In utero ultrasound diagnosis of congenital heart disease.

Two hundred and one pregnancies considered at high risk for congenital heart disease (CHD) underwent fetal cross-sectional echocardiographic (CSE) examination. In 190 cases a structurally normal heart was correctly predicted; seven cases of CHD were identified, but in two of them the specific diagnosis was inaccurate. One false positive diagnosis of a small ventricular septal defect was made.

Early treatment of patent ductus arteriosus in premature infants with severe respiratory distress syndrome.

In 1983, a US National Collaborative Study (NCS) proposed criteria for the diagnosis of hemodynamically significant patent ductus arteriosus (PDA) in premature infants with respiratory distress syndrome (RDS), but the widespread use of pulsed Doppler cross-sectional echocardiography (PD-CSE) in neonatal intensive care units has made direct assessment of the ductus possible thus providing more timely therapy. We have compared the results in 30 premature infants with severe RDS, assessed according to the guidelines of the US NCS, with those in 51 infants whose PDA was diagnosed by PD-CSE. Together with a significant reduction in the age at treatment (7.

Unusual ultrasound finding of patent ductus arteriosus in a preterm infant.

Patency of the ductus arteriosus (PDA) is a common finding in small premature infants. Recently pulsed-Doppler-cross sectional echocardiography (PD-CSE) has been successfully used in these patients. We report a case of a premature infant with an unusual PD-CSE pattern.

Prenatal ultrasonic detection of truncus arteriosus with interrupted aortic arch and truncal valve regurgitation.

The echocardiographic appearances in a case of persistent truncus arteriosus with aortic arch interruption and truncal valve dysplasia was noted in a 24 week fetus. Elective termination of pregnancy was carried out and all the echocardiographic findings were confirmed by pathological examination suggesting the possibility of accurate prenatal diagnosis of such lesions.

Extracardiac malformations and congenital heart disease: frequency and patterns of associations.

Congenital Heart Malformations (CHM) can be present together with Extracardiac Malformations (ECM) in a single individual, however the frequency and the patterns of associations are not well defined because the casistics of the literature are little comparable. The diagnosis of CHM has been demonstrated with cardiac catheterization in any case. Between January 1st, 1976 and December 31st, 1983 cardiac catheterization has been performed in 1012 children and 971 of them were affected by Congenital there was at least one ECM as well (group B); 311 ECM were present in group B.

Ultrasound sequential analysis of the cardiovascular anatomy in utero.

Fetal cardiac anatomy was studied by ultrasound in 96 pregnancies between 16 and 24 weeks' gestation. Sequential approach was used to identify all venous, atrioventricular and ventriculoarterial connections as well as intracardiac anatomy. A standard CSE was performed after birth in all patients to confirm the normal heart anatomy.

Right atrial thrombosis in two premature infants: successful treatment with urokinase and heparin.

Vascular thrombosis is a harmful and rather frequent event in sick premature infants. Only recently has intracardiac thrombosis been described in preterm babies and virtually all the surviving cases are those treated surgically. We report the cases of two premature infants with intra-atrial thrombosis detected by cross-sectional echocardiography and successfully treated with heparin and urokinase for 12 and 16 days, respectively.

[Pulsed Doppler in children operated on for aortic coarctation: reliability in the evaluation of minor residual lesions].

The usual non invasive diagnostic methods may not be able to estimate a mild residual gradient in infants treated for Coarctation of the Aorta (CA) so we tried to determine whether Pulsed Doppler (PD) may be useful in these cases. We studied 16 children (Group A) treated for CA, clinically considered as good operative results (arm to leg gradient less than or equal to 10 mmHg) and admitted for cardiac catheterization to study associated cardiac defects. Ten children with congenital heart disease different from CA were studied as a control (Group B).

[Severe neonatal cardiac insufficiency due to arteriovenous fistula of the vein of Galen].

The cerebral arteriovenous fistula is a rare cause of neonatal cardiac failure. We have recently observed three cases of severe cardiac failure associated with an arterio-venous malformation of the vein of Galen. At echocardiography and angiography the right cardiac chambers were seen to be more enlarged than the left ones.