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

A 12-year-old male child was referred to our clinic for the surgical treatment of an anterior mediastinal mass, suspected to be a thymic cyst, which was considered to potentially lead to cardiac failure. The mass was resected completely with a median sternotomy. The postoperative course was uneventful. A pathological examination revealed a mature cystic teratoma of anterior mediastinum which is a very rare cystic tumor at this location. The incidence, diagnostic procedures, complications, and treatment of mediastinal teratomas are discussed along with a review of the literature.
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PMID:Benign mature cystic teratoma of the anterior mediastinum leading to heart failure: report of a case. 1450 96

Primary tumors of the heart are uncommon in the fetus and neonate. Nevertheless, the widespread use of new imaging techniques has contributed significantly to earlier diagnosis, treatment, and thus improved survival. The clinical findings, imaging studies, pathology, and outcome of 224 fetuses and neonates with cardiac tumors collected from the literature are evaluated and discussed. Most tumors are benign, and of these rhabdomyoma is the most common, followed by teratoma, fibroma, oncocytic cardiomyopathy, vascular tumors, and myxoma. Malignant and metastatic tumors are described but are rare. Murmurs, arrhythmias, cyanosis, respiratory distress, and cardiac failure are the main presenting signs of cardiac tumors in the perinatal period. Disturbances in hemodynamic function are correlated with the size and location of the tumor. Cardiac vascular tumors have the best outcome, whereas malignant tumors have the worst. The purpose of this review is to concentrate on the fetus and neonate in an attempt to determine the various ways cardiac tumors differ clinically and morphologically in this age group from those occurring in older children and adults and to show that certain types of tumors have a better prognosis than others.
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PMID:Fetal and neonatal cardiac tumors. 1536 Jan 17

Most of benign mediastinal tumors are asymptomatic; however, sometimes we encounter emergent cases. In this article we discuss with regard to the situation that benign mediastinal tumors with severe symptoms need to be treated emergently. Any benign mediastinal tumors can cause respiratory and cardiac failure as they grow large enough to compress surrounding structures. It is very unique that the symptoms are relieved or worsen according to the patients' position. Rupture of mature teratoma is another situation which necessitates emergent therapy. The symptoms due to rupture depends on the site, that is pericardial space, intrapulmonary, and thoracic cavity. The mechanism of rupture is suspected to autolysis, infection, and necrosis of the tumor. Anesthesia is an important issue in treating such huge mediastinal tumors, because general anesthesia using muscle relaxants can introduce acute respiratory or cardiac failure. Patient's position is again very important, for example, in the patients with orthopnea anesthesia is sometimes initiated and the patient is intubated in sitting position. Although it is rare, we must be aware of these emergent situations when we treat patients with benign mediastinal tumors.
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PMID:[Benign mediastinal tumors]. 1536 60

Cellular cardiomyoplasty is an attractive option for the treatment of severe heart failure. It is, however, still unclear and controversial which is the most promising cell source. Therefore, we investigated and examined the fate and functional impact of bone marrow (BM) cells and embryonic stem cell (ES cell)-derived cardiomyocytes after transplantation into the infarcted mouse heart. This proved particularly challenging for the ES cells, as their enrichment into cardiomyocytes and their long-term engraftment and tumorigenicity are still poorly understood. We generated transgenic ES cells expressing puromycin resistance and enhanced green fluorescent protein cassettes under control of a cardiac-specific promoter. Puromycin selection resulted in a highly purified (>99%) cardiomyocyte population, and the yield of cardiomyocytes increased 6-10-fold because of induction of proliferation on purification. Long-term engraftment (4-5 months) was observed when co-transplanting selected ES cell-derived cardiomyocytes and fibroblasts into the injured heart of syngeneic mice, and no teratoma formation was found (n = 60). Although transplantation of ES cell-derived cardiomyocytes improved heart function, BM cells had no positive effects. Furthermore, no contribution of BM cells to cardiac, endothelial, or smooth muscle neogenesis was detected. Hence, our results demonstrate that ES-based cell therapy is a promising approach for the treatment of impaired myocardial function and provides better results than BM-derived cells.
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PMID:Engraftment of engineered ES cell-derived cardiomyocytes but not BM cells restores contractile function to the infarcted myocardium. 1695 71

Pathogenic causes underlying nonischemic cardiomyopathies are increasingly being resolved, yet repair therapies for these commonly heritable forms of heart failure are lacking. A case in point is human dilated cardiomyopathy 10 (CMD10; Online Mendelian Inheritance in Man #608569), a progressive organ dysfunction syndrome refractory to conventional therapies and linked to mutations in cardiac ATP-sensitive K(+) (K(ATP)) channel subunits. Embryonic stem cell therapy demonstrates benefit in ischemic heart disease, but the reparative capacity of this allogeneic regenerative cell source has not been tested in inherited cardiomyopathy. Here, in a Kir6.2-knockout model lacking functional K(ATP) channels, we recapitulated under the imposed stress of pressure overload the gene-environment substrate of CMD10. Salient features of the human malignant heart failure phenotype were reproduced, including compromised contractility, ventricular dilatation, and poor survival. Embryonic stem cells were delivered through the epicardial route into the left ventricular wall of cardiomyopathic stressed Kir6.2-null mutants. At 1 month of therapy, transplantation of 200,000 cells per heart achieved teratoma-free reversal of systolic dysfunction and electrical synchronization and halted maladaptive remodeling, thereby preventing end-stage organ failure. Tracked using the lacZ reporter transgene, stem cells engrafted into host heart. Beyond formation of cardiac tissue positive for Kir6.2, transplantation induced cell cycle activation and halved fibrotic zones, normalizing sarcomeric and gap junction organization within remuscularized hearts. Improved systemic function induced by stem cell therapy translated into increased stamina, absence of anasarca, and benefit to overall survivorship. Embryonic stem cells thus achieve functional repair in nonischemic genetic cardiomyopathy, expanding indications to the therapy of heritable heart failure. Disclosure of potential conflicts of interest is found at the end of this article.
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PMID:Embryonic stem cell therapy of heart failure in genetic cardiomyopathy. 1866 12

After more than two decades of experimental and clinical work, fetal surgery is an accepted treatment option for highly selected fetuses with life-threatening anomalies. Fetal lung masses associated with hydrops are usually fatal. These lesions can be resected in utero if they are predominantly solid or multicystic. Fetal sacrococcygeal teratoma complicated with progressive high output cardiac failure may benefit from in-utero resection of the tumor. Important lessons have been learned about perioperative management and maternal, fetal, and neonatal outcomes after open fetal surgery.
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PMID:Open fetal surgery for life-threatening fetal anomalies. 1954 Jan 78

Sacrococcygeal teratoma develops from all three germinal layers (endoderm, mesoderm and ectoderm). Sacrococcygeal teratomas (SCT) are the most common neoplasms in the fetus and newborns, with an estimated prevalence of 1 in 20,000 to 1 in 40,000. Female to male ratio is 3:1. Perinatal mortality rate among fetuses with prenatally diagnosed SCT is high, mainly due to cardiac failure. According to Polish Gynecology Society Recommendation, the main aim of intrauterine intervention or pharmacological treatment in case of prenatally diagnosed SCT is to prevent development of severe fetal cardiac failure. Fetal cardiac failure is one of the most important prognostic factors in surveillance of fetus and newborns with SCT. The following article describes a case report of a 34-year-old pregnant woman, 23 weeks of gestation, with a diagnosis of fetal sacrococcygeal teratoma. Each pregnant woman with suspicion of neoplasm in fetus should be referred to tertiary center of perinatal care to gain access to specific diagnostic methods and medical care of many specialists, such as obstetricians, neonatologists, general practitioners and infant surgeons. The role of psychological care during hospitalization is also invaluable and helps the patient to minimize the mental trauma, due to diagnosed fetal abnormalities.
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PMID:[Sacrococcygeal teratoma in foetus--case report]. 2008 2

We report the anesthetic management of a low birth weight infant (1912 g including the tumor) with a giant sacrococcygeal teratoma (Altman type II). The diagnosis was prenatally made at 24 weeks of gestation. She was delivered by emergent cesarean section at 28 weeks gestation, because fetal heart failure was aggravated by arteriovenous shunting through the tumor. Total resection was planned on day 0. Her trachea was intubated via nasotracheal route to prevent accidental extubation during surgery, which was performed in supine and prone position. A central venous line (5 Fr. double lumen) was inserted via right internal jugular vein for monitoring central venous pressure (CVP) and for rapid volume infusion. We infused volume to keep CVP at 10 mmHg throughout the surgery. The resected tumor weighed 766 g, total blood loss was 770 ml and blood transfusion was 965 ml. Although transient acidosis and hyperkalemia occurred, the surgery was completed and she was transferred to a neonatal intensive care unit in stable condition. In this case, nasotracheal intubation and the insertion of a central venous line were necessary and useful for the anesthetic management of the resection of giant sacrococcygeal teratoma.
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PMID:[Anesthetic management of a low birth weight infant with giant sacrococcygeal teratoma]. 2096 Sep 2

A 52-year-old female physician was admitted to hospital because of severe dyspnea and massive pleural effusion. At first, it seemed she may have been suffering from heart failure with an associated malignant disease. The patient was seemingly unaware of her progressive illness. During her hospital stay, it became evident that she was denying the possibility of cancer because of her husband's death from adenocarcinoma of the esophagus three years earlier. The carcinoma was inoperable and he was treated with chemotherapy. The patient was very upset about her husband's untimely death, and his treatment convinced her that she did not want chemotherapy if she was found to have cancer. Fortunately, it was discovered that she had benign cystic teratoma of the ovary with ascites and hydrothorax (Meigs' syndrome).
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PMID:Meigs' syndrome. 2127 51

Intrapericardial teratoma is a rare congenital tumor that without treatment leads to cardiac failure in either the prenatal or postnatal period. Early diagnosis and recent surgical advances can, in some cases, delay development of intrauterine symptoms and allow final treatment through a tumor resection. However, a large number of intrapericardial tumors go undetected during prenatal diagnostics, until they are found as a cause of intrauterine death or postnatal cardiorespiratory insufficiency, as in our case report. An abortion was induced in the 23rd gestational week because there was no cardiac activity detected during a routine ultrasound scan in a 35-year old woman. The tumor was found during the postmortem of the fetus.
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PMID:Intrapericardial teratoma as a cause of fetal death--a case report. 2214 21


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