Cardiology clinics
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Review
Clinical assessment of ventricular function after surgical treatment of congenital heart defects.
The assessment of ventricular function has contributed to the current surgical evaluation and surgical treatment of congenital heart defects, but many issues remain unresolved. The challenge of assessing ventricular function after surgical repair of congenital heart defects includes not only the general problem of distinguishing adverse loading conditions from myocardial failure but also more unique problems of right heart function and developmental differences in ventricular function. ⋯ Many of the technologies and methods are currently available and there is the beginning of a move toward better designed clinical trials and analysis of results. The assessment of ventricular function will become increasingly important as surgical techniques are improved and we are left with the more difficult choices between competing approaches.
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This article discusses recent information regarding the normal and abnormal structural maturation of the pulmonary vascular bed, features that govern the functional behavior of the pulmonary circulation. Special emphasis is given to the cell biology of the vessel wall.