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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The experience of the Thoracic and Cardiovascular Surgery Service of the Columbia-Presbyterian Medical Center with the surgical correction of Tetralogy of Fallot was reviewed. This includes 444 patients operated on between 1960 and 1975. The operatory mortality was 5.6%. The major cause of death was related to a decreased cardiac output. The postoperatory mortality is minimal (2.9%) and reoperations are rarely necessary. The 91.3% of the patients presented right bundle branch block in the immediate postoperatory period and 8.7% was accompanied by left anterior hemiblock. All of these patients are clinically well and to not present syncopal crisis or signs of AV block. 145 patients (33%) were re-catheterized in the late postoperative period. The hemodynamic results and the clinical evaluation show that in 85.6% of these cases the results obtained are from "Good to Excellent".
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PMID:[Tetralogy of Fallot: long term results]. 93 48

An 8-month-old Labrador retriever bitch was evaluated for sudden-onset, progressive abdominal distension. Physical examination revealed an exaggerated inspiratory effort, severe ascites, bilateral jugular vein distension, and hypokinetic femoral arterial pulses. Thoracic auscultation detected tachycardia with muffled heart sounds, without audible cardiac murmurs. Thoracic radiographs identified severe right ventricular enlargement and pleural effusion. The electrocardiogram was consistent with incomplete right bundle branch block or right ventricular enlargement. Echocardiography demonstrated severe right ventricular and atrial dilation, secondary tricuspid regurgitation, and thinning and hypocontractility of the right ventricular myocardium. Left heart chamber sizes were slightly decreased, with normal left ventricular contractility. A diagnosis of arrhythmogenic right ventricular cardiomyopathy was reached, based on the characteristic clinical, electrocardiographic, radiographic and echocardiographic findings, and the exclusion of other causes of isolated right ventricular failure. Treatment effected good control of clinical signs, until acutely decompensated congestive right heart failure led to euthanasia after 4 months. Arrhythmogenic right ventricular cardiomyopathy is a well-described clinical entity in humans, and has previously been documented in 3 male dogs. The condition is characterised by progressive fibro-adipose replacement of right ventricular myocardium, while the left ventricle usually remains unaffected. It should be considered a differential diagnosis in any young dog presented with isolated right heart failure, syncope, or unexplained ventricular tachyarrhythmias. This article reports the 1st case of arrhythmogenic right ventricular cardiomyopathy in a female dog, and highlights its echocardiographic features.
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PMID:Arrhythmogenic right ventricular cardiomyopathy in a dog. 1103 Mar 67

This article describes a patient in whom a broken cerclage wire migrated from the left hip into the left ventricle. A 71-year-old woman was admitted to the authors' hospital for preoperative examination before femoral hernia repair. Chest radiograph showed a metallic wire in the left ventricle. Twenty-four years earlier, she had a revision arthroplasty. During revision surgery, fragments of the osteotomy were fixed to the femur with multiple cerclage wires. During the past 5 years, radiographic follow-up showed progressive multiple ruptures of cerclage wires. The cerclage wiring was not removed because the patient had no related clinical symptoms. Radiograph of the left hip showed a well-fixed cemented acetabular ring and an uncemented femoral stem with a healed trochanteric osteotomy. All cerclage wires were broken into multiple parts, and it was very difficult to determine which part had migrated into the heart. Thoracic computed tomography scan showed wire that had migrated into the anterior left ventricular myocardial wall at the atrioventricular level. The patient had no clinical symptoms. Electrocardiogram showed a normal sinus rhythm and right bundle branch block. Because of the high risk of surgical left ventriculotomy associated with searching for wire that had migrated into the myocardial wall, patient monitoring was planned. Definitive management of this complication constitutes a dilemma. Although this complication is highly unusual, the possibility of intracardiac migration of broken wire should be considered when deciding on prophylactic surgical removal of hardware after fracture or osteotomy healing.
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PMID:Intravascular migration of a broken cerclage wire into the left heart. 2527 83