[Non-invasive and invasive assessment of the function of aortic valve homografts in infancy and childhood]. / Homograft aorta billentyü conduit funkciójának noninvazív és invazív vizsgálata csecsemö- és gyermekkorban.

Study population involved 21 pts with complex congenital heart disease after corrective surgery using homografts between the years 1986 and 1992. Diagnoses included double outlet right ventricle, tetralogy of Fallot, transposition of great arteries, truncus arteriosus, pulmonary atresia with VSD, corrected transposition with pulmonary stenosis, and absent pulmonary valve. Pts age at surgery ranged from 18 days--to 15 yrs mean, 6.7 yrs. Time interval between surgery and diagnostic procedures was 8 days--6 yrs (mean 11 months). All pts were studied by Echo/Doppler. 2 pts by TEE and 3 pts by MRI. 6 pts had cardiac catheterisation. Distal (5) or proximal (1) stenosis was present in 6 cases. The severity and the type of stenosis was correctly identified by noninvasive technique compared to invasive findings. Homograft valve regurgitation was mild (4) or moderate (3). In two pts severe insufficiency was associated to homograft endocarditis. Postoperative residual shunts were found in 8 pts. Homograft stenosis can correctly be diagnosed using Echo/Doppler technique. Distal stenosis was more frequent than proximal. Homograft tends to become insufficient, but severe incompetence did not occur except in endocarditis.

[Congenital absence of the left pericardium. Case report and review of the literature]. / Veleszületett bal oldali pericardiumhiány. Esetismertetés és irodalmi áttekintés.

Congenital absence of the pericardium, whether partial or total, is a rare abnormality. If suspicion of such a malformation arises it should be classified because of possible herniation of the atrium or ventricle. The authors report the case of an asymptomatic young male patient in whom the diagnosis was suggested radiographically, electrocardiographically (total electrical alternans has been noticed) and confirmed by cross-sectional echocardiography, computed tomography and magnetic resonance imaging. Only in exceptional cases should it be necessary to perform an exploratory thoracotomy. In patients with complete pericardial defects no specific therapy is indicated, however, in patients with partial defects surgical treatment is indicated. Congenital pericardial defects are not completely benign, as has been suggested before.