Myocardial apoptosis after cardioplegic arrest in the neonatal lamb.

Objective: Myocardial apoptosis is observed after various cardiac injuries and is also a normal part of fetal cardiac development and early postnatal maturation. Cardioplegic arrest and reperfusion result in ischemic injury and oxidative stress, known triggers of apoptosis. Because the neonatal heart is in a proapoptotic state, we hypothesize that apoptosis is triggered after cardioplegic arrest in neonatal myocardium.

The modified Konno procedure for complex left ventricular outflow tract obstruction.

Background: Complex left ventricular outflow tract (LVOT) obstruction with normal aortic valve function requires aggressive resection in the subaortic region and preservation of the aortic valve. The modified Konno procedure allows generous exposure of the LVOT from the left ventricular apex to the inter leaflet trigones of the aortic valve. Widespread use of this procedure has been limited by concern over injury to the aortic valve, the conduction system, and possibility of residual ventricular septal defect (VSD).

Total anomalous pulmonary venous drainage associated with complex cardiac anatomy.

Patients with total anomalous pulmonary venous drainage (TAPVD) presenting with associated complex cardiac anatomy have a markedly less favorable prognosis when compared to patients with isolated TAPVD. The impact of associated cardiac lesions on the pathophysiology of TAPVD and the wide array of operative strategies for surgical palliation is discussed. Copyright 2000 by W.