摘要:

Scalar electrocardiograms of 31 patients with double-outlet right ventricle (19 with and 12 without pulmonary stenosis) were correlated with the hemodynamic and anatomic findings. Atrioventricular conduction defects, intraventricular conduction delay, and counterclockwise frontal-plane loops were found less often than formerly reported. Counterclockwise frontal-plane loops were found with, as well as without, pulmonary stenosis. The presence or absence of left ventricular hypertrophy did not correlate with the severity of pulmonary vascular obstructive disease. Electrocardiographic evidence of left atrial enlargement was difficult to interpret. Additional intracardiac malformations could not be appreciated from the electrocardiographic findings. The predictive value of the electrocardiogram for the diagnosis of double-outlet right ventricle was considered to be low. In patients with double-outlet right ventricle without pulmonary stenosis, the electrocardiogram was not helpful in predicting the severity of pulmonary vascular obstructive disease.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Five patients have had the common features of pulmonary atresia or severe stenosis associated with a septal defect and a coronary artery-to-pulmonary artery (CA-PA) fistula. Four had pulmonary valvular atresia, and one had severe pulmonary stenosis. In all five, the CA-PA fistula contributed the principal component of the pulmonary blood flow. Cyanosis, continuous murmur, right ventricular hypertrophy, and decreased or normal pulmonary vascularity were frequent clinical manifestations, but angiocardiography was required to establish the diagnosis. The fistula was a side-to-side communication between the left coronary artery and the main pulmonary artery in each of the five patients. The dilated proximal coronary artery connecting the aortic root with the pulmonary artery gave a unique angiocardiographic appearance distinguishing it from truncus arteriosus or aorticopulmonary window. It is suggested that this unique angiocardiographic appearance be called an “aorticopulmonary tunnel.’ The surgical repair of this anomaly is closely related to that for severe tetralogy of Fallot and should involve a comparable risk and achieve a comparable result.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A right axillary A-V fistula has been made in a 13-year-old patient with tricuspid atresia who, after undergoing two unsuccessful attempts in infancy to establish a left Blalock shunt and having had a superior vena cava-right pulmonary artery (SVC-RPA) shunt at age 3, showed increasing disability and profound cyanosis (HCT 80%). One year following creation of the fistula there is marked increase in exercise tolerance, a decrease in HCT to 56%, and an increase in pO2from 57 to 105 mm Hg.Creation of an axillary A-V fistula in patients with an SVC-RPA shunt is an effective means of supplementing blood flow to the right lung by increasing the flow through the shunt and by giving it a pulsatile character, and, eventually, by decreasing the blood's viscosity. Axillary A-V fistula may be required by many patients with a cava-pulmonary shunt who have inadequate perfusion of the contralateral lung and clinical deterioration.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Sixty-four children with pulmonary stenosis were studied by cardiac catheterization both at rest and on exercise. Whereas milder degrees of stenosis were associated with normal right ventricular function, more severe stenosis was associated with fixed stroke index and elevated RVEDP, and suboptimal response of cardiac index. These changes result from altered right ventricular compliance. In several the compliance abnormality was related to myocardial hypertrophy, whereas in four patients it was most likely caused by myocardial fibrosis.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Pseudocoarctation, buckling, and kinking of the aorta are terms used to describe a roentgenologic deformity of the aorta similar to that in classical coarctation but in which no obstruction is demonstrable. It is probable that the first three terms used are synonyms for subclinical coarctation. In this state, the lesion of classical coarctation of the aorta is present and the two show the same associated anomalies.

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1972

数据来源: OVID