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

Eighty-five patients operated on before January 1976 have survived at least 30 days after insertion of a valved external conduit by the venous ventricle (usually the right) and the pulmonary arteries as a part of the repair of their congenital heart disease. Follow-up information is available on 83 patients, and mean follow-up time has been 27.7 months. Seven patients have required reoperation because of obstructive complications. Actuarial analysis indicates that the proportion of patients requiring reoperation is 4.0 +/- 2.8% at 2 years, 12.9 +/- 5.5% at 3 1/2 years, and 30.4 +/- 12.1% at 5 years. In five patients compression of the conduit between the sternum and heart was the primary cause of the obstruction. The proportion requiring reoperation for conduit compression is 2.0 +/- 2.0% at 2 years, 8.6 +/- 4.9% at 3 1/2 years, and 27 +/- 12.4% at 5 years. Age at operation is not related to the proportion of patients requiring reoperation, nor is the type of conduit. No patients have yet required reoperation for conduit compression whose operation has been done since we began systematically to position the conduit well away from the sternum. By actuarial analysis the proportion of patients surviving 5 years is 76.7%. Of those alive at follow-up examination, 78% were without limitation of activity.
Circulation 1977 Sep
PMID:Late results with synthetic valved external conduits from venous ventricle to pulmonary arteries. 88 31

Entry into the left atrium during cardiac catheterization may be essential for full assessment of the hemodynamic situation, particularly for the accurate calculation of pulmonary blood flow and pulmonary arteriolar resistance. The retrograde transaortic transmitral technique of left atrial catheterization has been described in adults but no detailed reports are available for the pediatric age group. Experience of this technique in 43 children with congenital heart disease is now presented, with a success rate of 67 per cent and a low incidence of complications. This method compares favorably with other methods of left atrial catheterization when the interatrial septum is intact.
Am Heart J 1977 Sep
PMID:Retrograde left atrial catheterization in children with congenital heart disease. 88 66

Two cases of complex congenital heart disease are described in which systemic and pulmonary bloodstreams crossed at the atrioventricular level. Both patients were examined clinically, echocardiographically, and by cardiac catheterization, including angiography, and both underwent cardiac surgery and had intraoperative mapping of their conduction systems. Both patients were found to have levocardia and situs solitus of viscera and atria, large ventricular septal defect, and straddling right atrioventricular valve. One patient had atrioventricular discordance but with the left ventricle anterior and alightly on the right and with pulmonary atresia and dextromalposition of the aorta. The other patient had atrioventricular concordance but with the left ventricle inferior and slightly on the left and with ventricular-arterial concordance to normally related great arteries and banded pulmonary trunk. To our knowledge, this combination including straddling right atrioventricular valve has not been reported in the literature before. In both patients the straddling atrioventricular valve was thought to preclude corrective operation at that time. A unique palliative procedure--left ventricle-to-pulmonary trunk shunt--was successful in the first case and partial debanding of the pulmonary trunk in the second.
Mayo Clin Proc 1977 Sep
PMID:Straddling right atrioventricular valve in criss-cross atrioventricular relationship. 89 98

A total of 46 patients who survived aortic valve replacement with the present model Smeloff-Cutter prosthesis between 1968 and 1973 were followed up postoperatively. All patients received oral anticoagulant therapy. The average age at implantation was 44 +/- 13 (mean +/- standard deviation) years; 36 patients were male and 10 were female. The valve damage was caused by rheumatic disease in 19 (41 percent), infective endocarditis in 14 (30 percent), congenital heart disease in 7 (15 percent) and other factors in 6 (13 percent). Late death occurred in eight patients (17 percent). All available patients were followed up until December 1976. During the 8 years of follow-up study, seven patients, including four heroin addicts, had postoperative endocarditis (15 percent); five of the seven had cerebral involvement, possibly from septic emboli. Four patients were reoperated on; three had active endocarditis and one had a high transvalve pressure gradient. The mean follow-up time was 4.9 years per patient. Of the 38 living patients, 33 have functional improvement and are still being followed up. Only one patient had a bland embolism to a systemic artery. No ball variance or other types of material failure have been detected. Although the chronic aspects of valve disease remain after prosthetic valve replacement, the Smeloff-Cutter aortic prosthesis deserves strong consideration when selecting a rigid prosthesis for aortic valve replacement.
Am J Cardiol 1977 Sep
PMID:Clinical experience with the Smeloff-Cutter aortic valve prosthesis: an 8-year follow-up study. 90 32

In transposition of the great arteries, a Blalock-Hanlon closed atrial septectomy is performed to improve intracardiac mixing at the atrial level. Although the Blalock-Hanlon septectomy is a common surgical procedure in cyanotic congenital heart disease, it has not been adequately assessed pathologically. In 14 heart specimens from patients (aged 3 days to 19 years) with transposition of the great arteries and Blalock-Hanlon septectomy, the margins of the septectomy, fossa ovalis and atrial septum were identified. The total area of the septum and its defects was calculated using planimetry. The ratio of defect size to atrial septal area was expressed as percent communication, which ranged from 5 to 39 (mean 18) percent in eight specimens with intact limbus of the foramen ovale and 26 to 57 (mean 42) percent in six specimens in which the limbus had been excised. The finding that specimens in which the Blalock-Hanlon defect extended into the fossa ovalis had the largest total communication emphasizes that to obtain optimal bidirectional atrial mixing the surgeon should extend the Blalock-Hanlon procedure across the limbus into the foramen ovale.
Am J Cardiol 1977 Sep
PMID:Atrial defect size after Blalock-Hanlon atrioseptectomy. 90 39

The effects of phentolamine, 0-3 mg/min given intravenously for 15 minutes, on His bundle electrograms were studied in 11 patients with heart disease. Recordings were made at varied heart rates, using atrial pacing. Phentolamine significantly reduced the AH interval in every patient but it had no effect on the HV interval. Functional and effective refractory periods were measured with the use of the atrial extrastimulus technique. The effective refractory period of the atrium and atrioventricular node as well as the functional refractory period of the atrioventricular node all significantly decreased after phentolamine infusion. This improvement in conduction is probably mediated by a release of catecholamines.
Br Heart J 1977 Sep
PMID:Electrophysiological properties of phentolamine in man. 90 72

The incidence of rheumatism and rheumatic valvulopathy in Sicily is assessed and the sites most commonly involved in the first and second attacks described. The medical aspects of te question are examined from several points of view: prophylaxis of sites, medical treatment personal and ambient hygiene, gradual defectiveness of the pump, associated diseases, etc. The concept of invalidity is viewed in terms of direct and associated anatomical damage and frank and potential invalidity (absolute or relative), the weight or assistance attributable to the family and the incidence of the local social environment in the question of finding work, etc. The basic criteria for surgery are noted. Care must be taken to preserve the few remaining structures. Mortality is still high and the incidence of heart disease is higher among rheumatic Sicilian children. Not enough is known about overcrowding, the schools attended by the poor, and the higher incidence in low-income classes. Failure to affront some of these features, determined as much by action (or its postponement) by government as by income, results in meaningless medicine, divorced from social reform and true the scientific spirit, a cover for special interests and a demonstration of profit factors wherein the commercialising relationship is increasingly evident.
Minerva Med 1977 Sep 30
PMID:[The medico-social problem of rheumatic valve disease in Sicily]. 91 36

The effects of intravenous infusion of sodium nitroprusside were studied in 11 children immediately after open-heart surgery for congenital heart disease. The patients were selected because, following bypass, their cardiac index was below 2,0 L/min/m2 and their systemic vascular resistance exceeded 30 units. In order to eliminate the effects of preload, mean left atrial pressure was maintained at a constant level by blood transfusion. During infusion of nitroprusside the mean decrease of mean arterial pressure was 18.6%, of systemic vascular resistance was 53.7%, and the increase in cardiac index was 76.9%. All children recovered.
Circulation 1976 Sep
PMID:Nitroprusside after open-heart surgery. 94 76

A case of recurrent ventricular paroxysmal tachycardia in a young man without obvious heart disease is described. Posttachycardiac T-wave inversion followed the arrhythmic episodes. Programmed stimulation of the heart in association with intracardiac recordings showed evidence in favor of reentry within the bundle branches and its divisions during tachycardia. A critical prolongation of the H2-V3 interval preceded each paroxysm of tachycardia.
Chest 1976 Sep
PMID:Recurrent ventricular tachycardia due to reentry within the bundle branches. 95 68

Despite the fact that necrotizing enterocolitis is considered a disease of premature infants, 20% of all affected infants at Babies Hospital over the past 20 years were products of term gestations. Two distinct subgroups of such infants were noted (1) five infants with congenital heart disease and/or congestive heart failure (e.g.hypoplastic left heart syndrome), all but one of whom developed the disease in the first week of life; (2) eight infants who developed the disease at a much later age after a protracted period of diarrhea. This histopathologic features of the disease in term infants are the same as those in premature infants. Further, the pathogenesis of the disease in term infants does not appear to differ basically from that in premature infants. These facts, lead away from the concept of NEC as a disease of simple etiology.
J Pediatr 1976 Sep
PMID:Necrotizing enterocolitis in term infants. 95 75


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