Pediatric cardiology
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Pediatric cardiology · Jul 1992
Case ReportsBalloon atrial septostomy under transesophageal echocardiographic guidance.
Balloon atrial septostomy is an established method of palliation for several forms of congenital heart disease. Previously performed under fluoroscopic x-ray control, recent reports have demonstrated the utility of transthoracic echocardiographic monitoring. We report the first application of uniplane transesophageal echocardiography (TEE) (6.7-mm probe) as an alternative imaging modality for control of balloon atrial septostomy on neonates in the intensive care unit.
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Pediatric cardiology · Apr 1992
Case ReportsCor triatriatum associated with total anomalous pulmonary venous drainage in the setting of mitral atresia and a restrictive interatrial communication.
A rare variant of cor triatriatum is described in which the proximal "accessory" chamber received all four pulmonary veins and drained into the levoatriocardinal vein and then into the innominate vein. The distal "true" chamber contained the left atrial appendage. The left atrioventricular valve was atretic and the interatrial septum was restrictive.
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Pediatric cardiology · Jul 1991
Open heart surgery in children of Jehovah's Witnesses: extreme hemodilution on cardiopulmonary bypass.
Between January 1979 and July 1989, 15 children of Jehovah's Witnesses underwent corrective open surgery for congenital heart disease (CHD) on cardiopulmonary bypass (CPB). Ages ranged from 1.5-17 years and body weight from 9.1-63 kg, with five patients weighing less than 15 kg. Eight children were cyanotic, and two of them had had previous thoracic operations. ⋯ There was one postoperative death, not related to the technique. Our results demonstrate that bloodless cardiac surgery on bypass is feasible in children as shown in this special group of children of Jehovah's Witnesses. Knowing the risks of homologous blood transfusion this technique should be used more extensively in the future.
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Pediatric cardiology · Jan 1987
Case ReportsAcute hepatic failure after open-heart surgery in children.
Acute hepatic failure (AHF) combined with acute renal failure (ARF) is a well-known complication of open-heart surgery in adults. The occurrence of this complication in two children after open-heart surgery for correction of congenital heart disease is reported. Hypotension occurred during the operation and was treated by catecholamine vasopressors. ⋯ ARF also developed in both children. One of the patients survived the acute episode of hepatic failure. The importance of early diagnosis, routine close monitoring, and appropriate selection of vasopressors is emphasized.