摘要:

A group of 25 patients was studied by cardiac catheterization before and after open operation for isolated pulmonary stenosis by direct vision with use of cardiopulmonary bypass Organic infundibular obstruction, when present, was resected. The hypertrophied infundibulum, when it constitutes a severe obstruction, must also be resected. The average right ventricular systolic pressure preopratively was 124 mm. Hg and postoperatively it was 35 mm. Hg.The average gradient across the pulmonary valve preoperatively was 99 mm. Hg and postoperatively it was 17 mm. Hg, a mean decrease of 82 mm. Hg.The long-term hemodynamic response was distinctly superior in this group of patients operated upon under total bypass when compared with a similar series operated upon by us with a closed transventricular approach.The specific diagnosis of lesions causing obstruction to the outflow of the right ventricle is particularly crucial in selecting an operative approach if open operation by inflow stasis is utilized.Careful review of the selective right ventriculograms is an excellent preoperative guide in determining whether infundibular obstruction is present and hemodynamically significant.Patients having severe valvular stenosis, with right ventricular pressures above 140 to 150 mm. Hg should have an immediate one-third to one-half decrease in their right ventricular systolic pressures at the time of surgery, or infundibular resection should be done to reduce postoperative mortality.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

An attempt has been made to uncover the vectorcardiographic spectrum of combined ventricular hypertrophy by studying a group of 82 patients with cyanotic tetralogy of Fallot representing right ventricular hypertrophy with normal or less than normal left ventricular muscle mass and 140 patients with tetralogy of Fallot and surgically created systemic-pulmonary shunts representing right ventricular hypertrophy combined with varying degrees of increased left ventricular muscle mass.An analysis of the spatial orientation of the maximal QRS vectors has demonstrated a continuum of vectorcardiographic patterns. These extend starting with severe right ventricular hypertrophy through a series of ventricular hypertrophy patterns representing right ventricular hypertrophy with progressively increasing left ventricular potentials toward dominant left ventricular hypertrophy patterns of combined ventricular hypertrophy. An estimate of the relative contribution of the two ventricles to a given vectorcardiographic pattern of combined ventricular hypertrophy is possible by analysis of the direction of maximal spatial QRS vectors.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

The usefulness of factor analysis as a means of describing in both general and specific terms an equivalent cardiac generator has been explored. High-fidelity, high-frequency electrocardiograms and vectorcardiograms of 31 normal subjects have been analyzed. The information in the electrocardiogram was reduced by factor analysis to the minimum number of independent waveforms which could account for all of this information. Because the first three principal factors might or might not represent a simple dipole, the efficiency of these three principal factors to resynthesize the originally recorded electrocardiograms was compared with the efficiency of McFee vectorcardiographic leads to perform the same resynthesis. The first three principal factors contained more information than that contained in the vectorcardiographic leads, suggestingthat the factors contain more than simple dipolar information. This would in turn suggest that a more complex generator than the dipole must be employed to explain the surface potentials derived from the standard electrocardiogram. With only two principal factors the precordial leads were rather easily reconstructed but reconstruction of leads I and VFwas considerably more difficult. Because the principal factors represent the most commonly occurring waveforms in the group, the less perfect resynthesis of leads I and VFwith two factors alone may result from lack of detection of multipolar component in the limb leads which have less in common with the precordial leads than the precordial leads do with each other.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Electrocardiographic abnormalities have been studied after administration of chloroquine in 25 patients, of emetine in 28 patients, and of emetine and chloroquine in 28 patients.Abnormalities after chloroquine were less in severity and of shorter duration than after emetine. They were more severe, became maximum later after cessation of emetine therapy, and were much longer in duration after emetine and chloroquine than after emetine. These differences are attributed to combined effects of the two drugs.Serum potassium levels showed some decrease after antiamebic therapy, the decrease being more after emetine than after chloroquine.A case is reported in which severe abnormalities and muscular paralysis occurring after emetine and chloroquine were rapidly reversed by oral potassium administration.Administration of potassium simultaneously with emetine and chloroquine often prevented or delayed the appearance or decreased the severity of abnormalities. Subsequent potassium administration usually reversed the abnormalities except in cases in which they were present before emetine therapy. It is concluded that the abnormalities are functional in nature and not due to organic myocardial damage.It is suggested that some disturbance of potassium metabolism in the myocardium and skeletal muscles may be the cause of electrocardiographic abnormalities and emetine neuritis, respectively.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Four cases of congenital heart disease that showed coarse atrial fibrillatory waves in V1and evidence of right atrial or biatrial enlargement were discussed. It is suggested that the coarsefwaves may be due to distention of the atria.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

The case of an 8-year-old girl with a singlecoronary artery is presented. This vessel arose as a left coronary artery and followed the distribution of one coronary artery. The long circumflex branch traveled in the atrioventricular groove and continued as a vessel occupying the position usually held by the right coronary artery. It ended as a fistula to the outflow tract of the right ventricle. A continuous murmur was present clinically. Cardiac catheterization and selective angiocardiography demonstrated the anatomy of the lesion and the presence of a left-to-right shunt. Operation consisted of ligation of the fistula and anastomosis of the right ventricular portion of the coronary artery to the aorta with a Dacron tube graft. This latter maneuver established a dual inflow into the coronary arterial system and should overcome the disadvantage of a single coronary artery in the event that arteriosclerotic occlusive lesions develop in later life. Furthermore, the procedure demonstrated the feasibility of grafting technics that may find application in the treatment of anomalous origin of a coronary artery from the pulmonary artery.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Scans of the cardiac blood pool are of practical value and are being widely used. Simple methods of measuring cardiac output and blood volume are available, but they have not yet been exploited by clinicians. With the rapid advances in nuclear technology, practical and innocuous methods for measuring regional blood flow in the heart and other areas will probably become available in the near future. Such methods will undoubtedly be used by clinical investigators. Their widespread clinical application will depend on whether or not they provide a practical way of solving a recognized medical problem.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID