1/19. Right juxtaposition of the atrial appendages.We present an infant with right-sided juxtaposition of atrial appendages who had open heart surgery for ventricular septal defect and patent ductus arteriosus. Of 12 cases thus far reported, ventricular d-loop was observed in nine, and normal position of great vessels in four. Contrary to previous views, this condition may not be accompanied by severe conotruncal anomalies.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/19. A genesis of the lung complicated by vascular compression and bronchomalacia.A child with compression of a solitary left bronchus was treated by anterior fixation of the great vessels and dividing the ductus arteriosus, which proved ineffective. Bronchial resection was performed but was also ineffective because there was persistent compression by the aorta. Aortic graft was finally elected but the infant died later with sepsis. From this experience we believe it would be better in another similar case to graft the aorta initially if necessary to insure complete relief of bronchial compression, reserving resection of the collapsing bronchial segment as a secondary procedure should functional obstruction persist.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/19. A new use for the amplatzer duct occluder device.We report a case in which the Amplatzer device for percutaneous occlusion of ductus arteriosus was successfully used for occluding a large systemic-pulmonary collateral vessel in a patient who had previously undergone surgery for correction of pulmonary atresia and ventricular septal defect (Rastelli technique), and was awaiting the change of a cardiac tube. In the first attempt, the device embolized to the distal pulmonary bed and, after being rescued with a Bitome, it was appropriately repositioned with no complications and with total occlusion of the vessel.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/19. Arteriovenous malformation of the vein of Galen: treatment in a neonate.heart failure in a 2-day-old infant was not readily explained by clinical examination. cardiac catheterization suggested an intracranial arteriovenous (AV) fistula, and cerebral arteriography showed a malformation of the vein of Galen. The major feeding arteries were surgically obliterated. At age 27 months, the boy has normal mentation but moderate left hemiparesis. review of the literature disclosed 39 other infants with AV malformations of the vein of Galen producing heart failure before age 3 months. Most of them were boys, and had cyanosis, a systolic murmer, cranial bruit, cardiomegaly, and right bentricular hypertrophy. Only three of the 13 who had surgery for their malformation survived. Removal of the malformation is difficult; obliteration of the nutrient vessels, using the operating microscope, is the currently accepted treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/19. Systemic arterial pneumatosis in a neonate with necrotizing enterocolitis.Ultrasound is exquisitely sensitive for the identification of portal vein pneumatosis, which in neonates is commonly caused by necrotizing enterocolitis. We describe the ultrasound finding of systemic arterial pneumatosis in a case of necrotizing enterocolitis associated with congenital heart disease. A combination of a patent ductus venosus and an extracardiac right-to-left shunt via the great vessels through a patent ductus arteriosus provided a pathway for the pneumatosis from the portal vein to the abdominal aorta.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/19. Ductus-dependent fetal cardiac defects contraindicate indomethacin tocolysis.The hemodynamics of critical aortic stenosis in the fetus make it a ductus-dependent cardiac defect because the ductus arteriosus supplies blood not only to the descending aorta but also to the aortic arch and coronary vessels. In utero closure of the ductus arteriosus has been reported in association with tetralogy of fallot, truncus arteriosus, maternal use of prostaglandin inhibitors, and as idiopathic events. This is the first report of a ductus-dependent congenital heart defect (critical aortic stenosis) where treatment with indomethacin, a prostaglandin synthetase inhibitor, precipitated premature closure of the ductus and hydrops fetalis. review of reported cases of premature closure of the ductus show that acute, in utero closure of the ductus in a fetus with limited cardiopulmonary reserves has a worse prognosis than with previously reported cardiac anomalies. This study strongly supports published concerns of increased perinatal morbidity and mortality when fetuses are exposed to prostaglandin inhibitors in utero, and shows that ductus-dependent fetal cardiac defects are contraindications to the maternal use of prostaglandin inhibitors during pregnancy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/19. Use of tissue plasminogen activator for femoral artery thrombosis following transcatheter coil occlusion of patent ductus arteriosus.femoral artery thrombosis is an uncommon but potentially serious complication following pediatric cardiac catheterization. Management options include heparin infusion, thrombolytic therapy, and surgical thrombectomy. The use of thrombolytic agents following coil occlusion of shunts, collaterals, and patent ductus arteriosus (PDA) may be successful in resolving the femoral arterial thrombosis but may also reopen the device-occluded vessel. We report the successful use of tissue plasminogen activator for management of femoral artery thrombosis in a child following transcatheter PDA coil occlusion in which the PDA remained occluded.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/19. heart transplantation in repaired transposition of the great arteries.Cardiac transplantation was carried out in a 40-year-old man with the diagnosis of repaired transposition of the great arteries and right-sided aortic arch who had end-stage cardiac failure due to myopathy of the ventricles. Because of several previous surgical repairs and the orientation of the great vessels, the operation presented some technical problems. Therefore, modifications of operative procedures were used, including recipient hypothermia, circulatory arrest, and changes in the donor heart implantation. The removal of the donor heart was modified in such a way that the graft included the aortic arch and both pulmonary arteries. With the extra length of ascending aorta and transverse arch, the innominate, left carotid, and left subclavian vessels were excised as a button, thereby leaving the distal orifice of the aorta in the superior portion of the transverse arch. For the recipient, the operation was performed using hypothermic total circulatory arrest to dissect free the huge pulmonary artery and the short right-sided aortic arch to place the clamp. Implantation of the donor heart was modified accordingly. The technical results were confirmed one and a half months later on a control digital angiogram. Thirty-five days postoperatively the patient was discharged. Six months after operation, the patient is doing better than ever before in his life. Our findings suggest that a complicated conotruncal development does not preclude cardiac transplantation.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/19. Systemic to pulmonary shunting masquerading as patent ductus arteriosus: a pitfall in clinical diagnosis.Patent ductus arteriosus (PDA) frequently complicates the course of respiratory distress syndrome in premature infants. A 920-g, 28 weeks' gestation infant with clinical and radiographic evidence of left to right shunting, was presumed to have a patent ductus arteriosus. Following ductal ligation the signs persisted. Aortic angiogram demonstrated multiple collateral vessels arising from the systemic circulation and communicating with pulmonary vessels. Accurate diagnosis of left to right shunting is imperative if such collateral shunting is not to go undiagnosed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
10/19. Right aortic arch, right patent ductus arteriosus, and mirror-image branching of the brachiocephalic vessels.Two patients with a right aortic arch, right patent ductus arteriosus, and mirror-image branching of the brachiocephalic vessels are described. The clinical, angiographic, and surgical findings in these two cases are detailed, and a description of the embryologic basis for these anomalies is given.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
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