Pediatric cardiology
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Pediatric cardiology · Mar 2000
Comparative StudyPhase-velocity cine magnetic resonance imaging measurement of pulsatile blood flow in children and young adults: in vitro and in vivo validation.
Quantification of blood flow in vessels provides valuable information that aids management decisions in a variety of cardiac conditions. Current flow measurement techniques are often limited by accuracy, time resolution, convenience, or anatomic localization. This study examined the accuracy of a commercially available phase-velocity cine magnetic resonance imaging (PVC MRI) technique to quantify flow rate in a pulsatile flow phantom. ⋯ Interobserver agreement was excellent (Bland-Altman bias = 0.09 L/min, 95% limits of agreement = 0.15-0.33 L/min). PVC MRI is an accurate technique to quantify pulsatile blood flow at a specific location. It can be used to noninvasively calculate Q(p) and Q(s) under normal flow conditions.
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Pediatric cardiology · Jan 2000
ReviewReal-time magnetic resonance imaging: diagnostic and interventional applications.
The advent of ultra-fast imaging techniques has extended the utility of magnetic resonance imaging (MRI) from a static and purely diagnostic status to an imaging modality ideally suited for a number of therapeutic applications. These advances--along with the recent development and refinement of miniature intravascular imaging catheters and MRI-compatible guidewires, balloon catheters, and radiofrequency ablation catheters--have created an exciting forum of novel approaches for detecting and treating both acquired and congenital cardiovascular disease. ⋯ Early diagnostic and therapeutic applications, such as high-resolution intravascular and intracardiac imaging, balloon angioplasty, stent placement, and radiofrequency ablation techniques, are discussed and extended to several potential approaches specific to pediatric cardiac therapeutic catheterization. Lastly, safety aspects of MR-guided interventional procedures are presented.
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Pediatric cardiology · Sep 1999
Comparative StudyBranch pulmonary artery growth after blalock-taussig shunts in tetralogy of fallot and pulmonary atresia with ventricular septal defect: a retrospective, echocardiographic study.
We performed a retrospective echocardiographic study in tetralogy of Fallot (TOF) or pulmonay atresia with ventricular septal defect (PA&VSD) to evaluate the effects of Blalock-Taussig shunt on branch pulmonary artery growth. There were 35 patients with TOF and 11 with PA&VSD. We measured the right and left pulmonary artery area index and also the combined pulmonary artery area index, both before and after shunt operation. ⋯ In the PA&VSD group the comparable values before shunt operation were 66.5 +/- 16.0, 55.4 +/- 10.6, and 120.9 +/- 26.9 mm(2)/m(2) and after shunt operation were 90.5 +/- 22.9, 77.2 +/- 24.1, and 166.6 +/- 44.4 mm(2)/m(2), respectively (p values <0.0006, <0.014, and <0. 002, respectively). We also examined the effect of distensibility of pulmonary arteries by comparing the percentage change in size of the combined pulmonary artery area index in the first 4 months after shunt with those after this time (p < 0.023). There were no significant differences between left- and right-sided shunts, origin and distal pulmonary artery growth, and the TOF and PA&VSD groups.
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Pediatric cardiology · Mar 1999
Complement activation, cytokines, and adhesion molecules in children undergoing cardiac surgery with or without cardiopulmonary bypass.
The effect of cardiopulmonary bypass (CPB) on various blood parameters in children undergoing major cardiovascular surgery was investigated in a prospective clinical study. Blood samples of children with CPB (CPB group, n = 18) or without CPB (control, n = 12) were collected before, during, and after surgery. The concentration of routine laboratory parameters, components of the complement system (C3, C4, C5, C1 inhibitor, total hemolytic complement, C3d, and C5a), circulating interleukins (IL-6 and IL-8) and soluble adhesion molecules (sICAM-1 and sE-selectin) were determined. ⋯ Although complement activation and ICAM-1 consumption are more pronounced in the CPB patients, none of these changes occurs exclusively in the CPB group. We conclude, therefore, that these changes are the combined effect of anesthesia, surgical trauma, and endothelial lesions. Additional, undefined CPB-induced reactions may also contribute the postoperative morbidity.
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Pediatric cardiology · Mar 1999
ReviewAortic arch anomalies associated with chromosome 22q11 deletion (CATCH 22).
Chromosome 22q11 deletion or CATCH 22 is associated with DiGeorge syndrome, conotruncal anomaly face syndrome, and velocardiofacial syndrome. Associated congenital heart diseases include tetralogy of Fallot, truncus arteriosus, and ventricular septal defect. Associated anomalies of the aortic arch, aortic branches, ductus arteriosus, and pulmonary arteries are more frequent in patients with the deletion than in those without the deletion. Associated anomalies include right aortic arch, cervical aorta, aberrant origin or isolation of the subclavian artery, the absence of the ductus arteriosus, major aortopulmonary collateral arteries, isolation of the left pulmonary artery, and vascular ring formed by the right aortic arch, retroesophageal aortic arch, and left descending aorta.