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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ventricular septal defect repair had been performed in 57 infants ages 21 days to 21 months and under 10 kg in weight using profound hypothermia-circulatory arrest technics. Severe congestive heart failure was the indication for operation in all but two infants under 6 months of age, and in those under 3 months there was usually an associated moderate or large sized atrial septal defect or patent ductus arteriosus or a coarctation. In infants over 6 months controlled heart failure was accompanied by failure to thrive and often recurrent respiratory infections. The main indication for surgery in three infants was repeated severe respiratory infections and in 7 infants, ages 10-15 months, an elevation of pulmonary vascular resistance of 6 units M2 or more. There were two hospital deaths among the 49 infants without coarctation (ages 6 and 20 months) and two among the 8 with coarctation. Postoperative respiratory and other complications were uncommon. On late review there was no significant residual VSD amongst the 11 recatheterized patients. Psychometric studies in 19 children who had reached the age of three to four years gave no evidence of cerebral damage due to the circulatory arrest period. In view of these results palliative pulmonary artery banding is no longer performed for VSD in infancy unless there is a Swiss cheese septum or an associated severe coarctation.
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PMID:Repair of ventricular septal defect in the first two years of life using profound hypothermia-circulatory arrest techniques. 96 2

Sixty-eight infants with clinical evidence of a large ventricular septal defect (VSD), refractory to conventional medical treatment, underwent surgical closure within the first 12 months of life from August 1987 to June 1991. There were 43 males and 25 females. The ages of the patients ranged from two to 12 months, with a mean age of 6.6 months. The mean body weight of the patients was 5.4 kg (range, 2.3-10 kg). Surgery was performed because of intractable heart failure in 27 infants (39.7%), failure to thrive in 40 (58.8%), repeated pneumonia in 43 (63.2%) and prolonged endotracheal intubation in nine (13.2%). There were 21 patients with a supracristal VSD (30.9%) and 47 patients with perimembranous VSD (69.1%). Nine patients (13.2%) had preoperative cardiac catheterization. Transatrial repair of perimembranous VSDs and transpulmonary repair of supracristal VSDs was used exclusively without ventriculotomy. Surgically induced heart blocks did not occur in any of the patients. Only two patients (2.9%) died during the early postoperative period. Diagnosis in most cases was confirmed by the present advanced integrated color Doppler echocardiographic technology which is widely used by pediatric cardiologists. There was no need to perform cardiac catheterization in most patients with VSDs. The morbidity and mortality were very low. We strongly suggest that for infants with a large VSD, primary repair should be the procedure of choice.
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PMID:Surgical repair of ventricular septal defect without ventriculotomy in the first 12 months of life. 135 8

Sleep apnea in children develops when airway obstruction at night is severe; however, lesser degrees of obstruction may also cause problems. The most common cause of nighttime obstruction with or without apnea is hyperplasia of the tonsils and adenoids. Other conditions such as craniofacial anomalies and neuromuscular disorders may predispose children to obstruction of the airway during sleep. Although cor pulmonale, heart failure, and cardiorespiratory arrest are the most dramatic results of obstructive apnea, before these occur many other problems may develop that are detrimental to the child's health, including failure to thrive. A careful history and physical examination are usually sufficient to determine if obstruction and apnea are present at night. Additional studies such as sleep sonography and polysomnography are helpful for documentation of the disorder. The treatment of obstructive apnea, unless associated with central apnea, is surgical. The vast majority of children with obstruction have dramatic resolution of their obstruction following a tonsillectomy and adenoidectomy. Occasionally additional procedures including uvulopalatopharyngoplasty and tracheotomy are needed.
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PMID:Sleep apnea in children. 265 82

Galenic A-V fistulas typically result in hydrocephalus and increased cerebral venous pressure, with symptoms of progressive seizure activity, chronic cardiac failure and failure to thrive. Surgery and arterial embolization have been only partially successful in reducing flow through these shunts. The authors present technical details of a procedure for embolizing such lesions via a transtorcular venous approach. Early results in 15 patients are reported: Twelve patients appear to have had significant symptomatic improvement; two have died of persistent heart failure, and one died of a subdural hematoma associated with ventriculostomy.
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PMID:Gianturco coil embolization of vein of Galen aneurysms: technical aspects. 322 31

6 children aged 9 months to 13 8/12 years developed reduced physical capacity, failure to thrive, dyspnoea on effort and heart failure after viral infection. Bed rest and anticongestive therapy did not reduce the severe heart failure. Immunosuppressive therapy with prednisolone 2 mg/kg/d and azathioprine 2 mg/kg/d was added on the assumption of chronic myocarditis (n = 4) or endocardial fibrosis (n = 2). 3 of the 6 children showed a considerable improvement in heart size, ECG and systolic heart function. Interruption of immunosuppressive therapy due to side effects in one child led to cardiac deterioration, which was reversed by renewed prednisolone therapy. Two patients died of progressive congestive heart failure. Heart transplantation was successfully performed in the now 14 year-old girl who was suffering from terminal dilated cardiomyopathy. Since there is no specific test for selecting patients who are likely to benefit from immunosuppressive therapy we feel this regimen would be justified in hopeless cases of congestive cardiomyopathy who have not responded to conventional therapy with anti-congestive drugs.
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PMID:[Immunosuppressive treatment of chronic myocarditis]. 323 64

Metabolisable energy intake, determined by bomb calorimetry of food, vomit, stool and urine, and resting metabolism, assessed by respiratory gas exchange, were studied in 21 infants with congenital heart disease and nine control infants. Weight for age, growth rates, and daily metabolisable energy intake per kg tended to be lower in infants with heart disease than in control infants. Resting oxygen consumption was high in those infants with pulmonary hypertension and persistent cardiac failure. Energy intake, as a percentage of that recommended for age, correlated with weight gain, and resting oxygen consumption correlated inversely with both percentage body mass index and relative fatness. Failure to thrive in infants with congenital heart disease may be due to a combination of low energy intakes and, in some cases, high energy requirements allowing insufficient energy for normal growth. Increasing the energy intakes of infants with congenital heart disease may be a way of improving their growth.
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PMID:Why does congenital heart disease cause failure to thrive? 409 78

Three boys were treated for arteritis of the aorta and great vessels and bilateral renal artery stenosis. One presented at age 6 months with failure to thrive, excessive sweating, and vomiting: hypertension and cardiac failure were subsequently diagnosed. The two older boys (7 and 14 years) presented with symptomless hypertension. The clinical and angiographic findings in the three patients suggest that the illness may have been Takayasu's arteritis, which should be included in the differential diagnosis of hypertension in infancy and childhood. Renal autotransplantation was performed in all three patients with good results. Early renal autotransplantation may reduce the morbidity associated with this disease.
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PMID:Three patients with arteritis. 614 18

Pulmonary valve agenesis is a rare malformation, and is usually associated with a ventricular septal defect. Occasionally it may be associated also with right ventricular outflow obstruction. Children with this syndrome usually die early in infancy either of intractable heart failure or of severe respiratory distress. Rare instances of association with peripheral pulmonary stenoses have also been reported. We report the case of a three-year-old girl, asymptomatic except for failure to thrive, with pulmonary valve agenesis and coarctation of the pulmonary artery trunk.
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PMID:Pulmonary valve agenesis and supravalvular pulmonary stenosis. Report of a case and review of literature. 651 91

Four infants with congenital heart disease showed in their first months of life poor weight gain in spite of the absence of cardiac failure; a diagnosis of intolerance to cow's milk proteins was made on the basis of laboratory findings and subsequently confirmed by the success of the avoidance diet and the positivity of the challenge tests; all four children had previously received nasogastric feeding, and this may represent a favouring factor for sensitization. Intolerance to cow's milk proteins should be considered as a possible cofactor for failure to thrive in infants with congenital heart disease.
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PMID:Congenital heart disease and cow's milk intolerance. 654 11

Nasopharyngeal airways have been assessed in the management of infants with severe Pierre Robin syndrome. In 12 such infants the positioning and subsequent maintenance of these tubes were found to be important in ensuring adequate relief of the airway obstruction. In five infants measurements of lung mechanics demonstrated the benefits of NP tube placement and confirmed the observed improvements in cyanotic episodes, heart failure, electrocardiograms, and arterial gas tensions. In a retrospective survey of 40 infants with PRS, failure to thrive was found to be significantly correlated with the severity of the airflow obstruction. This failure to thrive was reversed in the infants managed with NP tubes in comparison with an age-matched groups nursed while prone. The lack of significant complications with the NP airway and its acceptability to nursing staff, patients, and their parents suggest that this method deserves more widespread use in PRS and perhaps in other situations in which high upper respiratory tract obstruction is predominant.
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PMID:Nasopharyngeal airways in Pierre Robin Syndrome. 706 30


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