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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fourteen patients younger than two years of age with persistent truncus arteriosus underwent primary repair. Twelve of them were less than 1 year and 4 less than 3 months of age. Intractable heart failure was the indication for surgery in all patients but one who had increased pulmonary vascular resistance. There were 5 hospital and 2 late deaths. Six out of the 7 survivors (median follow-up: 29 months) were symptom-free. The remaining infant who preoperatively had significant truncal valve regurgitation was doing fairly well 2 1/2 years after repair. Our experience suggests that, although the mortality remains high, primary repair for infants with persistent truncus arteriosus is feasible and offers better overall results than does pulmonary artery banding followed by later intracardiac repair. We advise primary repair for all infants with intractable heart failure or increasing pulmonary vascular resistance with or without truncal valve regurgitation. Elective repair is recommended before the age of 2 years to minimize the risk of pulmonary vascular disease.
Thorac Cardiovasc Surg 1980 Feb
PMID:Surgical repair of persistent truncus arteriosus in infancy. 615 30

Two hundred twenty-seven patients (median age 5.4 months) in whom a Waterston anastomosis was done for initial palliation of tetralogy of Fallot between 1966 and 1979 were studied. Twelve patients died in the hospital (5.3%; 70% confidence limits, 3.8% to 7.3%). Young age, low weight, and poor clinical condition did not appear to be incremental risk factors, whereas a too large or a too small shunt was largely responsible for the hospital mortality and morbidity. Follow-up information was available in all the 215 patients discharged from the hospital. At the last follow-up visit, before any further surgical procedure, 74% of the patients were clinically in good condition. By actuarial methods, 97.7% of hospital survivors were alive and 95.8% were event-free at and beyond 3 years postoperatively. Eighty-six patients have been catheterized in preparation for secondary repair (mean interval between Waterston shunt and catheterization, 2.9 +/- 1.38 years). One patient developed pulmonary vascular disease, four acquired pulmonary atresia, and 14 had a severe kinking of the right pulmonary artery at the site of the anastomosis.
J Thorac Cardiovasc Surg 1981 Aug
PMID:Waterston anastomosis for initial palliation of tetralogy of Fallot. 616 14

Lung biopsy specimens of 20 patients (aged 6 months to 29 years) with isolated ventricular septal defect (VSD) and various degrees of pulmonary hypertension were obtained at operation. The cross-section area of the pulmonary arteries was measured by a morphometrical method in each biopsy specimen and the grade of the hypertensive pulmonary vascular disease was determined according to the Health and Edwards classification. These findings were correlated to the pulmonary-to-systemic pressure ratio, to the pulmonary-to-systemic resistance ratio, and to the pulmonary-to-systemic flow ratio. The thickness of the media of pulmonary arteries (measured as area ratio) was well correlated to both the systolic blood pressure ratio and the resistance ratio resulting in a product moment correlation of r = 0.73. No direct relationship was found between the hypertrophy and the pulmonary-to-systemic flow ratio. Our quantitative morphometric data were well correlated with the qualitative Health and Edwards classification. Medial wall thickness was not significantly higher in grade III when compared to grade II. The mean values of the hemodynamic parameters were not significantly different in the Health and Edwards grade II and grade III groups. Our results indicate that the calculation of the mean pulmonary pressure and of the pulmonary-to-systemic resistance ratio are of no higher predictive value than the systolic pressure ratio. The classification of Health and Edwards appears to the sufficient for clinical evaluation.
Thorac Cardiovasc Surg 1981 Dec
PMID:Pulmonary arterial changes and hemodynamic parameters in isolated ventricular septal defect. 617 17

From 1976 through 1981, 8 corrective operations for truncus arteriosos communis type I have been performed. The patient's ages ranged from 2 months to 4 1/2 years; 2 of the children had previously undergone banding of the pulmonary artery. Intracardiac correction consisted in closure of the ventricular septal defect (VSD) and disconnection of the pulmonary trunk from the aorta with reconstruction of the right ventricular outflow tract using a valved Dacron conduit. One 3 1/2-year-old child died postoperatively because of right heart failure. In this child the pulmonary vascular resistance had risen to 13 U x m2 despite banding of the pulmonary artery in infancy. All other children have survived the operation without major complications and are in good condition. Postoperative follow-up (re-catheterization in 6 out of 7 survivors) showed a faultless function of the conduits in all instances. Persistence of pulmonary hypertension was ascertained in one patient. According to these findings, which are in agreement with the experience of others, it is concluded that primary correction of truncus arteriosus should be undertaken in early infancy prior to development of pulmonary vascular disease.
Thorac Cardiovasc Surg 1982 Jun
PMID:Surgical correction of truncus arteriosus type I. 618 May 11

Between 1971 and 1980, 65 children, aged 2 weeks to 15 years (mean 6.8 years) had "fresh" antibiotic sterilized aortic homografts inserted as a valved external conduit. Thirty-six patients (55%) had undergone previous palliations. Operations were performed on cardiopulmonary bypass, with hypothermia and cardioplegia. In selected young infants, deep hypothermia with circulatory arrest was used. Twenty-five patients (38%) died after the operation. Mortality was related to the complexity of the lesion, the condition of the child on admission, and the degree of pulmonary vascular disease. In addition, there were 7 late deaths. Twenty-one patients were recatheterized, either as a part of routine postoperative assessment (13) or because of symptoms (8). Satisfactory conduit performance, judged by the absence of significant gradients or regurgitation, was found in 18 out of 21 restudied patients. Calcification of the homograft aortic wall was seen on chest X-ray in 56% of patients. The aortic valve calcified in only one child, following an episode of subacute bacterial endocarditis. We conclude that fresh antibiotic preserved aortic homografts perform well in extracardiac valved conduits. They are easy to insert and better hemostasis can be achieved. Degeneration of the valved leaflets is extremely rare.
Thorac Cardiovasc Surg 1984 Feb
PMID:"Fresh", antibiotic sterilized aortic homografts in extracardiac valved conduits. Long-term results. 619 66

Intravenous digital subtraction angiography (IV DSA) is a new imaging modality that utilizes techniques of video image acquisition and computer image manipulation to provide anatomic information about blood vessels and organs. In many ways, it represents an electronic version of classic intravenous and film-subtraction angiography. As a means of imaging the thoracic and abdominal aorta, IV DSA has demonstrated great potential, particularly in vessels originally imaged by the former techniques. We have imaged the aorta in over 300 cases at Brigham and Women's Hospital, either alone, or in combination with other vessels in the course of work-up for vascular disease. Although experience has been limited, intravenous imaging of the aorta can be routinely performed, providing reliable and clinically significant information.
Cardiovasc Intervent Radiol 1983
PMID:Intravenous digital subtraction angiography of the thoracic and abdominal aorta. 636 Mar 59

We evaluated the diagnostic accuracy and complications of digital subtraction angiography (DSA) in a series of clinical trials conducted on patients primarily with cerebral vascular disease and those evaluated before and after surgery or percutaneous transluminal angioplasty. Double-blind studies of the carotid-vertebral arteries of 300 of the 2,200 patients using DSA imaging and a variety of ionic and nonionic contrast agents showed that although subjects tolerated the injection of nonionic contrast better than ionic, nonionic contrast administration did not lead to better image quality. Of 764 patients receiving ionic contrast media, 3.3% had mild-to-serve adverse reactions; of 350 injected with nonionic contrast agents, 1.7% had mild-to-severe adverse reactions. If the sole consideration is safety, use of ionic contrast media is justified.
Cardiovasc Intervent Radiol 1983
PMID:Efficacy and safety of digital subtraction angiography with special reference to contrast agents. 636 Mar 67

The translumbar approach was used for renal angiography and transcatheter embolization in a patient whose usual sites of vascular entry were not available because of arteriosclerotic occlusive vascular disease. A description is given of the reasons for embolization and the method used.
Cardiovasc Intervent Radiol 1984
PMID:Case report of translumbar renal angiography and embolization. 649 66

Three groups of patients were analyzed to ascertain the risk of combined carotid/coronary operations and the risk factors for perioperative stroke following coronary artery bypass (CAB). Group 1 (N = 132) had simultaneous carotid endarterectomy and CAB, Group 2 (N = 51) were patients having perioperative stroke following elective CAB, and Group 3 (N = 169) had CAB alone but had prior history of either asymptomatic cervical bruit, stroke/transient cerebral ischemic attack (TIA), or carotid endarterectomy. Hospital mortality and perioperative stroke rate in the combined carotid/coronary group were 3.0% (4/132) and 1.6% (2/126), respectively. These rates were not significantly different from those of a control group having CAB alone. Overall incidence of postoperative stroke in 5,676 patients having CAB alone was 0.9% (51 patients). The incidence of perioperative stroke in patients with asymptomatic bruit or prior history of stroke or TIA undergoing CAB alone was 3.3% (2/60) and 8.6% (6/70), respectively. The majority of strokes following CAB appear to be embolic in origin. Indications for simultaneous carotid/coronary operations are bilateral carotid disease and symptomatic carotid vascular disease associated with unstable angina, left main obstruction, or diffuse multivessel disease. Staged procedures are recommended for patients with stable angina and symptomatic carotid lesions and for difficult carotid revascularization procedures. CAB alone may be performed for most patients with asymptomatic cervical bruit, moderate or mild carotid artery obstruction, and unstable angina associated with prior stroke, although in the third situation postoperative risk of neurological injury may be increased.
J Thorac Cardiovasc Surg 1984 Jan
PMID:Combined carotid and coronary operations: when are they necessary? 660 38

Homocystinuria (HC) is an inborn error of amino acid metabolism characterized by ectopia lentis, mental retardation, and skeletal abnormalities. Vascular disorders may also occur in HC, although they are less common. Arteriographic studies of two sisters with HC are described. The younger woman's renal arteries showed wall irregularities and aneurysms, narrowing of the celiac and superior mesenteric arteries, and some aneurysmatic changes. In the older patient, irregular right carotid and splenic arteries were seen and a splenic aneurysm was present.
Cardiovasc Intervent Radiol 1983
PMID:Angiographic findings in homocystinuria. 662 57


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