1/8. Successful closure of the arterial duct in the setting of rubella syndrome.A 9-year-old boy, with significant left-to-right shunting across a large duct in the context of rubella syndrome, was tested during catheterization to establish the feasability of occluding the duct with a device. The testing, including temporary closure of the duct and monitoring of pulmonary vascular reactivity to vasodilative substances, lead to the decision to implant an Amplatzer occluder. Sixteen months later, there was no residual shunting across the duct, and pulmonary arterial pressures had normalised. It remains unclear why the patient had not developed irreversible pulmonary vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/8. Tissue-specific mosaicism for trisomy 21 and congenital heart disease.Cytogenetic studies in a girl with ventricular septal defect and mosaicism for trisomy 21 showed that trisomy was present in most cells from the myocardium and lung but in only a minority from the skin and lymphocytes. These findings emphasize the importance of tissue-specific mosaicism as a cause of certain cardiovascular diseases.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/8. Lobar emphysema associated with patient ductus arteriosus and pulmonary obstructive vascular disease.Three cases of respiratory distress with patent ductus arteriosus are presented. The left-to-right shunt across the ductus arteriosus produced dilated pulmonary arteries and secondary bronchial compression, leading to lobar emphysema. The increase of blood flow across the ductus arteriosus causes structural changes of the wall of the preacinar and intra-acinar arteries. All three patients died, most probably from the association of parenchymatous pulmonary disease and pulmonary obstructive vascular disease.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
4/8. Surgical treatment of infantile lobar emphysema in cardiovascular disease with left-to-right shunts.Serious symptoms associated with the lobar emphysema in congenital heart diseases with left-to-right shunt disappeared after radical operation for cardiac lesion. The study of seven autopsied cases revealed that the lobar emphysema resulted from check valve mechanism created by compression of the bronchi by distended pulmonary artery. Eight cases of our experience of lobar emphysema disappeared shortly after the operation for congenital heart disease with left-to-right shunt seems to indicate infantile lobar emphysema in congenital heart diseases with left-to-right shunt should not be treated by resection but rather by radical operation for cardiac lesion as soon as possible even in infancy.- - - - - - - - - - ranking = 4keywords = vascular disease (Clic here for more details about this article) |
5/8. Progressive pulmonary vascular disease after surgery in a case of patent ductus arteriosus with pulmonary hypertension.In a 15-month-old girl with patent ductus arteriosus (PDA) with pulmonary hypertension, division of the PDA was undertaken, but she died of heart failure 7 months post-operatively. Morphometric study of biopsy and autopsy lungs showed that medial hypertrophy and pulmonary intimal lesions developed markedly after surgery. Severe pulmonary hypertension and hypoxemia were present preoperatively. The pulmonary hypertension remaining postoperatively and aggravated pulmonary hypoxemia are thought to have caused postoperative constriction of the pulmonary vessels and to bring about unusual medial hypertrophy. Since it is known that marked hypertrophy of the media can easily cause vasospasms, it is thought that, in the present case, the smooth muscle cells of the media became necrotic, which brought about damage to endothelial cells. Such damage, in turn, led to the development of occlusive pulmonary vascular disease.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
6/8. Severe pulmonary vascular disease consisting of ventricular septal defect and patent ductus arteriosus. A case diagnosed as the indication for total correction by the hemodynamic study.A 12-year-old girl with ventricular septal defect, patent ductus arteriosus and pulmonary hypertension was hemodynamically diagnosed as the indication for total correction by the initial cardiac catheterization. However, histologic assessment by lung biopsy revealed the terminal stage of plexogenic pulmonary arteriopathy, i.e. plexiform lesions, dilatation lesions and fibrinoid necrosis of the media which denied the possibility of corrective surgery. We would like to stress that the open lung biopsy should be performed when the hemodynamic study indicates marginal operability, especially in older children and adults in order to investigate the grade of occlusive pulmonary vascular disease.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
7/8. An unusual aorto-pulmonary communication secondary to syphilitic aortitis.With the advent of antibiotics syphilis and its complications appear to have been declining as an important cause of cardiovascular disease. We describe a patient with an unusual aorto-pulmonary communication secondary to syphilitic aortitis. The case illustrates the difficulty in defining the anatomy of this rare association preoperatively. The reason for the rarity of this manifestation is discussed and finally doubt is cast upon the assumption that cardiovascular syphilis is of only historical interest.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/8. Absent mesosternum in congenital heart disease.The association of developmental abnormalities of the sternum with congenital heart disease is well known. These abnormalities include hypoplasia, multiple centers, and premature fusion. The absence of the sternal bodies in patients with congenital heart disease unrelated to a specific syndrome complex has not been previously described. Possible association with congenital pulmonary vascular disease was noted.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |