1/190. The physiology of congenital heart disease: assessment by Doppler color flow mapping.The use of Doppler echocardiography is a routine part of the noninvasive assessment of the patient with heart disease. In children with congenital heart disease, pulsed- and continuous-wave Doppler echocardiographic techniques provide accurate, reproducible hemodynamic data relative to structural defects. Doppler color flow imaging, however, allows for qualitative assessment of blood flow patterns, which may give important insights into the changing physiology of the newborn infant or that of a patient in the medical or surgical intensive care settings. Ten cases are presented in which this flow information is instructive in understanding the physiological sequelae of congenital heart disease.- - - - - - - - - - ranking = 1keywords = heart disease, heart (Clic here for more details about this article) |
2/190. Intravascular ultrasound imaging of a patent ductus arteriosus in an adult.A small patent ductus arteriosus (PDA) is compatible with a normal life span. A non-restrictive PDA may present with signs of heart failure, supraventricular arrhythmia's, bacterial endocarditis or endarteritis later in life. Fewer than 50% of patients, including those with small shunts, are symptomatic by the age of 50. Considering that 40% of patients with PDA's will die before the age of 45 as a result of bacterial endocarditis or heart failure, closure of the PDA is recommended. Exceptions are patients with a nondilated heart, a right-to-left shunt, or age greater than 60 years old. Because of the wider use of echocardiography, especially transesophageal echocardiography, many PDA's are now detected incidentally in patients without symptoms.- - - - - - - - - - ranking = 0.098666133391285keywords = heart (Clic here for more details about this article) |
3/190. The use of transesophageal echocardiography to evaluate the effectiveness of patent ductus arteriosus ligation.The ligation of patent ductus arteriosus (PDA) is a comparatively easy operation, but some complications are possible. The most common complication is incomplete ligation of the PDA; others include inadvertent ligation of the descending aorta or left pulmonary artery, transient rise in systemic blood pressure and increased left ventricular afterload, and acute right heart failure due to pulmonary hypertension. The completeness of the PDA ligation is usually determined only by the operating physician's experience, including the use of an esophageal stethoscope or a finger on the lesion to feel for vibration. These methods sometimes fail to detect an incomplete ligation. With transesophageal echocardiography (TEE), we have monitored the entire course of the PDA ligation directly without interrupting the surgical procedure, and precisely determined the completeness of the ligation. We also expect that TEE will enable us to avoid other complications as well.- - - - - - - - - - ranking = 0.032888711130428keywords = heart (Clic here for more details about this article) |
4/190. magnetic resonance imaging of ductus arteriosus Botalli apertus in adulthood.ductus arteriosus Botalli apertus is a congenital cardiovascular malformation usually diagnosed in childhood by echocardiography and/or cardiac catheterization. Reports about magnetic resonance imaging of ductus arteriosus Botalli apertus are rare. We report about three adult female patients and one adult male patient in whom magnetic resonance imaging was able to demonstrate the pathology. In all four patients quantitative data about right ventricular function were calculated. Pulmonary hypertension with Eisenmenger syndrome detected by cardiac catheterization had developed in three of the four patients excluding operative closure of the ductus. The patient in whom pulmonary hypertension had not developed underwent successful operative closure of the ductus. magnetic resonance imaging is a non-invasive tool that can be used for diagnosis of ductus arteriosus Botalli apertus and it allows to quantify right ventricular function. magnetic resonance imaging can be used repetitively in patients with Eisenmenger syndrome which may be helpful for better timing of combined heart-lung transplantation as ultimate therapeutic strategy because deterioration of right ventricular function can be monitored.- - - - - - - - - - ranking = 0.032888711130428keywords = heart (Clic here for more details about this article) |
5/190. High origin of the right coronary artery with congenital heart disease.We encountered a case of anomalous high origin of the right coronary artery associated with ventricular septal defect and patent ductus arteriosus. The right coronary artery originated from the distal part of the ascending aorta resulting in unsuccessful induction of cardiac arrest by cardioplegia. We describe this rare case with anomalous origin of the right coronary artery.- - - - - - - - - - ranking = 0.57142857142857keywords = heart disease, heart (Clic here for more details about this article) |
6/190. Char syndrome, an inherited disorder with patent ductus arteriosus, maps to chromosome 6p12-p21.BACKGROUND: Patent ductus arteriosus (PDA) is a relatively common form of congenital heart disease. Although polygenic inheritance has been implicated, no specific gene defects causing PDA have been identified to date. Thus, a positional cloning strategy was undertaken to determine the gene responsible for the Char syndrome, an autosomal dominant disorder characterized by PDA, facial dysmorphism, and hand anomalies. methods AND RESULTS: A genome scan was performed with 46 members of 2 unrelated families in which the disease was fully penetrant but the phenotype differed. Significant linkage was achieved with several polymorphic dna markers mapping to chromosome 6p12-p21 (maximal 2-point lod score of 8.39 with D6S1638 at theta=0.00). Haplotype analysis identified recombinant events that defined the Char syndrome locus with high probability to a 3. 1-cM region between D6S459/D6S1632/D6S1541 and D6S1024. CONCLUSIONS: A familial syndrome in which PDA is a common feature was mapped to a narrow region of chromosome 6p12-p21. Additional analysis with other families and polymorphic markers as well as evaluation of potential candidate genes should lead to the identification of the Char syndrome gene, which will provide insights into cardiogenesis as well as limb and craniofacial development.- - - - - - - - - - ranking = 0.14285714285714keywords = heart disease, heart (Clic here for more details about this article) |
7/190. Successful transcatheter closure of a patent ductus arteriosus: using two Gianturco coils in a 41-year-old woman. A case report.Patent ductus arteriosus (PDA) is a form of congenital heart disease uncommonly diagnosed in adult patients. Transcatheter closure of PDA has been widely used in children. However, the experience is limited in adults especially with use of Gianturco coils. The authors describe a case of successful transcatheter closure of a PDA, incidentally diagnosed in a 41-year-old woman, by successively deploying two coils by a transarterial approach. No residual shunting was seen angiographically after the procedure. A literature review of similar procedures in adult patients is discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = heart disease, heart (Clic here for more details about this article) |
8/190. The anesthetic management of a preterm infant weighing 500 grams undergoing ligation of patent ductus arteriosus--a case report.PDA (patent ductus arteriosus) is a common congenital heart disease. Usually surgical intervention through left thoracotomy or recently through video assisted thoracoscopy will be recommended if the preceding or intent medical treatment fails or is contraindicated. However, once surgical intervention is decided, various complications are still a real fear in the mind of the surgeon and the anesthesiologist, particularly if the infant is premature or very sick. Here we report an anesthetic management in a female preterm infant weighing 500 grams, who underwent PDA ligation. She was born at gestation age of 28 weeks at our hospital, and since her birth she was noted to have infant respiratory distress syndrome associated with renal dysfunction. She was admitted to the neonatal intensive care unit (NICU) straightaway. After thorough examination, a severe PDA was disclosed. The possibility of pulmonary hemorrhage and heart failure could be predicted in view of the large left to right shunt. Worst of all was that her poor renal function contradicted a medical treatment. So we decided to carry out the ligation procedure at once although she was premature and only 5 days old. The NICU was chosen as the operation theater for transferring concerns. General anesthesia was induced and maintained by atropine 0.01 mg, pancuronium 0.1 mg, fentanyl 2 micrograms, and ketamine 0.15 mg intravenously. Supplemental oxygen was given throughout the operation. The PDA was ligated through left thoracotomy and blood loss was minimal. The peri-operative course was uneventful. The patient recovered well following surgery and anesthesia.- - - - - - - - - - ranking = 0.17574585398757keywords = heart disease, heart (Clic here for more details about this article) |
9/190. Primary bronchomalacia and patent ductus arteriosus: simultaneous surgical correction in an infant.We report the clinical course of a 6-month-old girl with recurrent infection of the left lung, persistent wheezing, and a suspected congenital heart anomaly (patent ductus arteriosus. Chest radiography revealed hyperinflation and slight inflammation of the left lung. Tracheobronchoscopy and left-sided bronchography showed a collapsed segment of the left main bronchus, 3 cm long. Computed tomography confirmed hyperinflation of the left lung and atelectasis of the superior lobe. There were no signs of extramural compression. color-flow Doppler echocardiography confirmed the suspicion of patent ductus arteriosus. To the best of our knowledge, there is no other report in the literature of a patient with this combination of anomalies. After receiving 2 weeks of antibiotic treatment, the patient underwent surgical repair The patent ductus arteriosus was closed by means of a triple-ligature procedure, and during the same operation a bronchopexy was performed, securing the left main bronchus to the closed ductus tissue by means of sutures. There have been no complications in the postoperative period. Clinical follow-up, as well as echocardiography and bronchoscopy, have yielded normal results 14 months after surgery.- - - - - - - - - - ranking = 0.032888711130428keywords = heart (Clic here for more details about this article) |
10/190. Transcatheter coil embolization of large-size patent ductus arteriosus in adult patients: usefulness and problems.Transcatheter coil embolization of the patent ductus arteriosus (PDA) has been frequently used in children, especially for small lesions. It was attempted in 3 adults using Cook detachable coils. For 2 of the patients, relatively old age and heart failure were the reasons for choosing coil embolization of the PDA. In the remaining patient, who had wolff-parkinson-white syndrome, coil embolization was performed after radiofrequency catheter ablation of Kent's bundle. Their respective minimal PDA diameters were 5.0 mm, 4.5 mm and 4.0 mm measured by transesophageal echocardiography. Two coils were placed in 2 patients and 1 coil in the remaining patient. After the procedures, the size of the left ventricle decreased and heart failure was improved in 2 patients, although all 3 patients had a residual shunt, which caused hemolytic anemia in 2 patients. Repeat coil-embolization procedures resulted in complete occlusion and the hemolysis disappeared in these patients. In adult patients who have heart failure due to large PDA, coil embolization with detachable coils, even if residual shunt persists, is useful for improvement of the heart failure. In cases of hemolysis related to residual shunt, a second coil-embolization procedure can improve it completely.- - - - - - - - - - ranking = 0.13155484452171keywords = heart (Clic here for more details about this article) |
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