Desaturation and esterification of fatty acids in kidney cells from spontaneously hypertensive rats.

In previous studies, several alterations in lipid metabolism have been related to hypertension, but the mechanisms explaining this relationship have not been elucidated. None of the previous works has focused on the lipid metabolism in kidney, which is a key organ in the overall regulation of blood pressure. The aim of the present work was to study the metabolism of polyunsaturated fatty acids, and the possible compositional changes in kidney from hypertensive rats.

[Tetralogy of Fallot. A 20-year material].

Surgical repair of tetralogy of Fallot may be a first stage palliation with secondary physiologic correction or repair as a primary procedure. The aim of palliation is to increase the pulmonary blood flow. Since 1981 we have used an interposition shunt between the subclavian and the pulmonary artery for this purpose.

Factors influencing survival in total anomalous pulmonary venous drainage.

Surgical repair of total anomalous pulmonary venous drainage was performed on 20 patients in 1977-1986. In univariate and multivariate and survival-curve analyses of clinical, anatomic and haemodynamic features, elevated diastolic pulmonary artery pressure was the only parameter prognostic of total mortality. The early mortality rate was 25% and the 5-year survival was 65 +/- 10.

[Magnetic tomography in congenital heart defects].

Magnetic resonance imaging (MR) has been shown to be valuable in defining cardiac anatomy in a variety of cardiac abnormalities. The article describes the technique and results of MR in 32 children with congenital heart disease. MR clearly depicts the anatomy of the great vessels, and may be used for the evaluation of palliative systemic-pulmonary artery shunts.

Balloon debanding of the pulmonary artery.

Clinical balloon debanding of the pulmonary artery is reported in two patients, 6 months and 4 years of age. The band was made of Dacron, and was closed with one single polypropylene suture. This suture was subsequently ruptured with a balloon inflated within the pulmonary artery at the site of the band.

Coarctation of the aorta, early and late results of various surgical techniques.

In the 10-year period 1973-1983, 158 patients aged one day to 16.4 years were operated upon for coarctation of the aorta; 25% of them were less than one month of age. The main surgical procedure was aortoplasty with a prosthetic patch (114 patients), and resection and end-to-end anastomosis (36 patients).

[Aneurysm after patch graft aortoplasty in aortic coarctation].

In the period 1973-83, 114 patients with coarctation of the aorta were operated on with patch plasty. Early results were encouraging. Two of these patients had to be reoperated, however, because of aneurysmatic dilatation of the aorta adjacent to the prosthetic patch.

Senning operation for transposition of the great arteries in the first month of life.

Twelve patients with uncomplicated transposition of the great arteries were operated upon in the first month of life following an initial Rashkind procedure. They were all in a clinically unacceptable condition and were mostly acidotic or bad mixers without acidosis. Two patients died postoperatively from a cerebral haemorrhage not discovered prior to operation.

Altered natural killer cell activity in childhood acute non-lymphoid leukaemia. Augmented natural killer cell activity and cells expressing the Leu 7 and Leu 11b (CD 16) markers in the bone marrow of children in remission.

Peripheral blood and bone marrow mononuclear cells from 25 children with acute non-lymphoid leukaemia were analysed for natural killer cell activity and for cells with the Leu-7 and Leu-11b (CD 16) markers. Significantly reduced spontaneous cytotoxicity was detected in peripheral blood from children with untreated and active acute non-lymphoid leukaemia compared with that of the controls (P = 0.01 and P less than 0.

In vitro balloon dilatation of the banded pulmonary artery.

The pulmonary artery of unfixated human heart-lung specimens was banded by placing a Dacron tape around the artery and securing the tape with a 5.0 Prolene suture at selected circumferences. The banding was successfully dilated with a balloon catheter in 24 instances.

Balloon dilatation of pulmonary artery banding in dogs: an experimental study.

The technique at our institution for banding of the pulmonary artery (PA) makes debanding by balloon dilatation theoretically possible. Previously we tested this hypothesis in an in vitro study (see previous article in this issue). This study describes balloon dilatation in dogs.

Cerebral perfusion during major cardiac surgery in children.

Six children undergoing major cardiac surgery had extensive cerebral monitoring during cardiopulmonary bypass (CPB). The monitoring included continuous recording of arterial blood pressure (BP), central venous pressure (CVP), cerebral electrical activity by a cerebral function monitor (CFM), and middle cerebral artery (MCA) flow velocity by the transcranial pulsed Doppler (TCD) technique. Introduction of the precooled blood containing priming solution resulted in rapid fall in BP as well as MCA velocities in these children at the start of CPB.

Echocardiographic evaluation of atrial function after Senning and Mustard correction for transposition of the great arteries.

Two groups of six children who had undergone either Senning or Mustard repair for uncomplicated transposition of the great arteries were studied with M mode echocardiography derived from a phased array sector scanner picture. The newly created atria were visualised from the subxiphoid region and the upper systemic venous inflow was selected for a simultaneous M mode registration with a subsequent wall motion analysis with a commercially available computer. In the Mustard group of patients the atrial walls seemed to move passively with the overall heart movements, while abrupt atrial wall excursions of both atria synchronous with heart action were noted in all patients after Senning repair.

Coarctation of the aorta in infancy.

In 57 infants with coarctation of the aorta severe congestive heart failure was the indication for surgical correction. More than half of them were less than 1 month of age. Associated cardiovascular anomalies were found in 48 patients.

Tricuspid atresia corrected with valved xenograft conduits.

In eight patients from 1976 until 1980, tricuspid atresia (TA) was corrected with valved xenograft conduits between either the right atrium and the main pulmonary artery or between the right atrium and the rudimentary right ventricle. All patients suffered from transient right-heart failure postoperatively and eventually developed normalized cardiac function throughout the first two months after operation. At recatheterization one year postoperatively, the right atrial pressure had generally only increased slightly, the pulmonary artery pressure was normal in all patients and only minor pressure differences were present across the valved conduits.

"Balloon valvulotomy" of congenital pulmonary valve stenosis with tricuspid valve insufficiency.

The rare congenital anomaly of pulmonary valve stenosis and massive tricuspid valve insufficiency with intact ventricular septum is a lethal condition without reported survival after attempted treatment. In a neonate suffering from this syndrome, the pulmonary valve stenosis was relieved by rupturing the fused valve with a balloon catheter introduced transvenously. The desperate condition of the patient quickly improved after this procedure, with subsequent disappearance of the tricuspid valve incompetence.

Correction of Fallot's tetralogy after palliative operations.

During the period 1960 to 1978, 98 patients underwent intracardiac repair of Fallot's tetralogy after palliative operations. Preoperative symptoms were cyanosis, dyspnea, increased fatigue with squatting and hypoxic spells. The hemoglobin concentration varied from 19 to 22 g/100 ml.

Total anomalous pulmonary venous drainage.

Twelve patients with total anomalous pulmonary venous drainage (TAPVD) underwent complete surgical correction. Six were of the supracardiac type, 2 were cardiac and 4 of the infracardiac type. Pulmonary hypertension due to pulmonary vein obstruction was present in 6 patients.

The adhesiveness of blood platelets before, during and after cardiopulmonary bypass.

The influence of cardiopulmonary bypass on the adhesiveness of blood platelets, using both bubble (Bentley and Rygg-Kyvsgaard) and membrane (Landé-Edwards) oxygenators, was investigated. With both types of oxygenators, there was a considerable fall in platelet adhesiveness during cardiopulmonary bypass, particularly with the Rygg-Kyvsgaard apparatus. The adhesiveness increased 30 minutes after bypass, but it was still not restored to the initial value.

Transposition of great arteries. Early results of Mustard's operation in paediatric patients.

Between May 1969 and June 1975, 43 patients with d-transposition of the great arteries, ranging in age from 2 months to 13 years (mean 19 months), underwent surgical correction. In the first 3 patients Mustard's original method was followed. Later a modified procedure was performed using a Teflon patch.

Total correction of Fallot's tetralogy.

Eighty-six patients with Fallot's tetralogy underwent total correction; 80% of them were less than 15 years old. Twenty-five patients were operated upon with primary intracardiac repair, while 61 had undergone some form of palliative heart surgery previously. A patch of woven Dacron was used in the outflow tract reconstruction in 9 cases.

The Mustard operation for transposition of the great arteries (TGA). Technical considerations.

Among the late complications described after Mustard's procedure, obstructions of the pulmonar veins. SVC or IVC have been the most serious ones. We consider that these complications are mostly related to the size and shape of the baffle and also to the way in which it is sutured into place.