Pacemaker implantation in a premature low weight newborn with critical congenital atrioventricular block.

We describe a case of a preterm newborn with congenital complete atrioventricular block (CAVB), delivered for distress by cesarean section, and undergone, at 1295 grams of weight, to permanent pacemaker implantation. The pacemaker has been inserted between the upper left rectus abdominal muscle and the posterior rectus sheath and connected by two epicardial leads on the left ventricle wall. The procedure has been successfull.

[Immature intrapericardial teratoma: a case report in a newborn].

We report the case of an intrapericardial teratoma, diagnosed at 38 weeks of gestation. Echocardiography revealed a 38 x 39 mm multicystic pedunculated mass compressing the right atrium and the right ventricle, but without symptoms, associated with severe anterior pericardial effusion. Surgical resection of the mass was performed after birth successfully.

Regression of pulmonary fistulas in congenital heart disease after redirection of hepatic venous flow to the lungs.

Although the etiology of pulmonary fistulas in congenital heart disease remains unknown, several hemodynamic factors are thought to play a role. Recently it was postulated that hepatic venous effluent might protect the pulmonary bed from development of pulmonary fistulas. However, there are no experimental data supporting this hypothesis.

A rare form of interrupted aortic arch.

We report the case of a newborn with DiGeorge syndrome and aortic atresia associated with a complex anomaly of the aortic arch, interpreted as interrupted aortic arch type C, a persistent right ventral aorta and an aberrant right innominate artery. At 8 months the child underwent Norwood palliation with interposition of an 8 mm PTFE tube between the pulmonary trunk and the descending aorta and of a 3.5 mm shunt between the junction of the right ventral aorta to the left carotid artery and the right pulmonary artery.

Persistence of the left superior caval vein: can it potentiate obstructive lesions of the left ventricle?

Recent evidence has suggested that persistence of the left superior caval vein is associated with a high incidence of obstructive lesions of the left heart. To shed more light on this issue 1085 patients with congenital heart disease were studied retrospectively, with the aim of estimating the prevalence of a persistent left superior caval vein and its associated anomalies, focusing attention on obstructive lesions in the left and right ventricles. Patients with isomerism of the atrial appendages, or hypoplastic left heart syndrome, were excluded.

Arterial switch operation: myocardial ischemia reversed by internal mammary artery graft.

We report a case in which an internal mammary artery graft to the left anterior descending coronary artery was successfully used in a newborn boy to reverse life-threatening myocardial ischemia 24 hours after arterial switch operation. One year later, angiography showed patency of both the graft and the transposed coronary ostium with normal left ventricular function. A brief review of the literature shows encouraging results of internal mammary artery grafts in pediatric patients.

Late left atrioventricular valve insufficiency after repair of partial atrioventricular septal defects: anatomical and surgical determinants.

Risk factors for late left atrioventricular (AV) valve insufficiency, which occurred in 16 (18%) of 90 patients evaluated after repair of partial AV septal defect, were examined. The operative findings in 9 patients undergoing reoperation were also examined. Preoperative left AV valve insufficiency was significantly more common in the group with late left AV valve incompetence, as were associated valvular malformations as a whole and fenestrations of valve leaflets in particular.

Fontan repair for tricuspid atresia: experience with 50 consecutive patients.

From April, 1975, to October, 1985, 50 patients (mean age, 5.3 years; range, 2.5 to 14 years) underwent a Fontan repair for tricuspid atresia or severe tricuspid stenosis.

Palliative reconstruction of the right ventricular outflow tract in tricuspid atresia: a report of 5 patients.

Five patients with tricuspid atresia, normally related great arteries, and decreased pulmonary flow underwent reconstruction of the right ventricular outflow tract on enlargement of the ventricular septal defect (VSD) (outlet foramen) or both in order to increase pulmonary blood flow. The age of the patients ranged from 9 months to 4 years. All patients previously had had a systemic-pulmonary artery anastomosis.

Surgical repair of persistent truncus arteriosus in infancy.

Fourteen patients younger than two years of age with persistent truncus arteriosus underwent primary repair. Twelve of them were less than 1 year and 4 less than 3 months of age. Intractable heart failure was the indication for surgery in all patients but one who had increased pulmonary vascular resistance.

[Clinical use of a minicomputer in heart surgery intensive care units].

The Authors present three respiratory parameters useful to estimate the respiratory and hemodynamic conditions of a cardiac patients before these turn into obvious pathological clinical pictures. The parameters are: alveolar-arterial oxygen difference, respiratory index and arterial-venous pulmonary shunts. The sophisticated mathematic calculations necessary to calculate and to elaborate such data are made, in few seconds, by a minicomputer which is very easy to work with.

[Corrective surgery of double-outlet right ventricle and subaortic ventricular defect. Report of 12 cases surgically treated (author's transl)].

Experience with corrective surgery in 23 pts with double outlet right ventricle (DORV) and subaortic VSD is presented. The overall hospital mortality was 17%. Patients were divided into two groups: Group I includes seven cases without pulmonic stenosis and Group II sixteen cases with pulmonic stenosis.

[Results of palliative operations in infants with pseudotruncus arteriosus (author's transl)].

A palliative procedure in patients with pulmonary atresia with VSD should improve arterial oxygen saturation, allow growth and development, and promotes a uniform dilatation of the pulmonary arteries. Thirty-three severely symptomatic patients, ranging from 5 days to 24 mths of age and from 2,4 to 11 kg of weight underwent a variety of palliative operations, including the ascending aorta-right pulmonary artery shunt (intrapericardial: 15 cases; extrapericardial: 14 cases), the Blalock shunt (4 cases). In two cases, both with absence of the left pulmonary artery, a Waterston shunt was performed using cardiopulmonary by-pass.