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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Operative mortality from surgical treatment of congenital heart disease has been steadily reduced over the past 20 years. During the same period it has become clear that a proportion of survivors have residual clinical problems. Some of these are due to imperfect repair, a number being due to factors beyond present surgical control, and some are the consequence of associated cardiovascular defects. The chief problems can be elucidated by an analysis of the results of surgical treatment of six cardiac malformations: simple pulmonary valve stenosis, coarctation of the aorta, secundum atrial septal defect, isolated ventricular septal defect, tetralogy of Fallot and transposition of the great arteries. Recognition of the sequelae of preoperative hemodynamic strain and apparently minor associated malformations is important, and it is possible to anticipate such factors. Long-term follow-up of patients after operation is particularly important.
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PMID:Evaluation of late results of surgical treatment of congenital heart disease. 118 30

The authors present a case of completely interrupted aortic arch (Type B) associated with ventricular septal defect and patent ductus arteriosus in a child 3 years and 10 months old, who was successfully subjected to complete surgical correction in one procedure. The pre- and post-operative electrocardiographic and hemodynamic data are evaluated. The authors draw attention to the extreme rarity of surgical resolution, in one procedure, of this type of congenital heart disease.
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PMID:[Completely interrupted aortic arch, ventricular septal defect and patent ductus arteriosus. A complete surgical correction in one procedure (author's transl)]. 120 49

Coronary- and LV-angiography in coronary heart disease are indicated I) to clarify whether or not surgery is required (e.g. aorto-coronary-bypass operation, aneurysmectomy) in 1) drug resistent angina pectoris, 2) myocardial aneurysms (or the suspicion of), 3) VSD following myocardial infarction and/or 4) as preoperative investigations in mitral regurgitation or 5) other valve lesions. II) These investigations are furthermore indicated in the under-50-yr.-old considering their prognosis and diagnosis 1) following myocardial infarction 2) to clarify a pathological exercise test with or without angina pectoris 3) in the differential diagnosis of myocardial diseases and 4) occasionally in patients with a number of risk factors or exposed to particular occupational hazards or from families with a high incidence of early deaths from heart disease. Coronary- and LV-angiography are contraindicated in 1) generalized stenosing atherosclerosis, 2) acute myocardial infarction, 3) failure from other organ-systems (e.g. kidney), 4) drug resistent endogenous risk factors and/or relevant obesity, 5) biological age over 60-65.6) continued nicotine dependence. In many cases the specific diagnostic investigations will include the assessment of coronary flow at rest and during maximal drug induced coronary dilatation. This enables us to estimate the coronary reserve and to diagnose coronary insufficiency in patients with normal coronary angiograms.- Instructive morphological and/or functional results illustrate this presentation.
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PMID:[Indications for coronary arteriography and left ventriculography in coronary heart disease (author's transl)]. 125 Nov 19

Eighty cases of Down's syndrome were found among 1504 children with congenital heart disease under the age of 15 years. The most common cardiac anomaly, ventricular septal defect, was found in 49 per cent of the 80 cases studied, while the second most frequently encountered anomaly, common atrioventricular canal, was found in 15%. Haemodynamic investigations of 24 cases of ventricular septal defect showed Eisenmenger's syndrome to be present in 10 cases; this seemed to appear at an earlier age in mongoloid children than in other children with ventricular septal defect. Right-to-left shunt was found in 5 out of 9 cases of common atrioventricular canal. Pulmonary hypertension was found in all of 24 cases of ventricular septal defect and in 7 of 9 cases of common atrioventricular canal. The cumulative survival up to 10 years was 64% for girls and 49% for boys. Death was most commonly the result of pulmonary complications which occurred in 22 out of the 34 patients who died.
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PMID:Congenital heart disease in Down's syndrome. 125 93

This report presents the results of operation for congenital heart disease using two different methods of hypothermia: (1) Immersion hypothermia alone. Of the 782 patients who underwent open-heart operations using this method the results were good in patients whose intracardiac surgical repair took less than one hour (average mortality rate, 5.6%). (2) Rapid extracorporeal cooling. Of the 269 patients with congenital heart diseases such as ventricular septal defect, tetralogy of Fallot, or atrioventricular canal with low cardiac reserve who underwent operation with mild to moderate hypothermia utilizing rapid extracorporeal cooling, the mortality was 11.2%. In the 151 patients with more serious defects, including the extreme form of tetralogy of Fallot, single ventricle, and truncus arteriosus, who underwent open-heart operations with deep hypothermia utilizing extracorporeal cooling, the mortality rate was 15.2%.
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PMID:Surgical treatment of congenital heart disease with special reference to the application of hypothermia. 126 13

The clinical profile of 28 consecutive patients admitted with infective endocarditis (IE) between 1987 and 1988 was studied. There were 21 males and seven females with a mean age of 24 +/- 11 years. Rheumatic heart disease (RHD) was the commonest underlying disease (68%) followed by congenital heart disease (CHD). Mitral regurgitation with aortic regurgitation were the commonest valvular lesions (47%) in those with RHD while ventricular septal defect was the commonest (43%) in those with CHD. A younger age of onset, complicated course and high mortality were seen in these six patients with acute IE. Persistently positive blood cultures during life or at autopsy were obtained in 21%. Strep viridans was the commonest isolate and was often resistant to streptomycin. 2D echocardicgram revealed vegetations in 96% of patients, the aortic valve (39%) being more commonly affected than the mitral valve (11%). ESR of more than 20 mm drop 1st hour (Wintrobe) was seen in 96%. Thrombophlebitis was a common complication of therapy and cloxacillin the commonest drug implicated. A mortality of 21% as a result of refractory congestive heart failure (CHF) (50%), uncontrolled sepsis (33%) and embolic events (17%) was seen. A rising incidence of culture negative IE, combined aortic and mitral valve disease and CHF is noted.
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PMID:Changing spectrum of clinical and laboratory profile of infective endocarditis. 130 28

The authors reported 23 cases of re-open heart surgery in 1473 patients with congenital heart disease treated surgically in the last ten years. The incidence was 1.6%. In 13 cases of the 23 re-open heart procedure was performed before closing the chest during the operation because of missed diagnosis in 5, incomplete correction of the anomaly in 5, and injure to important organ in 3. All of the 13 patients were recovered and discharged. Of the 23 cases re-open heart surgery was performed during the early postoperative period in 8 cases, including 4 cases of misdiagnosis, and 4 incomplete correction. 1 patient with VSD had still residual ventricular septal shunt post reintervention and died of circulatory failure. Re-open heart surgery was performed during the late postoperative period in 2 of the 23 cases. There was 1 missed diagnosis, and another incomplete correction. 1 patient died of massive bleeding during the reoperation. The anthers pointed out that accurate diagnosis and error-free operation is of most importance in avoiding re-open heart surgery. Through exploration to the heart after resuscitation during the operation and positive re-opening of the heart when necessary were emphasized. Indication of early and late postoperative re-open heart surgery and methods to prevent its complication were listed.
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PMID:[Re-open heart surgery in congenital heart disease. An analysis of 23 cases]. 133 53

To evaluate the pulmonary extravascular space in patients with congenital heart disease, lung uptake of thallium-201 (T1-201) was quantitatively studied. A total of 50 T1-201 imagings were performed in 33 patients with total anomalous pulmonary venous connection (TAPVC); 4 preoperatively, 22 postoperatively in the early stage (within 6 months), and 24 in the late stage (7 months or later). The images consisted of 17 supracardiac TAPVC (type-I), 13 paracardiac (type-II) and 3 infracardiac (type-III). In patients with tetralogy of Fallot (T/F), T1-201 imaging was performed 15 times preoperatively, 12 in the early stage and 15 in the late stage, postoperatively. Furthermore, 29 patients with ventricular septal defect (VSD) or patent ductus arteriosus (PDA) were also studied preoperatively, and 21 in the late postoperative stage. Twenty-five patients with arrhythmias or a history of Kawasaki disease without perfusion defects were studied on T1-201 myocardial imaging. Lung uptake of T1-201 was analyzed with a computer using the anterior image of the chest, and the average count ratio of the right lung (P) to the left ventricular wall (LV) was calculated. P/LV values were compared between the patients before and after surgery, and differences in anatomical types in TAPVC were also evaluated. In TAPVC, P/LV values decreased gradually in the postoperative state, but were significantly higher than those of controls even in the late stage. In the late postoperative stage, type-I TAPVC had significantly higher P/LV values than those of type-II.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pulmonary uptake of thallium-201 in patients with congenital heart disease: comparison between total anomalous pulmonary venous connection and tetralogy of Fallot]. 133 7

Among 388 cases of congenital heart disease with magnetic resonance imaging (MRI) from September 1990 to February 1992, we came across two cases of Ebstein's anomaly. They had been previously diagnosed as Ebstein's anomaly by echocardiography and cinecardioangiography. The first case was a three-year-old boy with complex congenital heart disease that included Ebstein's anomaly, a double-outlet right ventricle, pulmonary hypertension, tricuspid regurgitation, mitral regurgitation, a ventricular septal defect and an atrial septal defect. The second was a 13-year-old boy who also had Ebstein's anomaly, but had received a tricuspid valve replacement at the age of five. In Ebstein's anomaly, we found that MRI offers exquisite endocardial and epicardial details. We anticipate that in the future MRI will help to eliminate invasive studies.
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PMID:Magnetic resonance imaging of Ebstein's anomaly: report of two cases. 136 45

To investigate possible associations between cardiovascular malformations and maternal occupational exposure to various factors during the first trimester of pregnancy, 406 cases and 756 controls were studied retrospectively. The cases were taken from all infants diagnosed with cardiovascular malformations born in Finland during 1982 and 1983. The controls were randomly selected from all normal births in the country during the same period. All mothers were interviewed approximately 3 months after delivery by a midwife, using a structured questionnaire. Maternal overall exposure to chemicals at work was more prevalent among the case group (35.8%) than the control group (26.2%, P less than 0.01). Among the specific chemical groups, maternal exposure to dyes, lacquers, or paints was significantly associated with the risk of congenital heart disease. Exposure to organic solvents during the first trimester seemed to increase to risk of ventricular septal defect (P less than 0.05). Work at video display terminals was slightly more prevalent among the case group (6.3%) than among the control group (5.0%). The mothers' education level, regular exposure to passive smoking at work, or temperature at the workplace were not risk factors for congenital heart disease in the offspring, neither was maternal exposure to microwave ovens, disinfectants, pesticides, or anesthetic gases. It is concluded that many maternal exposures at work seem not to have a teratogenic effect on the fetal heart, although the limited power of this investigation needs to be borne in mind.
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PMID:Occupational risk factors for congenital heart disease. 139 16


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