[Evaluation of abnormal myocardial wall motions in patients with univentricular heart by tissue Doppler echocardiography].

Introduction: Assessment of systolic and diastolic ventricular function in children and adults with morphologically and functionally univentricular heart is difficult using the conventional echocardiographic methods. Quantitative assessment of systolic and diastolic wall motion by TDE may provide information on abnormal systolic and diastolic ventricular function. Thus, the object of this study was to analyze the patterns of anterior and posterior wall motions in children with univentricular heart after palliative Fontan operation in comparison to normal subjects.

Patent ductus arteriosus in very low birthweight infants: complications of pharmacological and surgical treatment.

Aims: To evaluate complications of surgical and pharmacological treatment of symptomatic patent ductus arteriosus (PDA) in very low birthweight (VLBW) infants.

Patients And Methods: Of 931 VLBW infants consecutively admitted 1987-1998, a significant PDA prompted first-choice treatment by indomethacin in 101 infants, and surgery in 55 infants. PDA closed or became asymptomatic after indomethacin in 64 patients (63%), while 34 went on to surgery.

Pulsatile pediatric ventricular assist devices: Current results for bridge to transplantation.

While pulsatile ventricular assist devices have gained widespread use in adult patients awaiting heart transplantation, only very limited experience with these devices exists in the pediatric population. In the past mostly non-pulsatile systems such as ECMO have been used to support pediatric patients with heart failure for very limited periods of time. Only recently have miniaturized pulsatile devices became available.

[Artificial heart in terminal stage of dilated cardiomyopathy in childhood].

In children with dilated cardiomyopathy the disease may progress so rapidly that they die during the waiting period before a suitable donor organ is found. Fifteen children of 4 months to 15 years of age had been in congestive heart failure with multiorgan failure due to dilated cardiomyopathy, where intensive medical treatment had failed. After resuscitation, a miniaturized pulsatile ventricular assist device for the mechanical replacement of heart function was implanted.

Risk factors for early degeneration of allografts in pulmonary circulation.

Objective: The aim of this study was to define risk factors for early degeneration of allografts in pulmonary circulation and to recommend some guidelines to minimize them.

Methods: Between January 1988 and March 1995, 202 patients with various types of congenital heart disease received cryopreserved allograft conduits for reconstruction of their right ventricular outflow tract. We report on 63 patients receiving allografts ranging from 9-24 mm size within the first 2 years of life.

Freehand subcoronary aortic valve and aortic root replacement with cryopreserved homografts: intermediate term results.

Background And Aims Of The Study: The traditional method of aortic valve replacement with a homograft has been free-hand insertion in the subcoronary position. Recently, total root replacement has become increasingly popular. We present our experiences with both methods in this study.

Accelerated degeneration of allografts in the first two years of life.

Between January 1988 and May 1994, 53 of 159 patients have received cryopreserved aortic and pulmonary allografts for reconstruction of the pulmonary circuit in the first 2 years of life with body weight ranging from 2.2 to 18 kg (mean, 8.2 +/- 3.

Performance of aortic and pulmonary homografts in the right ventricular outflow tract in children.

Cryopreserved homografts have been used at the German Heart Institute Berlin since October 1986. Until 31st May 1994, cryopreserved aortic (AA) or pulmonary (PA) homografts were implanted in the pulmonary position and followed up in 104 patients. The mean age at operation was 5.

Improvement in left ventricular dysfunction after aortic reimplantation in 11 consecutive paediatric patients with anomalous origin of the left coronary artery from the pulmonary artery. Early results of a serial echocardiographic follow-up.

To study the potential for recovery of left ventricular function in patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) after aortic reimplantation, serial two-dimensional echocardiographic examinations were performed before and up to 9 months after operation in 11 consecutive paediatric patients (group 1: six infants; group 2: five children above the age of 1 year). End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial volume (MV), ratio of myocardial volume/end-diastolic volume (MVI), and regional wall motion of the left ventricle (LV) were studied. Pre-operatively, mean LVEDV was 339% of normal in group 1 and 289% in group 2 (P < 0.

Use of polytetrafluoroethylene surgical membrane as a pericardial substitute in the correction of congenital heart defects.

Patients who undergo repair of congenital heart defects have a high probability of eventually needing a repeat operation. In such cases, use of a pericardial substitute can preclude adhesion formation, thereby helping to avert the complications of a repeat sternotomy. This report describes our use of the GORE-TEX polytetrafluoroethylene surgical membrane in 321 patients who underwent repair of congenital heart disease at our hospital between May of 1989 and December of 1992 (these cases account for 37.

One-stage correction of congenital heart disease and complex rhythm disorders.

In an 8-month-old baby, one-stage correction of an atrial septal defect, multiple right and left atrial aneurysms and non-paroxysmal ectopic right atrial tachycardia was performed. An ectopic focus of atrial tachycardia was localized by a pre- and intraoperative electrophysiological study. Postoperatively, the patient's clinical status improved significantly.

Deep hypothermia with reduced flow rates for correction of ventricular septal defects in infants. An alternative approach.

In this presentation our experience of the correction of large ventricular septal defects (VSD) under deep hypothermia (DH) and reduced flow rates in infants is reported. Sixty patients with VSD and pulmonary hypertension were operated. The age of the patients varied from 1.

Evaluation of hemodynamics in infants and small babies after open heart surgery.

The study was undertaken to establish typical hemodynamic changes and reliable clinical tests for the evaluation of these in infants after open heart surgery. The cardiac index was measured using the thermodilution technique in 56 infants. The age of the patients varied from 6 to 28 months and body weight from 4 to 15 kg.