1/989. Right-sided endocarditis and ventricular septal defect. Right-sided endocarditis occurred in a 40-year-old woman with ventricular septal defect. This association is uncommon in adults. Because of the changing and variable clinical patterns of this disease, it is difficult to make a prompt diagnosis. In this case diagnosis was delayed for almost a year. The occurrence of pneumonia due to streptococcus viridans was the most important extracardiac manifestation. ( info) |
2/989. Echocardiographic detection of bacterial vegetations in a child with a ventricular septal defect. A 13-year-old boy with a small ventricular septal defect was admitted with clinical manifestations of acute endocarditis. coagulase-positive staphylococci were isolated from the blood. Definitive diagnosis was made by detecting bacterial vegetations in the right ventricle on the echocardiogram. Repeated embolization of these vegetations to the pulmonary circulation led to the death of the patient. ( info) |
3/989. MRI of supracristal ventricular septal defects. The MR features of two cases of supracristal ventricular septal defect are described. In both patients, axial SE T1-weighted images demonstrated a defect between the base of the aorta and the upper posterior aspect of the right ventricular infundibulum. Cine MRI in the two cases showed left-to-right shunting with a flow jet in the distal right ventricular outflow tract that propagated into the main pulmonary artery. Both patients had prolapse of the right sinus of Valsalva, and one had aortic insufficiency. ( info) |
4/989. Successful correction of double-outlet right ventricle with a ventricular D-l-malposition of the great arteries, bilateral conus, pulmonary stenosis and subaortic ventricular septal defect. The authors present the case of a fifteen-year old girl with double outlet right ventricle with ventricular d-loop and l-malposition of the great arteries, bilateral conus, pulmonary stenosis and subaortic ventricular septal defect, who was operated on successfully. This is the fourth case of double outlet right ventricle with l-position of the aorta that has been surgically corrected. The subaortic position of the interventricular defect favours the creation of the tunnel connecting the left ventricle with the aorta without obstructing the right ventricular outflow tract. The patient was doing well 11 months postoperatively. ( info) |
5/989. Anomalous origin of the right coronary artery from the left sinus of valsalva: transthoracic echocardiographic diagnosis. Anomalous origin of the right coronary artery from the left sinus of valsalva is a rare congenital defect that can be difficult to diagnose by echocardiography. We describe an infant with a ventricular septal defect that was diagnosed prospectively by transthoracic echocardiography as an anomalous origin of the right coronary artery from the left sinus of valsalva. Subcostal imaging and Doppler color flow mapping were instrumental in the echocardiographic diagnosis of this unusual coronary abnormality. ( info) |
| Penetrating cardiac trauma can result in a wide range of injuries to intracardiac structures. Missile injury, in particular, can cause damage in more than one cardiac chamber that may be difficult to identify at initial emergent operation. We report a case of late repair of traumatic ventricular septal defect and tricuspid valve perforation from gunshot wound. This case illustrates the importance of thorough examination of intracardiac anatomy during emergent and delayed repair for penetrating cardiac trauma. ( info) |
7/989. Complete atrioventricular septal defect and Ebstein's anomaly. A case child with complete atrioventricular septal defect (AVSD) and Ebstein's anomaly underwent surgical treatment at 3 months of age. She died on the third postoperative day. Postmortem examination showed complete AVSD, downward displacement of the right atrioventricular valve, left ventricular outflow tract obstruction, and hypertensive pulmonary vascular disease. association of complete AVSD and Ebstein's anomaly is a rare cardiac anomaly for which no attempt at surgical repair has previously been made. This report deals with our experience and also with the morphological features of this anomaly. ( info) |
8/989. Left ventricle to pulmonary artery conduit in treatment of transposition of great arteries, restrictive ventricular septal defect, and acquired pulmonary atresia. Progressive cyanosis after banding of the pulmonary artery in infancy occurred in a child with transposition of the great arteries and a ventricular septal defect, and a Blalock-Taussig shunt operation had to be performed. At the time of correction a segment of pulmonary artery between the left ventricle and the band was found to be completely occluded so that continuity between the left ventricle and the pulmonary artery could not be restored. A Rastelli type of operation was not feasible as the ventricular septal defect was sited low in the muscular septum. Therefore, in addition to Mustard's operation, a Dacron conduit was inserted from the left ventricle to the main pulmonary artery to relieve the obstruction. Postoperative cardiac catheterization with angiocardiography indicated a satisfactory haemodynamic result. The patient remains well 11 months after the operation. This operation, a left ventricle to pulmonary artery conduit, may be used as an alternative procedure in patients with transposition of the great arteries, intact interventricular septum, and obstruction to the left ventricular outflow, if the obstruction cannot be adequately relieved. ( info) |
9/989. Reversion to sinus rhythm 11 years after surgically induced heart block. A patient is presented in whom the heart reverted spontaneously to sinus rhythm 11 years after surgical closure of a ventricular septal defect complicated by complete heart block. It seems unlikely that regeneration of fibres in the bundle of his, if these had indeed been destroyed, could account for the restoration of sinus rhythm after so long an interval. ( info) |
10/989. Transcatheter closure of a mid-muscular ventricular septal defect with an amplatzer VSD occluder device. A 5 year old girl with a haemodynamically significant mid-muscular ventricular septal defect (VSD) had successful transcatheter closure using the Amplatzer VSD occluder. This device passes through a small diameter sheath and can be easily retrieved or repositioned. These properties may make it a suitable device for closure of large mid-muscular defects in small children. ( info) |