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

In this report, we present 2 cases of severe congestive heart failure and mild renal insufficiency in patients who underwent continuous ambulatory peritoneal dialysis (CAPD) after stabilization using the extracorporeal ultrafiltration method (ECUM). Long-term good control of congestive heart failure was achieved following the institution of CAPD. Case 1, a 58-year-old woman with rheumatic arthritis and diabetes mellitus had anteroseptal myocardial infarction at the age of 52. And case 2, a 68-year-old man, who underwent coronary artery bypass surgery at the age of 66 and had extensive anterior infarction after the operation. They were admitted to the hospital with dyspnea due to congestive heart failure. In both cases, systolic cardiac function was severely impaired and mild renal insufficiency was present at the time of hospitalization. After admission, symptomatic relief was not obtained by conventional therapies and symptoms of congestive heart failure worsened until the patients suffered from severe respiratory distress even at rest. ECUM was then instituted to remove excess fluid and clinical improvement was achieved. After the initiation of ECUM, responsiveness to diuretics was not restored, and the procedure was necessary every day or every other day for the prevention of symptoms due to fluid overload. About 20 days after the initiation of ECUM, CAPD was begun for the long-term control of congestive heart failure and renal failure, and for the purpose of hospital discharge. Good control of heart failure was achieved after the initiation of CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two case reports of refractory heart failure treated by continuous ambulatory peritoneal dialysis]. 823 16

A case of an 8-year-old girl with Bland-White-Garland syndrome (BWG) who successfully underwent a second mitral valve replacement is reported. The patient had a past history of mitral valve replacement under the diagnosis of mitral regurgitation and pulmonary hypertension at one year and 3 months of age. Cardiac catheterization at 6 years and 3 months of age revealed an anomalous origin of the left coronary artery from the pulmonary artery but she was asymptomatic. One year and 7 months later, she was admitted to our institution with a sudden onset of chest pain and respiratory distress. Right heart pressure study using a Swan-Ganz catheter showed severe pulmonary hypertension and elevated mean pulmonary wedge pressure (38 mmHg). Echocardiogram revealed severe mitral stenosis and moderate regurgitation. She was diagnosed under fluoroscopy as acute left cardiac failure due to stuck valve and suspected having myocardial damage due to BWG, thus, emergency surgery was performed. Under cardiopulmonary bypass, aorto-left coronary arterial continuity was established by intrapulmonary arterial tunnel using Hamilton's technique. After resection of the prosthetic valve, of which one of two leaflets had been fixed in pannus, re-MVR was done with a St. Jude. Medical valve (25 mm). Postoperative angiogram demonstrated satisfactorily reconstructed two coronary artery systems. Postoperatively, she has been doing well without complaint for the last eighteen months.
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PMID:[A case of mitral valve re-replacement with radical correction of Bland-White-Garland syndrome]. 828 41

Toxic effect of chemotherapy was found in 13 dead patients suffering from myeloic leukaemia, Hodgkin disease and malignant lymphoma during past 18 months. Drugs with known toxicity from various sorts of antineoplastic treatment were administered simultaneously or successively what did not allow to differentiate their effects. Clinical symptomatology of the patients comprised respiratory distress syndrome or heart failure which could not be otherwise explained. Pneumopathies prevailed (10 cases) over isolated cardiomyopathies (3 cases), their concurrence was found in 3 other cases. Pneumopathies were mostly (9 cases) characterized by diffuse alveolar damage, by often bizarre proliferating type II pneumocytes and capillary thrombi. Simultaneous organizing processes (7 cases) in alveoli and bronchioli were present and sometimes combined with interstitial lung fibrosis; a single secondary alveolar lipoproteinosis was combined with intraalveolar organization. Cardiomyopathies were mostly characterized by irregular cardiocyte hypertrophy and focal fibrosis, sometimes by distended and waved or vacuolated cardiocytes. Toxic lesions are reversible as usual and risky treatment modalities found out by pathologist are to be early modified.
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PMID:[Toxic manifestations in the treatment of leukemias and malignant lymphomas]. 831 82

Between November, 1987 and May, 1990, definitive operation was performed in 7 infants for tetralogy of Fallot with absent pulmonary valve. Preoperative respiratory failure was serious in 5 patients and semi-emergency operation was done. Surgical procedure consisted of closure of ventricular septal defect, reconstruction of right ventricular outflow tract using heterograft valved pericardial roll and plication of aneurysmally dilated pulmonary artery with or without pulmonary artery suspension in 5 infants with severe respiratory distress and heart failure, operated on 26 days to 5 months of age. In the other two less symptomatic infants, operated on at 13 months of age, reconstruction of right ventricular outflow tract was performed by transannular bovine pericardial patch with monocusp. There were no operative death and six infants are doing well 6 months to 3 years postoperatively, but one patient died of prolonged respiratory infection and respiratory failure one year after operation. Postoperative pulmonary arteriogram revealed a 42 to 61 (mean 54) percent reduction in right and left pulmonary artery size in 3 patients who underwent extensive plication of pulmonary artery. We suggest that definitive plication with or without suspension of pulmonary artery, together with closure of ventricular septal defect and reconstruction of right ventricular outflow tract is supposed to eliminate air way obstruction.
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PMID:[Surgical management of tetralogy of Fallot with absent pulmonary valve in infancy]. 845 46

A female infant weighing 2.4 kg had respiratory distress at birth. She became dyspneic and hypercapnic and required intubation with assisted ventilation 11 days after birth. Because cardiac failure and respiratory failure did not improve, she underwent total correction at 26 days old, which consisted of VSD closure, right ventricular outflow tract reconstruction with valved porcine pericardial roll (VPR) and plication of both pulmonary arteries. She was weaned from the ventilator 11 days after operation and discharged at 12 weeks of age. One year later, reoperation was successfully performed for the replacement of the stenotic VPR with a transannular patch.
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PMID:[A case report of successfully corrected 26 days old infant of tetralogy of Fallot with absent pulmonary valve]. 847 81

Angioneurotic oedema secondary to angiotensin-converting enzyme (ACE) inhibitors is a rare condition, but it is a side effect which is likely to be seen more frequently because of the increased use of these drugs in the treatment of heart failure and hypertension. We report two cases which illustrate problems in the diagnosis and management of this life-threatening condition, and also demonstrate that angioedema re-occurs if the ACE inhibitor is not discontinued. If angioedema is suspected, therapy with any angiotensin converting-enzyme inhibitor should be discontinued promptly, respiratory distress should be treated appropriately, and subsequent therapy should be initiated with an agent from an alternative class of drugs.
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PMID:[Angioneurotic edema in relation to therapeutic use of angiotensin-converting enzyme inhibitor]. 856 Jun 27

A female neonate with myelomeningocele but without Chiari type II malformation suffered from apneic spells. Magnetic resonance imaging showed no obvious brainstem anomaly. Brainstem auditory evoked potentials were initially abnormal and subsequently deteriorated during the 6 months after birth. The brainstem deficits were not reversed by a ventriculoperitoneal shunt. She died of respiratory distress and cardiac failure at 2 years of age. This case indicates an intrinsic dysfunction in the brainstem of patients with myelomeningocele not complicated by Chiari type II malformation.
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PMID:Apneic spells in a patient with myelomeningocele without Chiari type II malformation--case report. 858 84

From 1958 through 1992, 30 patients with hepatic hemangiomas were seen and treated at Children's Hospital Los Angeles. The majority of the patients were less 1 month of age (90 % younger than the first year of life) and there was no difference in sex distribution. Patients presented with coagulopathy, heart failure, abdominal mass, and respiratory distress. Eleven patients (33%) had hemangiomas in other sites. Fourteen patients were treated with steroid therapy. Of these, eight patients did not respond and received radiotherapy. Eleven patients who had the hemangioma confined to an anatomical lobe had resection of the hemangioma by liver lobectomy. Five of the most recent patients were successfully treated with hepatic artery embolization. Two other patients who were seen many years ago underwent diagnostic laparotomy and biopsy of the lesion before treatment with steroids. In one patient who presented with ruptured hepatic hemangioma, hepatic arterial ligation was performed. In another patient, seen recently, treatment with interferon alpha-2 was initiated, but the patient died. There were six deaths in the series. Four patients died of intractable congestive heart failure, steroids are given first. Course of steroid therapy may be repeated if necessary. Whereas formerly radiation therapy was added to the treatment of a patient resistant to steroids, therapeutic hepatic arterial embolization is a very good alternative for these patients. Surgical excision of the lesion can be performed by liver lobectomy if there is a solitary hemangioma within the boundaries of the surgical excision. Recently, in massive hemangioma with intractable thrombocytopenia, interferon alpha-2 therapy has been used, but so far our experience of this mode of therapy is limited.
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PMID:Hepatic hemangiomas in infants and children: a review of 30 cases. 861 61

Over a period of 6 years, 58 patients aged between 55 +/- 16 years have been treated for post-intubation tracheal stenosis (STPI). These patients were characterised by their frequency of an underlying respiratory or cardiac failure, a duration of intubation which was sometimes short and a delay between the extubation and the detection of stenosis which was les than one month in about one half of the cases. Thirty of the 58 patients presented with respiratory distress on admission. All the stenoses were treated initially by mechanical dilatation using a rigid bronchoscope. Radial incisions using an Nd-Yag laser were performed when necessary to facilitate the dilatation. The great majority of stenoses which were not fitted up with a tracheal endoprosthesis (EPT) at the first attempt recurred, leading to repeated therapeutic bronchoscopies (221 sessions in all). Fitting an EPT (Dumon prosthesis) was necessary in 35 cases on 12 occasions at the first attempt with the first bronchoscopy, and 23 times following a recurrence. Amongst the recurring stenoses a stabilisation was obtained at the price of repeated dilatations (4.3 sessions on average in only nine patients). Seven patients finally had a surgical resection and anastamosis of the trachea, of whom four had a transitory instillation of an EPT for the stenosis. The removal of the EPT was later attempted in 11 patients. Four did not present with any symptomatic recurrence. The secondary migration of the EPT is in practice one of the main inconveniences of the silicon prosthesis (8 cases now experienced). Our approach, which used to favour the mechanical dilatation has lead to a relatively high number of failures and thus to repeated bronchoscopies. This has lead us to re-define our therapeutic approach. The current schema which we propose is in the course of being validated in which we use EPT and surgical repair of the trachea more often. Only short stenoses (less than 1 cm) with a diaphragm are treated by dilatation and laser. The others are fitted initially with an EPT. The final management is guided by the progress in the stenosis, the tolerance of the endoprosthesis and the operability of the patients.
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PMID:[Endoscopic treatment of post-intubation tracheal stenosis. Apropos of 58 cases]. 867 52

A female infant presented with cyanosis, respiratory distress and unique to-and-fro murmur which she had since the age of 1-month-old. Absent pulmonary valve syndrome was diagnosed by echocardiography. She developed seizure disorders with hypocalcemia and pneumonia at the age of 2-month-old. The patient died from sepsis, intractable respiratory and heart failure. The postmortem study confirmed the diagnosis of congenital absent pulmonary valve associated with DiGeorge syndrome.
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PMID:Absent pulmonary valve syndrome associated with DiGeorge syndrome: report of one case. 894 31


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