[Contrast echocardiography in children]. / Echokardiografia kontrastowa u dzieci.

The purpose of this study was to present the use of contrast echocardiography in congenital heart disease such as atrial septum defect or in complex congenital heart disease for the identification of valve atresia. In spite of better and better methods of heart structure imaging with high resolution picture and the flow direction with the help of colour-Doppler the contrast echocardiography is a very useful method for the identification of pathological intracardiac flows. The analysis of contrast flow with the use of freeze frame allows the recognition of valve atresia accompanied by backwards inflow into the vessel.

[Reproduction problems in women with cardiovascular diseases]. / Problemy prokreacyjne u kobiet z patologia ukladu krazenia.

53 female patients who informed the obstetrician about their cardiological problems were examined. In 44 cases the heart defects were diagnosed, in 39 cases of the congenital origin. In 20 patients the shunt congenital heart disease were recognized, in 13 cases the valvular defects, in 6--Fallot Syndrome and in the single cases tricuspid atresia, pulmonary atresia, Ebstein anomaly were observed. The next 9 patients were diagnosed as: in 4 cases hyperthrophy cardiomyopathy, in 2 cases the post myocarditis status, in 2 cases complete atrioventricular block and in 1 case WPW syndrome. The analysed women were pregnancy together 98 times, finished the delivery in 86 times. The physiological delivery were observed in 53 cases. 3 neonates died in the first day of live, 6 children were born prematured. Among 83 newborns who alived 7 required intensive care. The congenital heart diseases was diagnosed in 4 children--the atrial septal defect, pulmonary stenosis, coarctation of the aorta and mitral valve malformation were seen. Two children of the mothers with hyperthrophy cardiomyopathy have the same cardiological problems. The child of mother with congenital aortic stenosis suffered from the anal atresia and agenesis of the kidney.

Atrioventricular septal defect: clinical and diagnostic problems in children hospitalised in 1993-1998.

INTRODUCTION: Atrioventricular septal defect (AVSD) is one of the most frequent congenital heart diseases, making up 7.5% of all developmental anomalies of circulatory system. MATERIAL AND METHODS: Sixty-seven children with the diagnosis of atrioventricular septal defect were hospitalised at the Department of Paediatric Cardiology, Medical University in Gdansk, in 1993-1998. Patients' age ranged at diagnosis between 3 days and 17 years (mean age 35 months). The analysed group included 20 children with partial atrioventricular septal defect (group I) and 47 children with complete AVSD (group II). The diagnosis was based on anamnesis, physical examination, ECG, chest x-ray and echocardiography. Cardiac catheterisation and angiocardiography were performed in 28 children. RESULTS: On the basis of the results obtained, 6 children with Down syndrome were disqualified from the surgery due to persistent pulmonary hypertension. Fifty-nine children--including all the patients from group I (20) and 39 children from group II were qualified for operations in extracorporeal circulation. Two children from group II required ventilation with the mixture containing NO in the early post-operative period. There were 8 deaths (12%). Three children from group II died preoperatively due to severe generalised infection in early infancy and 5 infants from group II died immediately after operation. No deaths occurred in group I. In one case of a 4 year-old boy with partial atrioventricular septal defect, atrioventricular block developed immediately after surgery and required constant stimulation of the heart. In two children it was necessary to replace mitral valve (2 and 5 years after ASD I surgery). CONCLUSIONS: 1. Children with Down syndrome require screening echocardiography. 2. Non-invasive diagnostic examinations of atrioventricular septal defect are usually sufficient for the full assessment of the defect and the choice of further treatment. 3. The correction of the congenital heart disease such as atrioventricular septal defect should be completed in the first 6 months of life, particularly in children with complete AVSD.

[The closure of persistent ductus arteriosus using coils in a child with Wilm's tumor]. / Zamkniecie droznego przewodu tetniczego za pomoca sprezynki wewnatrznaczyniowej u dziecka z guzem Wilmsa.

In Pediatric Institute of Medical University of Gdansk in all children with neoplasmatic diseases the echo examination is performed, due to exclude coexisting abnormalities of cardiovascular system. During this kind of procedure in 4.5-year-old girl with Wilms tumour the persistent ductus arteriosus was described. Because of the chemotherapy design and its potential cardiotoxicity the closure of PDA using coils was performed immediately. The successful closure of PDA gave the chance to apply the whole therapeutic protocol.

[The analysis of complications and mortality rate of children with congenital heart diseases (author's transl)]. / Analiza przyczyn powiklan i smiertelnosci u dzieci z wadami wrodzonymi serca

The highest mortality rate among 75 newborns and infants observed has been noted in children with hypoplastic left heart syndrome, transposition of the great arteries, double outlet of the right ventricle and single ventricle. In the newborn period the mortality rate was 96%, and later on it decreased. Cardiac failure complicated by pneumonia was the most frequent cause of the infant's death (47 cases), then anoxic spells and sudden death (12 cases), diagnostic and surgical procedures (10 cases). The causes of death of six children were apparently not related to the heart disease.