摘要:

Therapy for valvular heart disease in children has undergone tremendous progress over the past two decades.Interventional catheterization techniques were pioneered with balloon valvuloplasty of pulmonic stenosis in infants.Therapeutic catheterization is the treatment of choice in critical pulmonic stenosis but remains somewhat controversial for neonatal aortic stenosis. The use of cryopreserved homografts has improved reconstruction of the right ventricular outflow tract. The pulmonary autograft (Ross) technique for aortic valve replacement has now been applied in neonates, infants, and small children. Medium-term results of this technique are now becoming available. Innovations have been few, however, in the therapy of tricuspid valve anomalies, especially Ebstein's malformation. Annuloplasty and repair techniques are used very effectively for mitral insufficiency, whereas congenital mitral stenosis remains extremely problematic in the younger child.

ISSN:0268-4705    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In recent years there has been a strong emphasis from both medical and nonmedical communities to improve overall cardiovascular health. Continued attention has been focused on finding improved treatment regimens, and, encouragingly, increased attention is being directed toward prevention strategies for coronary heart disease. Emphasis on heart-healthy diets, fitness, and the now commonplace free blood pressure and cholesterol screenings have become part of our daily life.Multiple studies have demonstrated that atherosclerosis begins in childhood, and increasingly, the need for prevention to begin during childhood is being highlighted. Preventive cardiology in children, however, has long relied on adult data for definitions of risk factors, study protocols, and norms.Gradually, the pediatric data is becoming available. Elevated cholesterol levels, hypertension, obesity, and other risk factors defined in adults are all areas of intense interest in the pediatric population. This brief review of preventive cardiology in children provides a look at the risk factors for adult coronary heart disease as they relate to children, the current recommendations (and associated controversies), and a summary of some of the most recent clinical trials.

ISSN:0268-4705    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Fetal echocardiography has assumed an increasingly important role in the diagnosis of structural heart disease. Recently, the usefulness of this technique as a tool with which to observe the prenatal natural history of congenital heart disease has been appreciated. The application of spectral and color Doppler ultrasonographic interrogation has added to our ability to assess the integrity of the fetal and placental circuit. Only when we can consistently and accurately diagnose congenital heart diseasein uterowill we be able to successfully apply prenatal treatment for this condition.

ISSN:0268-4705    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Today, the arterial switch operation is the treatment of choice for patients with transposition of the great arteries. Midterm follow-up confirms the initial hopes for good systemic ventricular function and lack of arrhythmias. A two-stage operation can be performed in patients seen after 1 month of age or in subjects who have had an atrial switch operation and with late systemic dysfunction. Increasing experience with the arterial switch operation has led to its successful use in more complex lesions. Increased mortality and morbidity after the atrial switch operation has been confirmed, with decreased cardiac output, baffle obstruction, and arrhythmias. In some cases interventional catheterization is useful. In patients with corrected trans-position of the great arteries who have associated malformations, the poor midterm results seen with the classical surgical repair make the combined atrial and arterial switch an interesting option.

ISSN:0268-4705    

出版商:OVID    

年代:1997

数据来源: OVID