Percutaneous transluminal angioplasty of congenital coarctation of the aorta.

Two cases of successful dilatation of congenital coarctation of the aorta using the Grüntzig technique are reported. In a 3-week-old boy and an 11-month-old girl, systolic gradients across the narrowed areas were lowered from 50 to 8 mm Hg and from 23 to 8 mm Hg. Although the femoral pulses later disappeared in the younger patient, surgery was avoided. The second patient's gradient has remained minimal for 8 months and no surgery has been performed.

Neovascularity related to a mural thrombus.

This is a case report on an unusual angiographic finding related to a left ventricular mural thrombus. An abnormal vascular blush of contrast was noted on performing coronary arteriography. This was attributed to neovascularity in a left ventricular mural thrombus. This abnormality must be distinguished from vascular fistulas, intracardiac communications, and tumors in making appropriate therapeutic decisions.

Cardiac death in mucocutaneous lymph node syndrome.

A 12 year old boy had 4 symptom-free years after hospitalization for acute febrile mucocutaneous lymph node syndrome before he died suddenly from extensive myocardial infarction. Current evidence suggests that many patients with this syndrome have coronary artery disease and that those with significant cardiac findings should be studied with coronary angiography. Serial studies are recommended because of the danger of sudden death.

Thoracic coarctation associated with neurofibromatosis.

A child with neurofibromatosis and hypertension also demonstrated renal artery stenosis, the most common cause of hypertension in children with neurofibromatosis; abdominal coarctation, which has previously been described; and thoracic coarctation, which to our knowledge, has not been previously reported. Rib notching may appear in patients with uncomplicated nueorfibromatosis, but the possibility of associated thoracic coarctation must also be considered in these patients.

Primary venous obstruction of the upper extremity.

Three cases of primary axillary and subclavian venous obstruction presented herein demonstrated the classic findings of swelling, aching or pain, and discoloration following effort in an otherwise healthy person. The clinical diagnosis was confirmed by venography. Residual changes were frequent after treatment that included anticoagulation and thrombectomy.