Right ventricular function in congenital heart defects assessed by regional wall motion.

Objectives: To develop a simple method to assess right ventricular function by angiography.

Background: Conventional methods of evaluating right ventricular function are inaccurate, cumbersome, and expensive.

Methods: We analyzed biplane right ventricular angiograms taken in the posterior-anterior and lateral projections using software to measure right ventricular volumes and regional wall motion in 78 patients with normal hearts (n = 29), atrial septal defects (ASD n = 13), pulmonary valve stenosis (PVS n = 21), and postoperative atrial switch patients (n = 15).

Isolated cleft of the mitral valve: clinical spectrum and course.

We have reviewed the clinical presentations, courses, and outcomes of 90 patients seen at Texas Children's Hospital from 1983 through 2008 who had an isolated cleft of the mitral valve without some form of endocardial cushion defect. Additional congenital cardiac defects were present in 61 of the 90 patients, 35 of whom had a congenital syndrome. Seven patients had isolated cleft of the mitral valve without other intracardiac defects, and in these 7 there was a progressive increase in the degree of mitral regurgitation during a median time of 26.

Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: Initial results and long-term follow up.

Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs.

Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007.

Atrial septostomy improves survival in select patients with pulmonary hypertension.

Background: Atrial septostomy is a palliative treatment for patients with pulmonary hypertension (PHTN) refractory to vasodilator therapy. Limited data exist in the pediatric population and in patients with repaired congenital heart defects.

Methods: We performed a retrospective analysis of hemodynamic and symptomatic changes in patients with PHTN who underwent an atrial septostomy at our institution.

Clinical presentation of persistent 5th aortic arch: 3 new cases.

We report 3 cases of a persistent 5th aortic arch. This anomaly is usually associated with other intracardiac defects. Although all 3 patients were found to have similar vascular structures that were best explained by the persistence of the 5th aortic arch into postnatal life, the clinical presentations were quite different.

Complex pulmonary atresia in a neonate: successful surgical palliation for right pulmonary artery arising from the right main coronary artery.

We describe the case of a 3-week-old infant who was diagnosed with pulmonary atresia, a ventricular septal defect, and discontinuous pulmonary arteries. The pulmonary artery anatomy was delineated by angiography: the right pulmonary artery arose from the proximal right coronary artery, and the left pulmonary artery arose from a left ductus arteriosus. This case illustrates the importance of careful delineation of the anatomy in complex pulmonary atresia before surgical intervention.

Refinements in the implantation of pulmonary arterial stents: impact on morbidity and mortality of the procedure over the last two decades.

Introduction: There is limited data on medium to long-term outcome, and the morbidity and mortality associated with the implantation, of pulmonary arterial stents.

Purpose: To assess changes in morbidity and mortality over the last two decades.

Methods: Retrospective analysis of all patients stented between September, 1989 and July, 2001.

Cardiac catheterisation in infants weighing less than 2500 grams.

Objectives: To investigate the indications for, and outcome of, cardiac catheterisation in infants weighing less than 2500 g at a single institution over an 8-year period.

Patients And Methods: We assessed all infants who were less than 2500 g at the time of cardiac catheterisation at Texas Children's Hospital from January 1993 to January 2001. Comparisons of morbidity and mortality were drawn with an equivalent number of infants of similar age weighing greater than 2500 g seen over the same period of time.

Initial experience with intratherapeutics Intrastent Doublestrut LD stents in patients with congenital heart defects.

Limitations of the currently available balloon-expandable stainless steel (BE-SS) stents for use in patients with congenital heart defects (CHD) include inflexibility, significant shortening with expansion, sharp ends, and limited sizes. These limitations increase risk and greatly effect success of stent placement in these patients. The recently approved IntraStent DoubleStrut LD (IS-LD) stents are BE-SS stents designed to address such limitations.