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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The two children of an epileptic woman who underwent therapy with hydantoin during both pregnancies showed the characteristic findings of the fetal hydantoin syndrome: growth retardation, microcephaly, mental retardation, and a distinct hysmorphic pattern. Both exhibited a ridged metopic suture, hypertelorism, a short nose with a broad base, hypoplasia of the distal phalanges and nails of the toes, and inguinal hernias. In addition the 18-month-old girl exhibited epicanthal folds, strabismus, ptosis, and a small ventricular septal defect; she had been exposed in utero to 300 mg mesantoin daily. Her 6 1/2-year-old brother was more severely retarded, lacking speech and presenting with infantile autism. During pregnancy the mother had taken 400 mg mesantoin daily. About half of the offspring of epileptic women treated with hydantoin during pregnancy are mentally retarded, and 11% exhibit in addition the pattern of dysmorphic findings known as the fetal hydantoin syndrome. Hydantoin should therefore be strictly avoided in epileptic women of child-bearing age unless safe contraceptive measures are taken. In the event of pregnancy, therapeutic abortion should be considered if hydantoin therapy must be maintained.
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PMID:[Fetal hydantoin syndrome in siblings]. 10 83

Ventricular septal defect is sometimes associated with aortic regurgitation. In this report, an echocardiogram demonstrating dramatic prolapse of the noncoronary cusp into the left ventricular outflow tract and ventricular septal defect in a patient with Down's syndrome and ventricular septal defect, confirmed by angiographic studies, is presented. The echocardiogram supports the concept of anatomic lack of support of the aortic ring due to a deficient septum and hemodynamically significant flow of blood to the right ventricle through the ventricular septal defect, resulting in trauma to aortic cusps and prolapse.
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PMID:Aortic regurgitation associated with ventricular septal defect. Echocardiographic and hemodynamic observations. 14 Jul 91

The clinical records and radiographs of 46 patients with a supracristal ventricular septal defect are reviewed to illustrate the spectrum of associated lesions and complications seen with this defect. The presence of a supracristal ventricular septal defect compromises the normal conal muscular support of the aortic valve, usually in the region of the right sinus of Valsalva, and, consequently, complications involving the aortic valve are frequently noted. Decreased sinus support may lead progressively to prolapse of the right aortic cusp through the supracristal ventricular septal defect into the right ventricular infundibulum effecting sequentially aortic regurgitation, right ventricular outflow obstruction, and ultimately right sinus of Valsalva-right ventricular fistula. This potential progression is an indication for early recognition and repair of the supracristal ventricular septal defect. A supracristal ventricular septal defect is also an integral component of the Taussig-Bing malformation, is present in the majority of patients with aortic arch interruption, and may be seen in as many as 25% of Oriental patients with tetralogy of Fallot.
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PMID:Supracristal ventricular septal defects: spectrum of associated lesions and complications. 40 94

The authors report a series of 11 patients with ventricular septal defect associated with aortic incompetence who underwent surgery between 1963 and March 1976. Separate consideration is given to the operations performed before and after 1972. 5 patients were operated on during the first period, with only mediocre results. At this time, the technique of valvuloplasty did not appear to be the right one. During the second period, 6 patients were operated on. In five of them the technique of Plauth, Frater, Spencer and Trusler was used. All these patients have a satisfactory result. The last of the series had an abnormally low commissure, and the adjacent valves were protuberant, and thickened, so that a valvular replacement was carried out. The operation of choice for a ventricular septal defect associated with aortic incompetence is valvuloplasty with closure of the defect. The following criteria are necessary indications for this type of surgery: --the aortic incompetence must be secondary to the prolapse of a valve; --the aortic valve must have three cusps. An early operation makes the valvuloplasty easier, and avoids the problems of damage to the left ventricle from a persistant and progressive aortic incompetence.
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PMID:[Interventricular communications with aortic insufficiency surgical considerations]. 40 44

Clinical and echocardiographic examinations were performed on 100 clinically stable, newborn baby girls. Mitral valve prolapse was noted on the echocardiograms of seven babies. Three subjects had systolic clicks, two of whom had systolic murmurs following the click. The four other babies who had echocardiographic evidence of mitral valve prolapse had no abnormal auscultatory signs. Of the 93 babies without evidence of mitral prolapse, 91 had normal echocardiograms and auscultatory features; one was noted to have a murmur consistent with a ventricular septal defect, and another had an eccentric aortic valve on the echocardiogram which was suggestive of a bicuspid aortic valve. Serial studies on our group of subjects will yield useful information regarding the natural history of mitral valve prolapse.
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PMID:Incidence of mitral valve prolapse in one hundred clinically stable newborn baby girls: an echocardiographic study. 47 76

Three cases of aortic sinus aneurysm and three cases of prolapse and regurgitation of the aortic valve associated with ventricular septal defect are discussed from an angiographic point of view. It is pointed out that aortic regurgitation into the left ventricle might be helpful for a correct diagnosis. Aortic regurgitation, in fact, is the result of an anatomically unsupported aortic valve that becomes gradually distorted by haemodynamic influences. This pathogenetic mechanism is often found in subpulmonar and infracrestal ventricular septal defect.
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PMID:[Aortic sinus aneurysm. The angiographic diagnosis (author's transl)]. 101 Jan 92

Six cases of aneurysmal formation of the pars membranacea septi (AMS) are presented. Three cases associated with a ventricular septal defect (VSD) and one with VSD, prolapse of the right aortic cusp and aorto-right ventricular fistula, were operated on and the aneurysm, unsuspected preoperatively, was found at the operating table. Two cases, both with aortic coarctation (CA), have been diagnosed on the basis of selective angiocardiography and operated solely for resection of the coarctation. In three patients a mild pulmonary infundibular pressure gradient was present at catheterization. This anomaly is considered rare. It has been reported to complicate surgery, may not require surgery, and is considered by some to be a prelude to spontaneous closure of a VSD. The English medical literature concerning aneurysm of the membranous septum has been reviewed and our opinions on the management of these patients are presented. Including our own six patients, we are aware of approximately one hundred and sixty five reported cases, with possibly an additional 16 cases to be added.
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PMID:Aneurysm of the pars membranacea of the interventricular septum. 120 38

Aortic root echocardiograms were recorded from 89 patients whose aortic valves had also been adequately defined by selective angiography or viewed surgically or at autopsy. The eccentricity index (E.I.) of the aortic leaflets was measured at the onset of diastole and an E.I. of 1.3 or greater was taken as abnormal. Of 31 patients with isolated nonobstruced or mildly obstructed bicuspid aortic valves (7 viewed previously at valvotomy and 24 diagnosed radiologically) 23 (74%) had an abnormal E.I. Varying eccentricity occurred in some of these patients. Central leaflet echoes (E.I. of 1.0 to 1.25) were present in the other eight patients. All 14 patients with nonobstructed tricuspid aortic valves had central echoes. Additional multilayered diastolic echoes were found in patients with bicuspid aortic valves as well as in two patients with abnormal tricuspid aortic valves. The valves of 13 patients with aortic stenosis or incompetence were viewed surgically and the E.I. was abnormal in all patients with a bicuspid aortic valve in this group. Aortic leaflet echo findings were not diagnostically helpful in ten patients with tetralogy of Fallot, one of whom had a normal E.I. with a surgically confirmed bicuspid aortic valve. Of 21 patients with VSD only one had a bicuspid aortic valve but six had an abnormal E.I. This false positive sign was related to a high membranous VSD, sometimes with aortic valve prolapse. It is concluded that an E.I. of greater than or equal to 1.3 in the absence of an associated VSD is diagnostic of a bicuspid aortic valve and can be expected to be found in approximately three-quarters of subjects with this abnormality.
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PMID:Echocardiographic assessment of bicuspid aortic valves. Angiographic and pathological correlates. 124 58

Aortic regurgitation associated with prolapse of an aortic cusp and an infundibular septal defect is caused by the lack of anatomical support for the aortic annulus by the conal septum. This fact is taken into consideration in the new surgical approach that we performed in 5 children 3 to 16 years of age with infundibular ventricular septal defect and severe aortic regurgitation. The ventricular septal defect is closed by a patch anchored to another patch through the prolapsed cusp. This second patch is pulled up with the prolapsed cusp and is then fixed in the aortic wall. In all 5 patients, all clinical signs of aortic insufficiency disappeared, and only minimal aortic regurgitation could be demonstrated by color Doppler mapping.
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PMID:Infundibular septal defect with severe aortic regurgitation: a new surgical approach. 157 Sep 82

The late results of 70 patients aged 1.96 to 35.9 (mean 10.1) years who had repair of ventricular septal defect and aortic insufficiency from 1968 to 1988 were reviewed. The ventricular septal defect was subcristal in 50 and subpulmonary in 20 patients. Two thirds were situated immediately below some part of the right coronary leaflet with prolapse of that leaflet. Most of the remainder were below the right commissure or the anterior part of the noncoronary leaflet with prolapse of one or both adjacent leaflets. Associated structural defects, usually including some fusion at a commissure, were present in 18 of the 70 patients and occurred more often with a ventricular septal defect in or below the commissure between the right and noncoronary leaflets (p less than 0.001). Follow-up ranged from 1.9 to 19.6 (mean 9.8) years. There were no early deaths or cases of atrioventricular block, but there were two late deaths. Patient survival rate was 96% at 10 years. Freedom from valvuloplasty failure and freedom from reoperation were 76% and 85%, respectively, at 10 years. The major predictor for failure by multivariate analysis was the presence of an associated structural defect (p less than 0.01). Age at repair and position of the ventricular septal defect were not significant risk factors. We conclude that aortic valvuloplasty produces good palliation in most children. The few failures occurred early and chiefly in patients with associated structural valve defects that occurred more frequently in children who had a ventricular septal defect in the right commissure, where both the right and noncoronary leaflets may be affected.
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PMID:Late results after repair of aortic insufficiency associated with ventricular septal defect. 173 93


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