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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Complete and unselected data concerning the postoperative pathology of congenital heart disease are presented for the first time. This study was based on 2,365 autopsies performed at the Children's Hospital Medical Center, Boston, in the 9 years from 1966 through 1974. Of these, 586 autopsies (25 percent) revealed congenital heart disease--238 performed in medically treated patients (41 percent) and 348 in surgically treated patients (59 percent). Tetralogy of Fallot, including cases with pulmonary outflow tract atresia and other associated malformations, was the congenital heart disease most often encountered in the postoperative autopsy series (88 cases, 25 percent of that series). D-transposition of the great arteries, including cases with other associated anomalies, was second (54 cases, 15.5 percent). Early death (hospital mortality) accounted for 320 (92 percent) of the 348 surgical cases; late death occurred in 28 patients (8 percent). Causes of late postoperative death included arrhythmias, excessively small ventricular septal defect with tricuspid atresia, massive hemoptysis, rupture of the pulmonary artery, cyanotic spell, congestive heart failure and infection. Prophylactic penicillin is recommended for patients with the asplenia syndrome because of their probably enhanced vulnerability to fulmfulminating septicemia by encapsulated bacteria such as the pneumococcus. Completeness and lack of selection in reporting data are essential in the interests of perspective and comparability of findings.
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PMID:Postoperative pathology of congenital heart disease. 95 66

Postoperative mycotic aneurysm of the thoracic aorta at the site of subclavian flap angioplasty (SFA) is very rare. A 6-year-old boy was admitted with a history of high fever for 10 days. He had undergone SFA at the age of 14 days and patch closure of VSD at 10 months. The chest X-ray film on admission revealed no abnormality. But, 7 days later, he suffered from frequent hemoptysis and chest X-ray film showed an abnormal mass shadow at the left upper lung field. Contrast enhanced CT scan and IV-DSA revealed a pseudoaneurysm of the aortic arch which had ruptured into the left upper lung. An extra-anatomical bypass was urgently made from the ascending aorta to abdominal aorta and the aneurysm was isolated by ligations of the aorta proximal and distal to the aneurysm. Aneurysmectomy combined with left upper lobectomy was carried out next day. Septic signs and hemoptysis dramatically improved after operation. Extra-anatomical bypass as a means of choice for the surgical treatment of the mycotic aneurysm greatly contributed to cure the severe ill patient. But a close follow up observation for the function of the graft is necessary.
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PMID:[A case report of ruptured mycotic aneurysm at the site of subclavian flap angioplasty]. 158 70

A case of unilateral pulmonary vein atresia in a 20-month-old girl is described in this report. A chest X-ray revealed a reticular shadow on the right side, while an electrocardiogram revealed right ventricular hypertrophy. After cardiac catheterization and angiography, a diagnosis of a ventricular septal defect, patent ductus arteriosus, severe pulmonary hypertension, and atresia of the right pulmonary vein was made. The patient underwent an operation for the ventricular septal defect and ligation of the patent ductus arteriosus. During the operation, the right pulmonary vein was found to be atretic, and unrepairable. Pneumonectomy was not performed because the pulmonary arterial pressure decreased to 41 mmHg after the surgical treatment of the intracardiac lesions. Pneumonectomy will be necessary if one or more complications such as persistent hemoptysis, repeated pulmonary infections or the development of pulmonary hypertension, may occur in future.
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PMID:[Unilateral pulmonary vein atresia]. 268 12

The objective of this study was to determine the long-term survival pattern and variables affecting long-term survival and complications occurring during follow-up of patients with Eisenmenger syndrome. A retrospective study of patients diagnosed with Eisenmenger syndrome were followed up. A tertiary care centre was used and it provided superspeciality services in various disciplines. The subjects included 201 patients with Eisenmenger syndrome--diagnosed by a combination of echocardiography and a peripheral arterial oxygen saturation study and/or cardiac catheterisation with or without angiocardiography--worked up and followed up for variable duration over a period of 16 years from 1976 to 1992. One hundred nine patients were females and 92 were males--age of presentation varied from 3 months to 62 years (mean +/- standard deviation 19.23 +/- 12.62 years). A total of 12 different anatomic lesions were seen--the most common three being ventricular septal defect (33.33%), aterial septal defect (29.85%), and patent ductus arteriosus (14.23%). History, physical examination, chest skiagram and electrocardiogram established only the presence of pulmonary arterial hypertension except where differential cyanosis indicating ductus was discernible or the degree of splitting of second heart sound provided some clue to the level of shunt. Contrast echocardiography, completed in 25.4% established the level of shunt in all patients. In others the diagnosis was confirmed by cardiac catheterisation. Twenty patients died during a mean follow-up period of 54.6 +/- 54.47 months. Sudden cardiac deaths (30%), congestive heart failure (25%) and haemoptysis (15%) were the most predominant causes of death. Only one patient died during puerperium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prognosis for patients with Eisenmenger syndrome of various aetiology. 796 Feb 65

A 26-year-old man had a total repair of tetralogy of Fallot at 1 year of age, and had redo surgery for restenosis of the right ventricular outflow tract and small residual VSD at 11 years of age. After the second operation, AV block developed and an endocardial pacemaker system was implanted. For the last 3 years, he had mild febrile episodes, cough, occasional hemoptysis and paroxysmal ventricular tachycardia. Because of his refractory tachycardia and suspected infective endocarditis, he was admitted for further study. Blood culture revealed Peptostreptococcus, echocardiogram showed vegetation around intravenous pacing lead, and electrophysiological study demonstrated delayed potential on the left side of the right ventricular outflow tract. He underwent scartectomy and cryoablation of the focus of the tachycardia which was reconfirmed by epicardial and endocardial mapping during the operation, which involved removal of the endocardial lead and new outflow tract patch repair. His postoperative course was uneventful without any antiarrhythmic drugs. Pathological examination of the scar showed myocardial fibrosis and replacement by fatty tissue which was different from the pathological characters of the arrythmogenic right ventricular dysplasia.
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PMID:[Successful scartectomy and cryoablation for ventricular tachycardia occurring late after correction of tetralogy of Fallot]. 896 97

A 32-year-old woman with transposition of the great arteries was referred to us for corrective surgery. She had severe cyanosis, dyspnea, and hemoptysis. The cardiac catheter study and echocardiography revealed that she had transposition of the great arteries, associated with atrial septal defect, ventricular septal defect, patent ductus arteriosus, and pulmonary stenosis. Rastelli operation was performed using equine pericardial roll with three valves made from autologous pericardium. After the operation she gave birth to two children without any symptom. Ventricular tachycardia occurred several times but was controlled by the drug. Eight years after the operation she underwent catheter study. Although the right ventricular pressure was 80 mmHg and the pressure gradient through the conduit was 38 mmHg, her general clinical condition was fairly good. We think the late postoperative result of this patient is satisfactory as an adult case of transposition of the great arteries.
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PMID:[The long-term result of an adult case of transposition of the great arteries corrected with Rastelli operation at the age of thirty-two years]. 963 44

A 2-month-old boy was diagnosed as having a rare combination of absence of left pulmonary artery and ventricular septal defect. He underwent intracardiac repair at the age of 8 months. Reconstruction of the left pulmonary artery was impossible because it could not be visualized through a median sternotomy. Although his early postoperative course was uneventful, he needed ipsilateral pneumonectomy 3 months later because of unremitting hemoptysis. Hilar left pulmonary artery, which used to exist, was not found even by histologic examination.
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PMID:Unilateral absence of pulmonary artery and ventricular septal defect in an infant. 969 77

A retrospective study of adults with Eisenmenger syndrome assessed at a tertiary referral center was performed to identify clinical characteristics and establish prognostic determinants. Mortality and cause of death are reported with baseline clinical data correlated with mortality to identify predictors of death. Clinical events during follow-up, including heart failure, atrial arrhythmia, hemoptysis, and syncope were also reviewed. A total of 109 adults with Eisenmenger syndrome (mean +/- SD age 29 +/- 11 years, 43% men) were followed for a median of 6.3 years. Sixty-six patients (61%) had simple cardiac anatomy (13 atrial septal defect, 43 ventricular septal defect, 10 patent ductus arteriosus). The remainder (43 patients) had complex cardiac anatomy (including atrioventricular septal defect, truncus arteriosus, univentricular heart, and transposition of the great arteries). There were 33 deaths and 9 transplantations during follow-up. Median survival was 53 years. Multivariate Cox regression analysis identified age at presentation (hazard ratio [HR] 0.90), supraventricular arrhythmia (HR 3.44), precordial electrocardiogram voltage (HR 1.61/mV increase), and poor New York Heart Association functional class (HR 2.60) as independent predictors of mortality. There is a large variation in the life expectancy for adults with Eisenmenger syndrome. Baseline characteristics associated with increased mortality include younger age at presentation (associated with complex anatomy), functional class, supraventricular arrhythmia, and an electrocardiogram index for right ventricular hypertrophy.
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PMID:Determinants of survival and length of survival in adults with Eisenmenger syndrome. 1049 38

We report on a 66-year-old man with severe hemoptysis following coronary artery bypass grafting and repair of a left ventricular septal defect after acute myocardial infarction. Initial diagnosis was delayed by misleading clinical symptoms and radiologic studies. Due to subfebrile temperature and sputum culture positive for Pseudomonas aeruginosa, he had been treated with antibiotics before reoperation. At reoperation, replacement of all foreign material and reconstruction of the ventricular repair with bovine pericardium resulted in reinfection with the same organism despite prolonged antibiotic therapy after 6 months. Removal of the pericardial tissue with direct suture closure of the ventricles and interposition of omentum led to complete healing of the infection without reoccurrence after 2 years.
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PMID:Hemoptysis following left ventricular aneurysm repair: a misleading clinical sign. 1108 11

The status of 58 patients, 3 to 57 years of age, with ventricular septal defect and a marked increase in pulmonary vascular resistance (pulmonary obstructive disease) was determined 5 years or longer after diagnostic catheterization. Forty-six (80%) were alive 5 years after that study. The probability of living 5 years was 95% for patients aged 10 through 19 years and 56% for those 20 years of age or older. The dissimilarity of actuarial curves between these two groups is consistent with the hypothesis that pulmonary vascular obstructive disease develops under age 20. Calculated pulmonary resistance increased with age of patient on admission to the study, suggesting its progressive nature. Hemoptysis was rare under age 20, and its presence over this age indicated a poor prognosis. The most common causes of death were "sudden" or "unknown." Most surviving patients were gainfully employed or attending school without severe symptoms.
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PMID:Prognosis for patients with ventricular septal defect and severe pulmonary vascular obstructive disease. 1171 81


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