RESUMO
When corrective surgery for tetralogy of Fallot was accomplished through the use of a transannular GORE-TEX patch with a pericardial unicusp, the right-ventricular end-diastolic volumes of all patients studied within a year of the surgery were within the normal ranges because of decreased pulmonary valve regurgitation. The right-ventricular ejection fraction was also only slightly depressed, indicating preservation of right-ventricular function. All patients were noted to maintain normal stroke volumes and normal systolic indices. In contrast, the patients who had transannular patches placed without unicusps showed significantly elevated right-ventricular end-diastolic volumes and lower right-ventricular ejection fractions. These resulted from markedly dilated right-ventricular outflow regions in conjunction with enlarged right-ventricular chambers, which manifested as large dyskinetic areas in the anterior right-ventricular walls.
Assuntos
Angioplastia com Balão , Coartação Aórtica/terapia , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , RecidivaAssuntos
Aorta/fisiopatologia , Pressão Sanguínea , Circulação Coronária , Permeabilidade do Canal Arterial/fisiopatologia , Artéria Pulmonar/fisiopatologia , Adolescente , Aorta/anormalidades , Aorta Torácica/diagnóstico por imagem , Criança , Pré-Escolar , Permeabilidade do Canal Arterial/complicações , Permeabilidade do Canal Arterial/diagnóstico por imagem , Eletrocardiografia , Bloqueio Cardíaco/complicações , Comunicação Interventricular/complicações , Hemodinâmica , Humanos , Lactente , Recém-Nascido , Radiografia , Fatores de TempoRESUMO
Reaction of an isolated, unruptured sinus of Valsalva aneurysm is described. Detection was serendipitous in a patient with previous surgical resection and grafting of significant aortic coarctation. The philosophy and importance of proceeding with elective resection in these progressive lesions is emphasized.
Assuntos
Aneurisma Aórtico/cirurgia , Adolescente , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/patologia , Criança , Feminino , Humanos , RadiografiaRESUMO
A 5-year-old boy had clinical, cardiac catheterization, and operative findings of a thoracic arteriovenous fistula arising from the right subclavian artery. The venous connection was to the paravertebral plexus with eventual drainage into the inferior vena cava through the right common iliac vein. To our knowledge, this type of fistula has not been reported previously and is believed to represent embryological defects of the first or second posterior intercostal arteries as well as maldevelopment of the venous connections of azygos vein to the superior vena cava, which resulted in the observed caudal venous pathways becoming operative.