Fluid accumulation in the staged Fontan procedure: the impact of colloid osmotic pressures.

Objectives: Despite Fontan surgery showing improved results, fluid accumulation and oedema formation with pleural effusion are major challenges. Transcapillary fluid balance is dependent on hydrostatic and colloid osmotic pressure (COP) gradients; however, the COP values are not known for Fontan patients. The aim of this study was to evaluate the COP of plasma (COPp) and interstitial fluid (COPi) in children undergoing bidirectional cavopulmonary connection and total cavopulmonary connection.

Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressure.

Objectives: Following paediatric cardiac surgery with cardiopulmonary bypass (CPB), there is a tendency for fluid accumulation. The colloid osmotic pressure of plasma (COPp) and interstitial fluid (COPi) are determinants of transcapillary fluid exchange but only COPp has been measured in sick children. The aim of this study was to assess the net colloid osmotic pressure gradient in children undergoing atrial septal defect closure.

Interstitial fluid colloid osmotic pressure in healthy children.

Objective: The colloid osmotic pressure (COP) of plasma and interstitial fluid play important roles in transvascular fluid exchange. COP values for monitoring fluid balance in healthy and sick children have not been established. This study set out to determine reference values of COP in healthy children.

Pulmonary valve replacement with a bovine pericardial valve: a five year follow-up study.

Objectives: From a population of 90 patients after pulmonary valve replacement with a biological valve (Carpentier-Edwards Perimount valve), 56 of 80 available patients were examined five years after surgery.

Background: Pulmonary valve replacement is needed in many patients with congenital heart disease. Homografts have limited availability and predictable degeneration, and mechanical valves require anticoagulation.

Right ventricular volumes assessed by echocardiographic three-dimensional knowledge-based reconstruction compared with magnetic resonance imaging in a clinical setting.

Objectives: A technique that uses two-dimensional images to create a knowledge-based, three-dimensional model was tested and compared to magnetic resonance imaging.

Background: Measurement of right ventricular volumes and function is important in the follow-up of patients after pulmonary valve replacement. Magnetic resonance imaging is the gold standard for volumetric assessment.

Blood flow imaging in transesophageal echocardiography during atrial septal defect closure: a comparison with the current references.

Background: Flow visualization before transcatheter atrial septal defect (ASD) closure is essential to identify the number and size of ASDs and to map the pulmonary veins (PV). Previous reports have shown improved visualization of ASD and PV using blood flow imaging (BFI), which supplements color Doppler imaging (CDI) with angle-independent information of flow direction. In this study, we compared transesophageal BFI with the current references in ASD sizing (balloon stretched diameter, BSD) and PV imaging (pulmonary angiography).

Left ventricular function in children and adults after renal transplantation in childhood.

Background: Renal transplantation improves left ventricular (LV) function, but cardiovascular mortality remains elevated. The aim of this cross-sectional study was to determine whether subclinical abnormalities of LV longitudinal function also persist in patients who underwent renal transplant in childhood.

Methods: Conventional and speckle tracking echocardiography was performed in 68 renal transplant recipients (34 children and 34 adults, median 9.

Eight years of pulmonary valve replacement with a suggestion of a promising alternative.

Unlabelled: In a retrospective study we assessed surgical results following right ventricular to pulmonary artery connection repair or replacement at a medium of 2.4 years (0-8) follow-up. Data were retrieved from hospital charts.

[Patent foramen ovale and decompression illness in divers].

Background: About 25 % of the population has patent foramen ovale, and the condition has been assumed to be a causal factor in decompressive illness. Transcatheter closure is possible and is associated with a relatively low risk, but it has not been clarified whether there is an indication for assessment and treatment of the condition in divers. The present study explored a possible relationship between a patent foramen ovale and the risk for decompression illness in divers, if there are categories of divers that should be screened for the condition and what advice should be given to divers with this condition.

[Thrombolysis in arterial cerebral infarction in children].

Background: After the neonatal period, the incidence of arterial cerebral infarction is 1-2/100 000 children/year. Thrombolysis in cerebral stroke is recommended for adults, but is still controversial for children. The aim of this paper was to provide an overview of documentation on treatment with thrombolysis after arterial cerebral infarction in children.

De novo HRAS and KRAS mutations in two siblings with short stature and neuro-cardio-facio-cutaneous features.

Mutations in genes involved in Ras signalling cause Noonan syndrome and other disorders characterised by growth disturbances and variable neuro-cardio-facio-cutaneous features. We describe two sisters, who presented with dysmorphic features, hypotonia, retarded growth and psychomotor retardation. The patients were initially diagnosed with Costello syndrome, an autosomal recessive inheritance was assumed.

[A 9-week-old boy with fever and diarrhoea].

A 9-week-year-old boy was admitted to the pediatric clinic after 12 hours of fever and diarrhoea. On admission he had a fever of 40 degrees C, rhinitis and moderate diarrhoea. Blood tests were normal, except for elevated CRP (89 mg/L).

De novo HRAS and KRAS mutations in two siblings with short stature and neuro-cardio-facio-cutaneous features.

Mutations in genes involved in Ras signalling cause Noonan syndrome and other disorders characterised by growth disturbances and variable neuro-cardio-facio-cutaneous features. We describe two sisters, 46 and 31 years old, who presented with dysmorphic features, hypotonia, feeding difficulties, retarded growth and psychomotor retardation early in life. The patients were initially diagnosed with Costello syndrome, and autosomal recessive inheritance was assumed.

[Do patients with ventricular septal defect need endocarditis prophylaxis?].

Background: Patients with ventricle septal defect are considered at higher risk of infectious endocarditis than the population in general. According to guidelines, these patients should receive prophylactic antibiotics prior to invasive procedures. Recently, several studies have been published that challenge this view.

Radiofrequency perforation and conventional needle percutaneous transseptal left heart access: pathological features.

Perforating radiofrequency (PRF) energy has been used to obtain percutaneous transseptal left heart access. Contrary to ablative radiofrequency (RF), myocardial tissue responses to PRF thermal injury are incompletely defined. In this study, a newly developed RF catheter system for transseptal left atrial entry was compared with conventional needle puncture.

[Evaluation of cardiac murmurs in children].

Background: Many normal children have heart murmurs, but most children do not have heart disease. Differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is largely clinical.

Material And Methods: This review is based upon the authors' own studies and PubMed searches.

[Referral practice and clinical assessment of heart murmurs in children].

Background: Heart murmurs in infants and children are common, and in most cases these are physiological murmurs. In a few cases they represent congenital heart disease; it is important to detect those few children by referral to paediatric cardiologists.

Material: 220 consecutive children with heart murmur were investigated prospectively as outpatients in the Children's clinic, Haukeland University Hospital from January through December 2001.

Exercise capacity in young adults with hypertension and systolic blood pressure difference between right arm and leg after repair of coarctation of the aorta.

Coarctation of the aorta represents 5-7% of congenital heart defects. Symptoms and prognosis depend on the degree of stenosis, age at surgery, surgical method and the presence of other heart defects. Postoperative complications are hypertension, restenosis and an abnormal blood pressure response during exercise.

[Risk factors in Kawasaki's syndrome].

Background: Few patients with Kawasaki's syndrome have been described in Norway. Different aspects of diagnosis and treatment are assessed in this article.

Material And Methods: We retrospectively reviewed 26 cases of Kawasaki's syndrome at Haukeland University Hospital 1985-1999.

Bladed balloon angioplasty for peripheral pulmonary artery stenosis.

Treatment for peripheral pulmonary artery stenosis is challenging, and conventional balloon angioplasty has not proved to be universally effective. Evaluated was the efficacy of bladed balloon (BB) dilation to address vessels resistant to conventional high-pressure (10-15 atm) balloon angioplasty (BA). Thirty-one procedures were performed on 14 children with age range 1 month to 15 years.

Native right ventricular outflow stent implantation in patients with unsalvageable extracardiac conduits.

We describe two patients with unsalvageable ventricular-to-pulmonary artery conduits in whom endovascular stents were implanted in the native right ventricular (RV) outflow providing double outlet ventricle and RV hypertension relief. Both patients are free from surgical reintervention at 7 years and 5 months, respectively.

Magnetic resonance imaging of patients with increased blood pressure and altered blood pressure response to exercise after coarctation repair.

Objective: Patients successfully operated for coarctation of the aorta are frequently subjected to altered blood pressure (BP) at rest and BP response during exercise. The relationship between these variables and blood flow, peak velocity, restenosis and other morphological features of the thoracic aorta as revealed by magnetic resonance imaging (MRI) was evaluated.

Design: Fifty-one patients subjected to coarctectomy of the aorta were examined by MRI.

Haemoptysis as a late complication of a Mustard operation treated by balloon dilation of a superior caval venous obstruction.

Haemoptysis was the presenting symptom in a 27-year-old male. He had undergone a Mustard operation for connection of complete transposition at the age of 2 years. For 6 months prior to admission, he had complained of dyspnoea without chestpain, and swelling of the fingers during hard physical work.