Evaluation of a temporal increase in ventricular septal defects: estimated prevalence and severity in northeastern New York, 1970-1983.

A marked increase or "epidemic" in ventricular septal defects (VSD) in recent years has been reported by the Center for Disease Control. Many pediatric cardiologists believe that this increase is simply a reflection of more intensive diagnosis and evaluation of infants throughout the country. Yet to our knowledge there has been no objective evidence for this explanation.

Cardiac rhabdomyoma in the neonate: surgical management.

Rhabdomyoma is the most common cardiac neoplasm in neonates. Tuberous sclerosis is found in half of the patients with rhabdomyomas. We maintain a surgical policy of accepting for operation only neonates in whom it has been demonstrated that the primary cause for hemodynamic compromise is obstructing, intracavitary neoplasms.

Right heart reconstruction following repair of tetralogy of fallot.

Ten patients in whom tetralogy of Fallot had been repaired underwent late reconstruction of the outflow tract of the right ventricle because of poor hemodynamic results. The major hemodynamic problems that necessitated right ventricular (RV) outflow tract reconstruction were severe pulmonary insufficiency in 9 patients and pulmonary stenosis in 1. Impaired RV contractility and RV aneurysm were the most important factors prompting valve replacement for severe pulmonary insufficiency.

Ventricular diastolic pressure-volume relations after the intra-atrial baffle operation for transposition of the great arteries.

Right and left ventricular diastolic pressure-volume (P-V) relations were assessed in 30 patients approximately 2 years after the Mustard operation. The overall distensibility index (delta V/ delta P), the compliance index at end-diastole (dv/dp), and the modulus of ventricular stiffness (Kp) were calculated in all, as well as the half-time of early diastolic pressure fall (T) in 10 cases. Transducer-tipped catheters were used in 15 patients and biplane cineangiography was employed in all.

Left ventricular function and compliance in pulmonary atresia with intact ventricular septum.

Left ventricular systolic function and compliance were assessed in 15 cases of pulmonary atresia with intact ventricular septum. The left ventricular ejection fraction measured from cineangiography was used for the evaluation of the systolic function. The end-diastolic pressure (EDP), left ventricular compliance index at end-diastole (dv/dp), and left ventricular stiffness constant K were used as compliance indices.

Atrial septal defect associated with drainage of left superior vena cava to left atrium and absence of the coronary sinus.

Atrial septal defect associated with drainage of the left superior vena cava (LSVC) to the left atrium and absence of the coronary sinus is a rare congenital cardiac complex. Management of the LSVC during operative repair is usuall by one of three methods: (1) an intra-atrial baffle of pericardium to divery flow from the LSVC to the right arrium and to close the atrial septal defect; (2) division and reimplantation of the LSVC into the right atrium; or (3) simple ligation of the LSVC. We will present an example of this cardiac lesion for which successful repair was achieved by end-to-side anastomosis of the LSVC to the main pulmonary artery when none of the aforementioned methods for handling the LSVC was feasible.

Cord blood hyperlipoproteinemia and perinatal stress.

In 275 neonates mean cord blood cholesterol level was 70 +/- 17 (SD) mg/dl, with a range from 30 to 153 mg/dl. Mean cord blood triglyceride level was 33 +/- 26 (SD) mg/dl, with a range of 5-192 mg/dl. In an attempt to correlate perinatal problems and hypercholesterolemia in neonates we compared 15 hypercholesterolemic neonates who had cord blood cholesterol levels above 95 mg/dl, range 100-153 mg/dl, and triglyceride levels less than 65 mg/dl, with 65 normal neonates whose cord blood cholesterol levels were less than 95 mg/dl and triglyceride values were less than 65 mg/dl.

Tetralogy of Fallot with atresia of the left pulmonary artery: surgical repair using a homograft aortic valve.

Two cases of tetralogy of Fallot with unilateral absence of the left pulmonary artery are presented. Both patients required a valve-retaining homograft because of severe pulmonary valve incompetence following previous surgical correction. This uncommon anatomic variant presents special surgical problems, as pointed out in a review of the literature.