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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Jehovah's Witnesses who require operation represent a challenge to the physician because of the patients' refusal to accept blood transfusion. We report a 20-year experience with a consecutive series of 542 Jehovah's Witness patients ranging in age from 1 day to 89 years who underwent operation. Early mortality (within 30 days after operation) was 9.4%. In 362 patients requiring temporary cardiopulmonary bypass, early mortality was 10.7%. Mortality was 13.5% among 126 patients who had single- or double-valve replacement. The only deaths among patients who had aortic valve replacement or repair of a ventricular septal defect occurred in those who had some serious complication before operation. Preoperative or postoperative anemia was a contributing factor in 12 deaths, and loss of blood was the direct cause of three deaths. Cardiovascular operations can be performed safely without blood transfusion.
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PMID:Cardiovascular surgery in Jehovah's Witnesses. Report of 542 operations without blood transfusion. 30 45

30 patients with tetralogy of Fallot were examined before and after correction. 10 of whom had previous procedures including 13 Blalock-Taussig shunts, 1 Cooley anastomosis and 6 pulmonary valvulotomies (Brock) with a dilator. Hemoglobin and blood gases were measured in 22 patients pre- and postoperatively on the 7th respectively 14th day and finally after 12 months. In 8 children the concentration of 2,3-DPG was accessed (pre-, postoperatively, immediately in ICU, on the 1st, 7th, 14th day and after 21 months). Hypoxia of various degrees was found at any time of the investigation, verified by a low venous oxygen saturation, high 2,3-DPG concentration and an erythrocytosis. The 2,3-DPG concentration was always elevated (preoperatively 18.2 +/- 1.8 muMol/g Hb; postoperatively 1st till 14th day 19.0 +/- 2.2; after 21 months 16.3 +/- 1.2 muMol/g Hb). Preoperatively hypoxia was correlated to the degree of the heart disease expressed by the hight of the Hb-concentration. In contrary after the correction signs of hypoxia (decreased venous oxygen saturation, increased 2,3 DPG-concentration) appeared with a low Hb as found in patients with anemia. The long term check-ups are indicative for slight cardiac residual disorders as there are hypoxic myocardial damage, residual gradients over the right ventricular outlet, reopened VSD's, and ventriculotomy scar tissue. Though the elevated 2,3-DPG-concentration and the consecutive rightward shift of the oxygen saturation curve obviously compensate these cardiac handi-caps as the excellent physical condition of the children shows.
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PMID:[Correction of tetralogy of Fallot and its influence to oxygen transport and lung changes. Part I. Oxygen transport (author's transl)]. 84 77

Fifty-four children without postoperative complications were admitted to the Department of Pediatrics, University Hospital Rebro, following a complete surgical correction of ventricular septal defect (VSD), atrial septal defect - secundum type (ASD II) and patent ductus arteriosus (PDA) in the period from June, 1989, to February, 1991. Twenty-two patients were treated surgically for VSD, 17 for ASD II and 15 for PDA. There were 23 male and 31 female children. In the early postoperative period, 57% of all the examinees had a murmur with the innocent or functional characteristics. The murmur was significantly more frequent among children with VSD than among children of other groups (ASD II, PDA). Sex, age and hematocrit did not influence this difference. There were 8 anemic children (3 with operated VSD, 4 with ASD II, and 1 with PDA). From this, it may be concluded that anemia also did not cause this difference. However, anemic children represented 50% of the examinees with a murmur among the operated for ASD II and 33% among those treated surgically for PDA. When these anemic children were eliminated, the others operated on for ASD II and PDA probably had the innocent murmurs, since the proportion of examinees with a murmur fits into the incidence of innocent murmurs in the population. The children operated for VSD have had a greater proportion of examinees with a murmur, and most likely, some of these murmurs do not belong to a group of innocent or functional murmurs. Their cause is unknown, as yet (probably, small organic lesion).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Residual postoperative murmurs in children with congenital heart defects]. 134 36

Two cases of severe haemolytic anaemia developed after heterograft valve replacement are reported. In one case haemolysis was caused by prosthetic degeneration; in the other case the heterograft was not altered, but a ventricular septal defect had created a high turbulence around the valve which was in pulmonary position. In both cases anaemia subsided after surgical correction of the abnormalities responsible for periprosthetic turbulence. Haemodialysis can only develop in patients with heterograft valve replacement if a change in blood flow rate occurs around the valve, due to its alteration or to an associated cardiac disease.
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PMID:[Hemolytic anemia and cardiac heterografts. Apropos of 2 cases]. 250 85

The short-term effects of increasing hemoglobin concentration were evaluated at cardiac catheterization in seven children (aged 0.3 to 7.5 years) with a right to left ventricular shunt and relative anemia. Diagnoses were tetralogy of Fallot in six and L-transposition of the great vessels with ventricular septal defect and pulmonary stenosis in one. Before and 20 minutes after isovolumic partial exchange transfusion with 20 ml/kg packed red cells, the following variables were measured: hemoglobin, partial pressure of oxygen (PO2), oxygen consumption, oxygen saturation and pressure in the aorta, superior vena cava and right and left atria. After partial exchange transfusion, hemoglobin increased from 13.7 +/- 0.5 to 16.4 +/- 0.4 g/100 ml (p less than 0.001, mean +/- SEM). Aortic PO2 increased from 55.0 +/- 3.5 to 62.0 +/- 4.1 mm Hg (p less than 0.01) and aortic oxygen saturation increased from 84.3 +/- 2.3 to 90.9 +/- 1.3% (p less than 0.002). Effective pulmonary blood flow increased by 17% from 2.72 +/- 0.10 to 3.17 +/- 0.10 liters/min per m2 (p less than 0.01), and right to left shunt decreased by 59% from 1.44 +/- 0.29 to 0.59 +/- 0.10 liters/min per m2 (p less than 0.01). Systemic oxygen transport increased from 658 +/- 48 to 738 +/- 46 ml/min per m2 (p less than 0.002). After partial exchange transfusion, systemic vascular resistance increased from 15.9 +/- 1.1 to 20.0 +/- 1.4 units (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute hemodynamic effects of increasing hemoglobin concentration in children with a right to left ventricular shunt and relative anemia. 396 19

Despite balloon atrial septostomy within the first days of life, some patients with complete transposition of the great arteries die before reaching elective definitive surgery in the second six months of life. To discover why, we analysed the fate of 144 patients who had balloon atrial septostomy after 1966, using a modified logrank survival test with multivariate capability. Patients were withdrawn "alive" on reaching definitive surgery. The following largely independent factors were associated with a statistically significant excess mortality: pulmonary hypertension, the presence and size of a ventricular septal defect of persistent ductus arteriosus, relative anaemia, absence of left ventricular outflow tract obstruction, low arterial oxygen saturation, aortic stenosis and coarctation, and balloon atrial septostomy between 1 week and 1 month of life. Those of the above factors which can be determined at balloon atrial septostomy or at routine cardiac catheterisation at 3 months of age were then introduced into discriminant function analysis on survival to 6 months. Hence the probability of any individual patient dying in the first six months was calculated, allowing for these factors. This prediction was correct in 76 per cent of the patients studied. By offering earlier definitive correction to patients thus identified as being at high risk of premature death, it should prove possible to reduce overall mortality in transposition of the great arteries.
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PMID:Factors influencing survival after balloon atrial septostomy for complete transposition of great arteries. 723 62

We observed a case of severe intravascular haemolysis following repair of subpulmonaic ventricular septal defect with pulmonic stenosis. In this case immunological studies and cardiac catheterization demonstrated haemolysis resulting from mechanical factors. When severe haemolysis and progressive anemia following intracardiac repair persist, inadequate intracardiac correction should be suspected and the second surgery is to be considered.
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PMID:Haemolysis following repair of subpulmonic ventricular septal defect with pulmonic stenosis. 743 48

A 44-year-old female admitted to our hospital because of fever, purpura and macroscopic hematuria. She had been diagnosed as having ventricular septal defect (VSD). She noticed purpura with pain on bilateral legs and macroscopic hematuria since September 18, 1994. Three weeks later she also manifested a fever. Physical examination of admission revealed numerous purpura and leg edema. Laboratory data showed macroscopic hematuria, marked anemia (Hb 3.3 g/dl), leukocytosis, azotemia (Cr 2.7 mg/dl) and positive acute phase reactants. Increased serum immune complex level and hypocomplementemia were also found. The diagnosis of allergic purpura was made initially, but positive blood culture of Streptococcus mitis and the detection of vegetation attached to the right ventricular wall near the ostium of the VSD made the definite diagnosis of infective endocarditis (IE). Chemotherapy with PCG was started for two weeks but with no effect. The chemotherapy was altered to panipenem/betamipron with a daily dose of 3 g, Then, her fever fell and purpura, macroscopic hematuria and renal failure gradually disappeared. In this case, the cause of renal manifestations was considered to be immune complex glomerulonephritis. This is the first report of IE with macroscopic hematuria due to immune complex glomerulonephritis.
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PMID:[A case of infective endocarditis with purpura and macroscopic hematuria as initial manifestations]. 869 Sep 52

We report on some members of two unrelated families showing the characteristic features of Robinow syndrome. In a consanguineous Kuwaiti family, the index case with Robinow syndrome showed some unusual features including severe IUGR, laxity of ligaments, hyperextensible joints, redundant skin folds, severe normocytic anaemia, repeated infection, increased percentage of total T cells and CD4 positive population, reduced percentage of CD8 positive cells, and EMG abnormality. In a Pakistani family with a high degree of multigenerational consanguinity, a single case with the Robinow phenotype also had congenital heart disease, mainly involving the right side of the heart, with pulmonary stenosis, tricuspid atresia, ASD, VSD, double outlet right ventricle, and right atrial isomerism. This report suggests that the disease profile of Robinow syndrome may be extended to accommodate the unusual traits mentioned above. The association of the Robinow phenotype with congenital heart disease in case 2 of this report is consistent with the previously reported finding that congenital heart disease, particularly involving the right side of the heart, may be a prominent component of Robinow syndrome in a subset of patients.
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PMID:Unusual traits associated with Robinow syndrome. 959 42

A 50-year-old woman was referred to our hospital because of skin purpura, anemia, high fever, and acute renal insufficiency. Five years ago, she had been diagnosed as having ventricular septal defect without any complications. A blood culture drawn during the hospitalization grew Streptococcus viridans. She was diagnosed as having infective endocarditis-induced crescentic glomerulonephritis (GN) according to echocardiography and renal biopsy results. Although antibiotic treatment alone showed no apparent efficacy, after the initiation of plasmapheresis, the high fever and acute renal insufficiency were dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment of infective endocarditis-induced crescentic GN. The possible mechanisms of this therapy are discussed.
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PMID:Infective endocarditis-induced crescentic glomerulonephritis dramatically improved by plasmapheresis. 970 18


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