Cardiology in the young
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Cardiology in the young · Aug 2008
The effects of surgically induced right bundle branch block on left ventricular function after closure of the ventricular septal defect.
To determine the long-term significance of right bundle branch block on left ventricular systolic and diastolic function in children subsequent to surgical closure of ventricular septal defect. ⋯ Systolic long axis function is significantly reduced in children after surgical closure of ventricular septal defects, irrespective of the presence of right bundle branch block. Diastolic dysfunction, in contrast, was observed primarily in children with post-operative right bundle branch block.
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Surgical results after repair of tetralogy of Fallot have remained excellent for the last decades, with current long-term rates of survival over 95%. Since functional capacity, quality of life, and social interactions are basically normal in this large group of patients, pregnancy obviously becomes a relevant issue for the female subgroup. In consequence, adequate obstetrical and cardiological management of pregnancy is particularly important. ⋯ Pregnancy is well tolerated in women with tetralogy of Fallot, and an excellent neonatal outcome is expected. The recurrence risk of congenital cardiac disease, most often tetralogy of Fallot, is high.
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Cardiology in the young · Aug 2008
Outcome in infants less than 3 kilograms for placement of saphenous venous homografts as systemic-to-pulmonary arterial shunts.
Establishing stable and adequate flow of blood to the lungs using a systemic-to-pulmonary arterial shunt in infants with low birth weight may involve significant morbidity and mortality. We reviewed our experience with this procedure in patients weighing less than 3 kilograms. ⋯ Systemic-to-pulmonary arterial shunts can be constructed safely in infants with biventricular physiology born with low weight. Those having functionally univentricular circulations carry an increased rate of mortality for the period of shunting. Using the saphenous venous homograft permits use of smaller grafts, which does not significantly increase the risk for thrombosis or survival when compared to previous studies using polytetrafluoroethylene grafts.