Use of tolazoline in newborn infants with diaphragmatic hernia and severe cardiopulmonary disease. A preliminary report.

Two newborn infants with congenital diaphragmatic hernia, one of whom died, had significant improvement in arterial oxygen tension (Pao2) after intravenous administration of tolazoline (Priscoline) (1 to 2 mg. per kilogram). In both infants, systemic hypotension developed within minutes of administration of the drug and required pharmacologic and hemodynamic intervention.

Staged surgical management of pulmonary atresia with diminutive pulmonary arteries.

A particular problem in treatment is presented by patients who have atresia of the pulmonary valve and ventricular septal defect but whose pulmonary arterial tree is extremely diminutive. The pulmonary blood flow results from naturally occurring large bronchial collateral arteries. In the experience reported, satisfactory palliation was provided for all 3 patients in whom right ventricle--to--pulmonary artery continuity was constructed by placing a pericardial patch graft during open-heart operation.

Aortic homograft obstruction.

At the Mayo Clinic from September 1967, to November 1972, 128 patients underwent operations in which an aortic homograft was used to establish right ventricle-to-pulmonary artery continuity. Recently, we studied 18 of these patients who had calcified, obstructed aortic homografts. Seven patients had histories of significant dysrhythmias, all of which required medication and two of which were life threatening.

Transient protein-losing enteropathy secondary to elevated caval pressures and caval obstruction after the Mustard procedure.

Protein-losing enteropathy, documented by 51Cr-labeled albumin excretion studies, was demonstrated in a 24-month-old girl following the Mustard operation for complete transposition. Apparent postoperative inferior vena cava obstruction had been diagnosed by angiocardiograms and both caval pressure were found to be elevated. There was no evidence of primary renal or hepatic disease or cardiac failure.

Valid climatological data from historical sources by content analysis.

Content analysis is used to derive dates of freeze-up and break-up from historical descriptions of river estuaries on Hudson Bay between 1714 and 1871. Validity testing of these dates indicates that they are comparable with modern data. It is thus proposed that the method affords potential for the systematic retrieval of a broad array of environmental data from the historical past.

Cor triatriatum: echocardiograhic findings.

The echocardiographic findings in a patient with cor triatriatum are presented. The preoperative echocardiogram demonstrated an unusual structure behind the mitral valve that moved anteriorly during atrial systole. There was also echocardiographic evidence of abnormalities of mitral valve motion, right ventricular and left atrial enlargement, and pulmonary hypertension.

Neonatal pneumopericardium.

Three cases of neonatal pneumopericardium are presented. Detailed ventilatory measurements and chest roentgenographic changes are described for each of the three patients. The literature of neonatal pneumopericardium is reviewed, and based on that review and our own cases, we offer guidelines for managing these patients.

Pneumococcal endocarditis in a 7-week-old infant. A case complicated by congenital heart malformation with mitral valve perforation.

A 7-week-old girl had pneumococcal endocarditis and perforation of the mitral valve. Pneumococcal endocarditis in children under 2 years of age is extremely rare, and is a prototype for endocarditis in general in infants less than 2 years of age. To our knowledge, this is the youngest reported patients with pneumococcal endocarditis in the penicillin era.