An adult case of Kawasaki disease with multiplex coronary aneurysms and myocardial infarction: the role of transesophageal echocardiography.

Kawasaki disease (mucocutaneous lymph node syndrome) is an acute inflammatory disease that primarily affects infants and young children. In spite of proper therapy, coronary aneurysms develop in 10 to 25% of cases. Adult diagnosis of coronary aneurysm, presumably caused by Kawasaki disease, is rare.

[Closure of the patent ductus arteriosus by means of cardiac catheterization].

Authors report their results with transcatheter closure of patent arterial duct during a period of 1 year. Thirty patients underwent the procedure at the mean age of 5.22 yrs (range 5 mos-22.

[Management of aortic recoarctation by transluminal balloon angioplasty in childhood].

Recoarctation balloon angioplasty is an interventional technique for the treatment of restenosis of the aortic isthmus after surgery. At present it is the treatment of choice prior to surgery. Authors report their experience with the first 30 patients in this country.

[Successful multi-step management of developmental heart defects after intrauterine diagnosis].

At 28th week of gestation a conotruncal malformation with ventricular septal defect was diagnosed by fetal echocardiography. Postnatal echocardiographic and angiocardiographic examinations confirmed the diagnosis of conotruncal malformation (pulmonary atresia, ventricular septal defect, patent ductus arteriosus, aortopulmonary collateral arteries). The unifocalization (age: 11 months) and total correction with aortic homograft (age: 7 years) were performed.

[Total cavo-pulmonary anastomosis in heart surgery for the correction of univentricular heart].

The total cavopulmonary anastomosis is one of the alternative surgical procedures which can be performed in the management of the most complicated congenital heart diseases. It was the first time in Hungary that this surgical management was performed successfully in a girl with univentricular heart, pulmonary valve stenosis, malposition of the great arteries, who was operated on palliative procedure previously.

[Thrombolysis by tissue plasminogen activator in acute myocardial infarct].

The authors participated in the European multicenter investigation, ESPRIT, organized by the Wellcome Research Laboratories. Thrombolytic treatment by intravenous tissue plasminogen activator was performed in 25 patients with early (less than 6h) myocardial infarction. The efficacy of the treatment was controlled by repeat coronary arteriography at 60 minutes, at 90 minutes and at 24 hours of the tpA treatment.

Ventricular pump performance in patients with obstructed right ventricular-pulmonary artery conduits.

Postoperative data were obtained from 18 patients with partially obstructed right ventricular (RV) to pulmonary artery (PA) conduits, who were studied 1 to 9 years following a Rastelli operation. Age at operation was 1 to 8 months in seven patients (group I: infant group) and 2 to 9 years in the remaining 11 patients (group II: childhood group). The diagnosis was pulmonary atresia in eight patients, truncus arteriosus in seven, and transposition of the great arteries with ventricular septal defect and pulmonary stenosis in three.

Direct cardiac effects of an ionic and a non-ionic contrast medium in dogs.

Direct cardiac effects of ionic diatrizoate (Uromiro) and non-ionic iopamidol (Iopamiro) were investigated in "in situ" heart-lung preparation of 19 vagotomized dogs. Diatrizoate was found to induce considerably greater alteration in plasma osmolality and subsequent dehydration of the myocardium compared with iopamidol. Myocardial dehydration resulted in a decrease of left ventricular compliance and in that of cardiac performance.

Surgical experience with thrombotic and fibrotic forms of non-tropical eosinophilic endomyocardial disease.

Surgical treatment in 8 cases of non-tropical eosinophilic endomyocardial diseases with (4 patients) and without (4 patients) eosinophilia is reported. Follow-up results (1 to 4 years) in the 6 survivors, including hemodynamic re-study, were excellent even in patients operated on in the thrombotic stage (3) or with hypereosinophilia (2), or with dominant right ventricular involvement (3). Two-dimensional echocardiography gave the correct description of the pathologic stage and ventricular involvement in 6 of the 8 cases before catheterization.

Relief of mitral incompetence by selective intracoronary thrombolysis in hyperacute myocardial infarction.

Left ventriculography and coronary arteriography were performed in 47 patients with hyperacute myocardial infarction prior to recanalization of the infarct-related vessel. Mitral regurgitation was found in ten patients. After successful recanalization, left ventriculography was repeated in eight of the ten patients with mitral incompetence, and the mitral regurgitation had disappeared in seven.

Combined use of selective intracoronary thrombolysis and percutaneous transluminal coronary angioplasty for the treatment of coronary obstruction.

The case of a young female patient with inferior infarction is presented. In the fifth hour after the onset of MI coronary angiography revealed complete obstruction of the right coronary artery. This obstruction has been recanalized by selective intracoronary infusion of streptokinase.

Effects of coronary occlusion and norepinephrine on the myocardium of alloxan-diabetic dogs.

The aim of this study was to clarify the role of altered diabetic vascular reactivity in ischaemic heart disease. In diabetic condition, the necrotic area of myocardial infarction was significantly extended and myocardial oedema failed to develop after administration of norepinephrine 2 or 48 hours after ligation of the left anterior descending coronary artery. In metabolically healthy dogs the necrotic area of myocardial infarction was considerably smaller and an increase in myocardial water content, in myocardial thiocyanate space, in microscopically demonstrable permeability and in diastolic stiffness of left ventricular wall occurred when norepinephrine was administered 2 or 48 hours after coronary infarction.

Effects of prostaglandins E2, I2 and F2 alpha on the tone of isolated coronary arteries from alloxan-diabetic dogs.

Contractile responses to PGF2 alpha of isolated coronary arteries from 7 healthy and 12 alloxan-diabetic dogs without ketosis were considerably increased by indomethacin and decreased by PGI2. The increasing effect of indomethacin was more prominent on diabetic vessels than on those of normal animals while PGI2 had the same relaxant potency in both groups. The contractions induced by PGF2 alpha were inhibited more effectively by PGI2 than those evoked by PGE2 both in healthy and alloxan-diabetic groups.

Assessment of left ventricular contraction and relaxation by systolic and diastolic time intervals measured from the first derivative of apex cardiogram in cardiomyopathy.

To determine the usefulness of the time intervals obtained from the first derivative of apex cardiogram (dA/dt) in assessing contraction and relaxation in cardiomyopathy, 11 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 9 with congestive cardiomyopathy (COCM) with hemodynamically and angiographically documented diagnosis were studied. The control group numbered 50 normal subjects. Since contraction and relaxation are dependent on preload and afterload, the time interval from R wave of the electrocardiogram to the positive peak of dA/dt (R to dA/dt) and two relaxation parameters derived from the negative peak dA/dt, as well as early apex cardiographic relaxation index EARI) and total apex cardiographic relaxation index (TARI) were determined in all the subjects investigated.

Assessment of left ventricular contraction and relaxation by systolic and diastolic time intervals measured from the first derivative of apexcardiogram in cardiomyopathy.

To determine the usefulness of the time intervals obtained from the first derivative of apexcardiogram (dA/dt) in assessing contraction and relaxation in cardiomyopathy, 11 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 9 patients with congestive cardiomyopathy (COCM) with hemodynamically and angiographically documented diagnosis were studied. As a control group 50 normal subjects were used. Since contraction and relaxation is dependent on preload and afterload, the time interval from R wave of electrocardiogram to the positive peak of dA/dt (R to dA/dt) and 2 relaxation parameters derived from negative peak dA/dt, early relaxation index (ERI) and total relaxation index (TRI) were investigated.