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

After lobectomy a slight increase of pulmonary arterial pressure can already be observed in the state of rest. The resistance of the pulmonary vessels reveals a marked dependance on the date of operation, it increases moderately on strain, but more significantly in the state of rest. At the same time cardiac output is decreased due to the exhaustion of the myocard after straining. Cardiac insufficiency developing postoperatively is due to the reduction of pulmonary hypertension. The reduction of VC and a slight increase of resistance do not cause the arterial PO2 pressure to be lowered under conditions of strain or rest.
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PMID:[Haemodynamic and respiratory changes after lung resection (author's transl)]. 89 24

In the 4 studied patients presenting with an Halasz's syndrome, the disease was complicated since the neonatal period by pulmonary arterial hypertension and heart failure. Three out of the 4 infants rapidly died, one after pneumonectomy. The fourth is surviving and benefitted solely from medical cardiotonic treatment. The pathogenesis of early pulmonary arterial hypertension in Halasz's syndrome is complex. The possibly associated cardiac malformations, the persistance of fetal obstructive hypertension due to the increase of the flow in the left pulmonary artery, the left to right shunt induced by the abnormal venous return and predominantly by the systemic blood supply to the right lung, are responsible, at various degrees, for pulmonary hypertension. Among surgical procedures to be proposed, the simple ligation of abnormal arteries which take their origin from the aorta seems to be preferable to pneumonectomy.
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PMID:[Halasz syndrome revealed in the newborn infant by pulmonary arterial hypertension. Study of 4 cases]. 90 33

A study was made of 29 cases of single ventricle confirmed by autopsy, hemodynamic study, or both. It must be emphasized that the term single ventricle excludes whatever malformation which shows traces of an intraventricular septum. Thus conceived, the malformation has been seen to have different clinical courses, which only permit partial diagnosis that may suggest the possibility of "single ventricle". In live patients this can only be diagnosed with specialized studies. In outline, there exist 4 types of clinical hemodynamic behavior: 1) The type with marked increase of pulmonary flow, in which the single cavity vascular systems, pulmonary and aortic, had similar pressures. This type behaves, in a certain way, like large interventricular communications. 2) The type which behaves hemodynamically like a large hypertensive communication with delayed cyanosis of rapid evolution and with few manifestations of heart failure. 3) The third type also has pulmonary hypertension with delayed cyanosis. This differs from the preceeding in that there is a preferential flow in such a way that the venous blood proceeding from the right atrium empties into the aorta and the arterial blood from the left atrium empties into the pulmonary artery. 4) The fourth type is characterized by rapid cyanosis and from the anatomical point of view has stenosis or atresia of the pulmonary artery. An analysis was made of the varieties which within these four classes actually ocurred or cases which were present as theoretical possibilities: single ventricle with crossed great arteries; single ventricle with transposition of the great arteries; single ventricle with partial distortion of the great arteries; single ventricle with common trunc. A detailed analysis was made of the clinical, hemodynamic, electrocardiographic, and radiological manifestations which are seen in these combinations and an anatomic-embriologic classification is proposed on the basis of the systematization of the 29 cases of the present study. Finally brief considerations are made of the operability of those cases of single ventricle according to their anatomic variety.
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PMID:[Single ventricle. II. Clinical study. Special studies and surgical treatment]. 101 98

1. We investigated the haemodynamic effects of intravenously administered hydrallazine, diazoxide and nitroprusside and orally administered minoxidil to determine whether vasodilators (such as nitroprusside) which do not increase cardiac output might be better treatment for hypertensive complications associated with, or caused by, myocardial failure than those that do. 2. Hydrallazine and diazoxide caused increases in heart rate, cardiac output, cardiopulmonary blood volume, the ratio of cardiac output to cardiopulmonary volume, and pulmonary artery pressure. Nitroprusside, although decreasing pressure and vascular resistance, caused no significant change in the other functions except for reducing pulmonary artery pressure. Minoxidil, when given orally, had the potential for causing pulmonary hypertension. This seemed explained by increased flow (hyperdynamic type) in some but by congestive cardiac failure in others; the latter condition was probably intensified by the marked fluid retention that the drug can cause. 3. On the basis of these results a classification of vasodilators was constructed which depends on the presence or absence of a venodilating effect. Vasodilators which produce no (or little) venodilatation, increase heart rate, cardiac output, cardiopulmonary blood volume and pulmonary artery pressure. In this class are diazoxide, hydrallazine and minoxidil. Those that cause venodilatation do not stimulate the heart nor do they cause pulmonary hypertension. Nitroprusside and nitroglycerine are drugs of this type. 4. These results suggest that drugs producing both venodilatation and arteriolar dilatation may be more specific therapy for hypertensive complications associated with cardiac failure than those that cause only arteriolar dilatation.
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PMID:Vasodilating drugs: contrasting haemodynamic effects. 107 83

The fate of aortocoronary saphenous vein bypass graft to the left anterior descending (LAD) coronary vein is reported. The vein graft communicated with the coronary sinus through the proximal LAD vein, producing a functional coronary arteriovenous fistula. The LAD vein was totally occluded distally at follow-up four months after operation. The natural history of congenital fistulas between coronary arteries and the coronary sinus suggested that bacterial endocarditis, pulmonary hypertension, and cardiac failure were all possible future complications in this patient. Operation was performed to revascularize the LAD artery to relieve persistent angina, and to close the fistula. Postoperative angiography showed a patent graft to the LAD artery with complete obliteration of the fistula. The patient is asymptomatic ten months after operation.
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PMID:Aortocoronary saphenous vein autograft accidentally attached to a coronary vein: follow-up angiography and surgical correction of the resultant arteriovenous fistula. 108 32

The authors report a case of a large ventricular septal defect with pulmonary hypertension, cardiomegaly and heart failure in early infancy, exhibiting marked improvement at five years of age. Subsequent followup, revealed spontaneous closure of the defect demonstrated by hemodynamic studies between 7 and 8 years of age, at which time the patient became completely asymptomatic with disappearance of all abnormal physical findings.
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PMID:Late spontaneous closure of a large ventricular septal defect. 108 33

Extrapulmonary support in respiratory failure has become possible for prolonged periods with clinical application of the membrane lung oxygenator. The membrane lung may be perfused in a venovenous circuit, in which case it functions by prepulmonary venous oxygenation, or it may be pumped in venoarterial perfusion as partial or total cardiopulmonary bypass. Four patients were placed on venovenous membrane lung (GE-Peirce) perfusion for periods ranging from 6 to 112 hours. In oxygenating blood flows of less than 50% of the cardiac output, a viable PaO2 (mean, 52 mm Hg) was obtained in 2 patients with 60% FIO2, including 1 survivor who was weaned from the membrane lung. The remaining 2 patients had heart failure and insufficient venovenous membrane lung flows to improve systemic oxygenation (mean PaO2, 45 mm Hg on 100% FIO2). Four other patients were placed on venoarterial membrane lung (GE-DuaLung) bypass for 18 to 110 hours. With 40 to 85% of the cardiac output bypassed through the membrane oxygenator, immediate improvement was seen in systemic oxygenation (mean PaO2, 75 mm Hg), effective compliance (mean increase of 75%), and reduction in pulmonary hypertension (mean decrease, 15 mm Hg). These changes during bypass allowed the lungs to be put at rest with a decrease in FIO2 and positive end-expiratory pressures. This clinical experience indicates that venoarterial membrane lung bypass may be both supportive and therapeutic, decompressing the pulmonary circuit and maintaining systemic oxygenation. Membrane lung supported by either mode of perfusion has been shown to be clinically effective in patients suffering acute respiratory failure.
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PMID:Clinical effects of membrane lung support for acute respiratory failure. 116 64

Intracardiac correction of VSD in infants should be indicated if the mortality and morbidity of the operation at this age group is lower than cumulative mortality of pulmonary artery banding plus second-staged procedure mortality. Experience with closure of VSD in 23 patients under 1 yr of age with 4% mortality and low morbidity is presented. Indications for operation are: (1) intractable heart failure; (2) persistence or progression of pulmonary hypertension; and (3) failure of banding procedure. Deep hypothermia and circulatory arrest facilitated the intracardiac repair in all patients. Mortality and morbidity related to the banding procedure are emphasized, and it is suggested that banding be restricted only to patients with associated coarctation of the aorta or to patients with multiple muscular ventricular septal defects in whom left ventriculotomy can be safely performed at an older age.
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PMID:Corrective treatment of isolated ventricular septal defect in infancy. 118 67

Sixty-four patients with large ventricular septal defects and severe pulmonary hypertension form the basis of this report. Prior to the end of 1970, 35 patients with a ratio of pulmonary to systemic artery pressure (pp/ps) of 0.8 or more were subjected to primary closure of the defect, resulting in 11 operative deaths Since the beginning of 1971, until March, 1974, however, the surgical results have markedly improved and 29 such patients were operated on without death. It has been our principle to perform elective closure of the defect at the age of 1 to 3 years. An earlier operation was planned when a decrease in the apical diastolic rumble and the size of the enlarged left ventricle on the chest x-ray were found on the periodical observation since infancey. If cardiac failure could not be controlled with medical treatment, primary closure of the defect has been performed even under one year of age.
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PMID:Surgical indication and results in ventricular septal defect associated with severe pulmonary hypertension. 124 1

Pulmonary artery aneurysm (PAA) usually carries an ominous prognosis due to the associated pulmonary hypertension. Six years ago a patient with a PAA secondary to cystic medial necrosis and pulmonary hypertension due to a ventricular septal defect (VSD) was treated by aneurysmorrhaphy and closure of the VSD. Although the patient had early postoperative cardiac failure, his cardiopulmonary status stabilized, and he has done well without recurrence of his aneurysm or cardiac failure. This report summarizes the patient's clinical course, operative treatment, and long-term follow-up.
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PMID:Aneurysm of the main pulmonary artery: long-term survival after aneurysmorrhaphy and closure of a ventricular septal defect. 126 20


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