Persistent eosinophilic infiltration of the myocardium in a child in complete remission of acute lymphoblastic leukemia and eosinophilia. Potential role in late cardiac disease?

This report describes the long-term (23 years) follow-up of a pediatric patient with acute lymphoblastic leukemia and eosinophilia who underwent multiple valve replacements. An 8-year-old boy with this complex disease was admitted in January 1984 and treated with 6-week course of vincristine, L-asparaginase, and prednisolone, which induced complete remission. He developed atrioventricular valvular insufficiency and infectious endocarditis at 13.

Surgical treatment of an unusual atrial septal defect: the vestibular defect.

A 14-year-old female patient underwent surgical treatment of multiple atrial septal defects associated with unroofed coronary sinus and pulmonary valvar stenosis. One of the defects was that of the superior oval fossa and the other a large ellipsoidal defect positioned inferior to the inferior rim of the oval fossa. The patient underwent primary closure of the defects with a favorable result.

Two-patch repair of complete atrioventricular septal defect using a small ventricular patch.

Since 1992, 19 patients with an atrioventricular septal defect have undergone surgical treatment using a novel annuloplasty technique in which a small ventricular patch was used to reduce the anterior-posterior dimension of the atrioventricular orifice. All patients recovered uneventfully and needed no reoperation for the residual regurgitation or shunt. The results showed that the new annuloplasty technique was promising, although a long-term result is yet to be seen.

Successful surgical repair of a ventricular septal defect and high take-off of the right coronary artery in an infant.

A 6-month-old boy was admitted in acute distress because of severe dyspnea and intractable congestive heart failure. With a diagnosis of the ventricular septal defect, pulmonary hypertension and deteriorated lung function due to the respiratory syncytial virus infection, he was taken to the operating room to undergo banding of the pulmonary artery. However, an intraoperative finding of the anomalous high take-off from the right coronary artery made us to discontinue the banding procedure.

Shallow stitching close to the rim of the ventricular septal defect eliminates injury to the right bundle branch.

Background: Complete right bundle branch block carries a deleterious effect on the long-term outcome of patients who undergo surgical treatment of the perimembranous ventricular septal defect. We describe a novel suturing method to reduce the prevalence of complete right bundle branch block.

Methods: From March 1996 through December 2000, 48 consecutive patients with perimembranous ventricular septal defect underwent patch closure using shallow stitches placed close to the rim (group 1).

Arrhythmia after modified total cavopulmonary connection without use of prosthetic material.

Background: Although total cavopulmonary connection without use of prosthetic material appeared to be a promising surgical procedure that would retain potential growth of the intraatrial tunnel, midterm incidence of arrhythmia remains unknown.

Methods: Twelve patients underwent modified total cavopulmonary connection. A prosthetic material was not used in 5 patients (group F) and was used in 7 patients (group P).