-1989 the authors operated 165 patients with the diagnosis of coarctation of the aorta, 197 cases of patent ductus arteriosus and 360 atrial septal defects. In all diagnostic groups they operated a large number of patients above 10 years of age whereby the oldest patient with a septal defect was 57 years old, patients with coarctation of the aorta or a patent ductus arteriosus 35 years old. The authors discuss the reasons why the patients were indicated for operation so late.

Adolescent↗
PubMed1989

[Heart arrhythmia following surgery of congenital heart defects].

As a result of the intraoperative trauma sinus node dysfunction and AV conduction defects have been observed. In addition bifascicular block (RBBB with LAH) may occur after repair of a ventricular septal defect. This electrocardiographic pattern indicates a high risk of developing a trifascicular block only in those patients with reversible AV block in the early postoperative period. After closure of an atrial septal defect, atrial fibrillation can develop as well as ventricular tachycardia and fibrillation after repair of a ventricular septal defect. The latter seems to be the underlying mechanism of sudden cardiac death occurring late after operation, especially in patients with Fallot tetralogy. In addition to the scar, persistent structural myocardial changes seem to be an important factor. Electrophysiological investigation is indicated in all symptomatic patients especially for detection and treatment of ventricular tachyarrhythmias. However, there is yet no proof that sudden death can be prevented by antiarrhythmic treatment of all ventricular premature beats in the endangered patients.

Arrhythmias, Cardiac↗
PubMed1986

[Evaluation of the status of the myocardium during surgical correction of congenital heart defects by simultaneous study of ultrastructure and macroergic phosphates (in biopsies of the human heart)].

During surgical correction of Fallot's tetrad the authors discovered the decrease of macroergic phosphate concentration and moderately marked signs of cardiomyocytic ultrastructural changes, such as mitochondrial injuries, decrease of glycogen levels, insignificant intracellular edema, no increase of membrane penetration. Changes of endothelial cells were absent. In children not over 1 year old under myocardial protection with hypothermic perfusion (at low volume rates) some decrease of macroergic phosphates occurred, as well as a moderate decrease of the mitochondrial index, glycogen content decrease, there was no intracellular edema. The discovered structural changes are minimal and reversible. A close correlation was found between the electron microscopic data and the character of myocardial energetic metabolism, the biochemical changes preceding the ultrastructural ones. Comparison of morpho- and biochemical changes in the myocardium of the majority of patients with impaired myocardial function confirmed the existence of a complex relationship between them.

Adenosine Triphosphate↗
PubMed1986

[Diagnosis of congenital heart defects using color-coded Doppler echocardiography].

Color Doppler echocardiography (CDE) enables visualization of blood flow and of cardiac morphology within color coded two-dimensional images. The diagnostic usefulness of this method in pediatric cardiology has been analyzed based on studies performed in 2414 children. Normal cardiac findings were seen in 769 patients according to the clinical and echocardiographic examinations. Normal diastolic inflow into the ventricles in the apical four-chamber-view is characterized by a similar distribution of the color spectrum across the inflow tracts, blood flowing on the two sides of the heart is completely separated from each other. Normal systolic outflow imaged from parasternal position shows an increase in velocity in the outflow tract passing through the semilunar valves without any change in flow patterns. Heart disease was present in 1645 patients, simple cardiac defects were found in 1473 cases and complex heart disease in 172 cases. Shunt lesions are detectable by the demonstration of blood flow in regions where normally no flow is detectable, flow velocities being pathologically increased in many cases. Diagnostic sensitivity and specificity of CDE as compared to invasive procedures is between 96 and 98%. In left-to-right shunting the shunt flow can be followed into the right-sided cardiovascular regions where its extent is a measure for the size of the shunt as indicated by initial results. In ventricular septal defects, bidirectional shunting is indicative of a rise in pressure in the right ventricle and can be reliably detected with the use of CDE. In valvular stenoses high flow velocities are found in the appropriate time which are associated with turbulence and poststenotic eddies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗