Value of fetal ultrasonography index in twin fetal heart malformation screening at 11-13 + 6 weeks of gestation / 中华超声影像学杂志

Objective:To investigate the clinical value of fetal ultrasonography in the screening of congenital heart malformations in twins at 11-13 + 6 weeks of gestation. Methods:A retrospective cohort study method was used.Cases were collected from Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital (January 2012 to December 2016) and the Fourth Hospital of Shijiazhuang City (January 2014 to December 2018). The twins with singleton or twins with cardiac malformation were screened out as the cardiac malformation group, and the twins with normal delivery during the same period were selected as the control group. Ultrasound data such as the nuchal translucency (NT), crown-rump-length (CRL), chorionicity, conception method, NT discordance, CRL discordance, NT discordance ≥20% incidence rate between twins, and the CRL discordance ≥10% incidence rate between twins in the two groups at 11-13 + 6 weeks were compared and analyzed. Results:①There were 30 cases in the cardiac malformation group (including 27 twins with singleton cardiac malformation and 3 twins with twin cardiac malformation) and 1 906 cases in the control group. ②The incidence rates of NT value ≥95th percentile and NT value ≥99th percentile in one or two pregnancies were significantly higher in the cardiac malformation group than in the control group (20.00% vs 2.20%, P<0.001; 10.00% vs 0.63%, P=0.002), the area under the ROC curve (AUC) for cardiac malformation screening was 0.589 and 0.549, respectively; CRL discordance in cardiac malformation group was higher than that in control group ( P=0.018), the incidence of CRL discordance ≥10% in the cardiac malformation group was higher than that in the control group (26.67% vs 12.70%, P=0.024), the AUC of cardiac malformation screening was 0.570; there were no significant differences in the incidence of NT discordance, the incidence of NT discordance ≥20%, pregnancy pattern and chorionicity between the two groups (all P>0.05). ③Multivariate Logistic regression analysis was performed using the incidence rates of NT value ≥95% and NT value ≥99%, CRL discordance ≥10%, and NT discordance ≥20%. The incidences of fetal NT value ≥95% and NT value ≥99% were risk factors for cardiac malformation in twins ( OR=11.095, 105.778; 95% CI=4.311-28.558, 16.984-658.796). Conclusions:Ultrasound at 11-13 + 6 weeks of gestation showing thickened value of one or two fetuses, and the CRL discordance≥10%, indicates an increased risk of cardiac malformation in the twins; NT value ≥95% and NT value ≥99% is a risk factor for heart defects in twins.

Síndrome coronario agudo e insuficiencia mitral-aórtica grave en un paciente con rubeola congénita / Acute coronary syndrome and mitral-aortic insufficiency in a patient with congenital rubella

Resumen La rubeola es una enfermedad exantemática que se produce en la infancia. En caso de que se presente durante la gestación y hubiera afectación del producto, este puede desarrollar el síndrome de rubeola congénita, el cual incluye malformaciones cardiacas que se presentan en el 67% de los pacientes, de las cuales la más común es la persistencia del conducto arterioso, seguida de la estenosis valvular pulmonar y la comunicación interauricular. Se presenta el caso de un hombre de 20 años con diagnóstico de síndrome de rubeola congénita, quien desarrolló glaucoma congénito, insuficiencia aórtica grave, insuficiencia mitral grave y enfermedad miocárdica isquémica. Se realizó procedimiento quirúrgico de revascularización coronaria y recambio valvular mitral y aórtico. Los estudios encontrados durante el proceso de investigación mencionan el daño de los vasos sanguíneos y del miocardio producido por el virus. Con los datos obtenidos se corrobora la baja incidencia de presentación con compromiso coronario y valvular, por lo cual se hace énfasis en la importancia de este caso.

Abstract Rubella is an exanthematous disease that occurs in childhood. If it occurs during pregnancy and there is an effect on the product, it can develop congenital rubella syndrome. The congenital rubella syndrome includes cardiac malformations, which occur in 67% of patients, of which the most common is patent ductus arteriosus, followed by pulmonary valvular stenosis and atrial septal defect. We present the case of a 20-year-old man with a diagnosis of congenital rubella syndrome, presenting with congenital glaucoma, severe aortic insufficiency, severe mitral regurgitation and ischemic myocardial disease. In which a surgical procedure is performed by a coronary revascularization and mitral and aortic valve replacement. Studies found during the research process mention the damage to the blood vessels and myocardium produced by the virus. With the required data, the low incidence of presentation with coronary and valvular involvement is corroborated, which is why the importance of the present case is emphasized.

Clinical and anatomopathological descriptions of dog with arterious Hemitruncus: case report / [Descrições clínicas e anatomopatológicas de cão com hemitruncus arterioso: relato de caso

The anomalous origin of the pulmonary trunk in the ascending aorta, defined as arterious hemitruncus, is a rare congenital malformation in dogs, caused by a defect in the spiral septum. Thus, given the unusual occurrence in the canine species, the systemic severity and the high lethality, the aim of this study was to describe this heart disease in a three-month-old male German Spitz puppy, emphasizing clinical changes of the necropsy and microscopics. The animal had cyanosis, dyspnea and weakness and was forwarded for necropsy after sudden death. Numerous changes were detected in the post-mortem examination, including in the heart, as cardiomegaly and absence of the arterial ligament, which was replaced by the complete fusion between the ascending aorta and the pulmonary trunk, after leaving both the left and right ventricles, respectively and, among the microscopic findings, cardiomyocyte hypertrophy stood out. The association of these findings with the history indicated the diagnosis of arterious hemitruncus followed by cardiorespiratory failure, emphasizing the importance of out complementary cardiological exams in young symptomatic patients for the survival of those affected. Arterious hemitruncus, although rare, must be added in the differential diagnosis of other heart diseases that cause similar clinical signs.(AU)

A origem anômala do tronco pulmonar em aorta ascendente, definida como hemitruncus arterioso, é uma malformação congênita rara em cães, causada por defeito no septo espiral. Assim, diante da ocorrência incomum na espécie canina, da gravidade sistêmica e da alta letalidade, o objetivo deste trabalho foi descrever essa doença cardíaca em um filhote de três meses de idade, macho, Spitz Alemão, enfatizando as alterações clínicas, de necropsia e microscópicas. O animal apresentava cianose, dispneia e fraqueza e foi encaminhado para necropsia após morte súbita. Inúmeras alterações foram detectadas no exame post-mortem, inclusive no coração, como cardiomegalia e ausência do ligamento arterioso, o qual foi substituído pela fusão completa entre aorta ascendente e tronco pulmonar, após a saída de ambas dos ventrículos esquerdo e direito, respectivamente, e, dentre os achados microscópicos, destacou-se a hipertrofia de cardiomiócitos. A associação desses achados com o histórico indicou o diagnóstico de hemitruncus arterioso seguido de insuficiência cardiorrespiratória, ressaltando-se a importância de exames complementares cardiológicos em pacientes jovens sintomáticos na sobrevida dos acometidos. O hemitruncus arterioso, apesar de raro, deve ser acrescido no diagnóstico diferencial de outras cardiopatias que causam sinais clínicos similares.(AU)

Echocardiographic features of indirect Gerbode defect in a cat / 대한수의학회지

This report describes the echocardiographic features of an indirect Gerbode defect in a young cat. Echocardiography revealed high-velocity, turbulent systolic flow directed from left ventricle to right ventricle through a ventricular septal defect. The flow immediately entered the right atrium through a tricuspid septal leaflet. The indirect-type Gerbode defect was confirmed through necropsy. When a high-velocity turbulent flow in the RA without pulmonary hypertension is observed on echocardiography, Gerbode defect should be considered.

Progress on congenital heart disease combined with non-cardiac malformation / 中华实用儿科临床杂志

Congenital heart disease(CHD) ranks the first in birth defects.Some children with CHD have other non-cardiac malformations, and the perioperative mortality and adverse events are higher in children with CHD.One of the main causes of this problem is that the risk assessment system and treatment plan for CHD with non-cardiac malformations are not perfect.This article summarizes the progress and epidemiology, diagnosis and treatment by reading the literature related to this disease, stratifies the severity of the disease, and summarizes the latest surgical program, and provides evidence for the treatment of patients with CHD and non-cardiac malformations.

Síndrome de hipoplasia del ventrículo izquierdo / Left ventricular hypoplasia syndrome

Antecedentes: el síndrome de hipoplasia del ventrículo izquierdo es un conjunto de alteraciones del corazón fetal que condicionan un hipodesarrollo del corazón izquierdo, que es insuficiente para mantener la circulación sistémica. El corazón derecho se encuentra dilatado e hipertrofiado y soporta la circulación pulmonar y la circulación sistémica fetal a través del conducto arterioso permeable. Representa el 2 a 3% de todas las cardiopatías congénitas. Sin embargo, la incidencia real está subestimada ya que es responsable de abortos espontáneos y otras muertes fetales intrauterinas no diagnosticadas. Reporte de un caso: paciente de sexo femenino, 32 años de edad, con antecedente familiar de importancia (padre con fibrilación auricular). Antecedentes gíneco-obstétricos: un parto céfalo-vaginal, sin complicaciones, de un neonato de sexo masculino que actualmente tiene 6 años de edad. Durante su segunda gesta el feto es diagnosticado de hipoplasia del ventrículo izquierdo y atresia de la válvula mitral a las 34 semanas. Acude al Hospital Metropolitano a las 39 semanas de gestación para terminación de su embarazo mediante parto céfalo-vaginal. El parto no tuvo complicaciones; al nacimiento se confirma el diagnóstico prenatal y el recién nacido fallece en las primeras 72 horas. Conclusiones: el síndrome de hipoplasia del corazón izquierdo es una combinación compleja de malformaciones cardíaca;, debe ser detectado durante la evaluación ecográfica prenatal para planificar su manejo al nacimiento en centros especializados donde sea posible realizar procedimientos con el propósito de mejorar la supervivencia de estos pacientes.

Background: It is a set of alterations of the fetal heart that condition a hypodevelopment of the left heart, which is insufficient to maintain the systemic circulation. The right heart is dilated and hypertrophied and it supports the pulmonary circulation and fetal systemic circulation through patent ductus arteriosus. It represents 2 - 3% of all congenital heart diseases. However, current incidence is underestimated because it produces spontaneous abortions and other undiagnosed intra- uterine fetal deaths. Report of a case: a 32-year-old female patient with an importance family history: father with atrial fibrillation. Obstetric-gynecological antecedents: a cephalo- vaginal delivery without complications who was a male product of 6 years. During her second pregnancy, fetus was diagnosed with left ventricular hypoplasia and mitral valve agenesis at 34 weeks. She went to Metropolitan Hospital at 39.1 weeks to finish her pregnancy due to cephalo-vaginal birth. Delivery occurred without complications, however, the prenatal diagnosis was confirmed and the newborn died in 72 hours. Conclusions: The left heart hypoplasia syndrome is a complex combination of cardiac malformations; it can be detected with a prenatal evaluation with ultrasound which provides an option to pose treatment and also it can guide physicians to prepare for postnatal interventions when it is necessary.

Consideraciones anestésicas en la anomalía de Ebstein / Anesthetic considerations in Ebstein's anomaly

Introducción: la anomalía de Ebstein es una rara malformación congénita cardiaca, definida por un desplazamiento apical de las valvas septal y posterior de la válvula tricúspide hacia el interior del ventrículo derecho, en vez de hacerlo a nivel del anillo auriculoventricular, lo cual conlleva un aumento del volumen de la aurícula derecha (megaurícula) a expensas de una reducción del tamaño del ventrículo del mismo lado (auriculización del ventrículo). Causa una significante regurgitación tricuspídea y reducción de la capacidad funcional del ventrículo, dilatación atrioventricular derecha, con arritmias auriculares y ventriculares, las que tienden a hacerse resistentes en ocasiones, o de difícil tratamiento. El desplazamiento del orificio valvular tricuspídeo produce una división del ventrículo derecho en una porción integrada al atrio derecho, lo que constituye la porción atrializada del ventrículo derecho, en tanto la porción apicotrabecular y de salida constituye su parte funcional. Objetivo: presentar la evolución clínico-anestesiológica de una paciente con anomalía de Ebstein. Caso clínico: paciente de 69 años de edad programada para cirugía electiva en dos ocasiones por diferentes enfermedades oncológicas, portadora de anomalía de Ebstein. Antecedentes de tromboembolismo pulmonar, tres cirugías cardiacas, diabetes mellitus e hipertensión arterial, enfermedad arterial aterosclerótica estable e infarto cerebral media derecha embólico. Se evitaron aquellas condiciones que aumenten el trabajo cardiaco y el consumo de oxígeno. Conclusiones: el desafío que representa para el anestesiólogo, aquellos pacientes que sufren anomalía de Ebstein puede variar de paciente a paciente, en dependencia del estado físico, el tipo de enfermedad y las técnicas de monitorización(AU)

Introduction: Ebstein's anomaly is a rare congenital cardiac malformation, defined by an apical displacement of the septal and posterior leaflets of the tricuspid valve into the right ventricle, instead of at the level of the atrioventricular ring, which leads to an increase of the volume of the right atrium (mega atrium) at the expense of a size reduction for the ventricle on the same side (auriculization of the ventricle). It causes a significant tricuspid regurgitation and reduction of the functional capacity of the ventricle, right atrioventricular dilation, with atrial and ventricular arrhythmias, which tend to become resistant at times, or difficult to treat. The displacement of the tricuspid valve orifice produces a division of the right ventricle in a portion integrated to the right atrium, which constitutes the atrialized portion of the right ventricle, while the apico-trabecular and exit portion constitutes its functional part. Objective: To present the clinical-anesthesiological evolution of a patient with Ebstein's anomaly. Clinical case: A 69-year-old patient, with Ebstein's anomaly, who was scheduled for elective surgery on two occasions for different oncological diseases. History of pulmonary thromboembolism, three cardiac surgeries, diabetes mellitus and arterial hypertension, stable atherosclerotic arterial disease, and right middle cerebral infarction. Conditions that increase cardiac work and oxygen consumption were avoided. Conclusions: The challenge patients suffering from Ebstein's anomaly represent for the anesthesiologist can vary from patient to patient, depending on the physical state, the type of disease, and the monitoring techniques(AU)

Follow-up of infants of diabetic mother combined with heart disease / 中华实用儿科临床杂志

Objective To investigate the cardiac structure and hypertrophic cardiomyopathy of infant of diabetic mother(IDM),to analyze of the outcome of hypertrophic cardiomyopathy in IDM.Methods Totally 23 cases of IDM admitted in NICU from Feb.2012 to Jan.2013 were selected as observation group,randomly selected from the same period with gestational age of diabetic mother baby 23 cases as control group.The interventricular septum thickness,left ventricular posterior wall thickness,aortic valve internal diameter,right ventricular diameter,ejection fraction were detected and compared between the 2 groups.And echocardiography was followed up in 3 months and 6 months old.Results In IDM group,interventricular septum thickness [(3.20 ± 0.28) mm],left ventricular posterior wall thickness [(3.40 ± 0.31) mm] were significantly higher than those in control group (all P ＜ 0.05).Ejection fraction [(54.00 ± 3.76) × 10-2] was significantly lower than that in control group(P ＜ 0.05).Follow-up after 3 months,6 months old,interventricular septum thickness,left ventricular posterior wall thickness and ejection fraction returned to normal.Four of the 23 cases(17.4％) had cardiac malformations.Conclusions IDM has high morbidity of congenital heart disease,echocardiography should be done to identify hypertrophic cardiomyopathy and congenital heart disease after birth.IDM combined with hypertrophic cardiomyopathy is a transient,benign process,prognosis is good.

Prenatal Diagnosis of Chromosome 22q11.2 Deletions: Experiences in a Single Institution

PURPOSE: This study was designed to determine the frequency and echocardiographic findings of 22q11.2 deletions in fetuses with cardiac defects on fetal ultrasound or familial backgrounds of 22q11.2 deletions. MATERIALS AND METHODS: We retrospectively reviewed the medical and ultrasonographic records of 170 fetuses that underwent fluorescence in situ hybridization (FISH) analysis for chromosome 22q11.2 deletions between February 2001 and April 2013. RESULTS: Among 145 fetuses with cardiac defects, six (4.1%) had 22q11.2 deletions. Deletions of 22q11.2 were detected in 6 (5%) of the 120 fetuses with conotruncal defects: 5 (8.9%) of 56 with tetralogy of Fallot (TOF) and 1 (5.9%) of 17 with double outlet right ventricle (DORV). No deletions were found in cases of pulmonary atresia, truncus arteriosus, right aortic arch, or transposition of the great arteries. No 22q11.2 deletions were found in non-conotruncal cardiac malformations. Among 25 fetuses with familial backgrounds of 22q11.2 deletions, one (4%) had a maternally inherited 22q11.2 deletion with no cardiac findings. CONCLUSION: Knowledge of the frequency and echocardiographic findings of 22q11.2 deletions might be helpful for prenatal genetic counseling. It is advisable to perform FISH analysis for 22q11.2 deletions in pregnancies exhibiting conotruncal cardiac defects such as TOF or DORV.

Diagnóstico prenatal del Síndrome Ellis van Creveld: reporte de caso y revisión de la literatura / Prenatal diagnosis of Ellis-van Creveld syndrome: case report and literature review

Introducción: el síndrome de Ellis van Creveld (EVC) es una entidad rara que se caracteriza por extremidades cortas, polidactilia y defectos cardíacos, que puede ser detectada prenatalmente por medio de ultrasonido. Se analiza un caso con el objetivo de discutir sus características, los posibles diagnósticos diferenciales y el pronóstico. Materiales y métodos: este artículo presenta un caso de diagnóstico prenatal de EVC por medio de ultrasonido, que se confirmó luego del nacimiento. Se realizó una búsqueda bibliográfica en la base de datos Medline vía PubMed en donde se encontraron 579 artículos, de los cuales se revisaron 15 debido a su pertinencia y actualidad. Conclusiones: el síndrome EVC es una condición susceptible de diagnóstico prenatal. Se debe sospechar en caso de mesomelia, polidactilia y defectos cardíacos. El pronóstico depende principalmente del tipo de malformación cardíaca.

Introduction: Ellis van Creveld (EVC) syndrome is a rare genetic disorder which is characterized by a person having short limbs, polydactylia and heart defects; it can be detected prenatally by ultrasound. A case is presented here so that its characteristics, possible differential diagnoses and prognosis can be discussed. Materials and methods: this article presents a case of prenatal diagnosis of EVC by ultrasound which was confirmed shortly after birth. A bibliographic search was made of the Medline via PubMed database; 15 of the 579 articles which were found were reviewed due to their pertinence and topicality. Conclusions: EVC syndrome is a condition which is susceptible to prenatal diagnosis. It should be suspected in cases of mesomelia, polydactyly and cardiac defects. Prognosis mainly depends on the type of cardiac malformation.

Experiencia de una madre con hijo con malformación / Experience of a mother with child with malformation

El propósito de este estudio es construir conocimiento desde la experiencia de vida de una madre con un hijo de un mes de vida, operado de malformación congénita cardiaca durante la hospitalización en una Unidad Pediátrica de un Hospital de la Región Metropolitana de Chile. OBJETIVO: comprender el significado de este fenómeno fortaleciendo el saber del cuidado de enfermería, y contribuir a mejorar la atención. METODOLOGÍA: investigación cualitativa. RESULTADO: se devela el significado de la experiencia vivida del sufrimiento constante y ganas de salir adelante junto a la firmeza en su autoconcepto de madre. INTERPRETACIÓN: la forma en que se presenta la experiencia de la madre, se analiza desde la perspectiva de Heidegger, evidenciándose como un proceso que implica sufrimiento desde la noticia del embarazo, diagnóstico y pronóstico. La falta de cuidado percibido, la escasa atención o protección otorgada por el equipo de salud acentúan emociones como miedo, temor, soledad, rabia e impotencia por su situación de vida. A pesar de ello la madre reafirma su autoconcepto. CONCLUSIÓN: se evidencian ámbitos totalmente posibles de modificar para humanizar el cuidado, en que prime la percepción de la madre y el hijo como una unidad de cuidado siempre que un niño se hospitaliza, y enfrentarla en una relación de cuidado de ayuda.

The purpose of this case study is to build knowledge from the life experience of a mother with a child 1 month old, with surgery by congenital cardiac malformation during hospitalization in a pediatric unit. OBJECTIVE: to understand the significance of this phenomenon strengthening the knowledge of nursing care, and to help improve attention. METHODOLOGY: qualitative research. RESULT: this reveals the meaning of the lived experience of constant suffering and desire to move forward with the strength in her self-concept of mother. INTERPRETATION: the way the experience of the mother is presented, is analyzed from the perspective of Heidegger, showing as a process that implies suffering from the news of pregnancy, diagnosis and prognosis. Lack of care perceived, the lin protection provided by the health team emphasize emotions like fear, loneliness, anger and helplessness about her situation in life. In spite of this, the mother confirms her self-concept. CONCLUSIONS: some areas entirely possible to modify to humanize the care, that prime the perception of the mother and child care as a unit whenever a child is hospitalized are evidenced, and faceit in a relationship of supportive care.

Estudo morfométrico do coração fetal: sua utilização como parâmetro para análise ecocardiográfica / Morphometric study of the fetal heart: a parameter for echocardiographic analysis", "_i": "en

OBJETIVO: Avaliar o diâmetro, o perímetro e a área das valvas atrioventriculares do coração fetal, bem como a espessura das paredes ventriculares e os diâmetros das cavidades ventriculares. MATERIAIS E MÉTODOS: Foram dissecados 20 corações de fetos com idade gestacional entre 28 e 36 semanas. Em seguida foram medidos os diâmetros ântero-posterior e transverso e aferidos as áreas e os perímetros das valvas mitral e tricúspide, bem como foram medidas as espessuras das paredes ventriculares e os diâmetros de suas cavidades, utilizando-se um paquímetro com acurácia de1/10 mm. RESULTADOS: Os diâmetros ântero-posterior e transverso da valva atrioventricular esquerda mediram, em média, 10,35 ± 1,62 mm e 9,90 ± 1,79 mm, respectivamente, e os diâmetros ântero-posterior e transverso da valva atrioventricular direita, 10,98 ± 1,90 mm e 9,51 ± 1,81 mm, respectivamente. A área e o perímetro da valva mitral foram de 84,06 ± 25,09 mm² e 29,87 ± 3,96 mm, respectivamente. A área e o perímetro da valva tricúspide mediram, respectivamente, 84,49 ± 26,79 mm² e 28,44 ± 3,85 mm. No ventrículo direito a espessura da parede anterior foi de 5,00 ± 1,70 mm e a da parede posterior foi de 3,83 ± 0,91 mm; no ventrículo esquerdo a espessura da parede anterior foi de 4,25 ± 0,87 mm e a da parede posterior foi de 4,14 ± 0,89 mm. O septo interventricular teve espessura de 4,10 ± 1,13 mm. O ventrículo direito teve como diâmetro ântero-posterior 9,25 ± 0,85 mm, e como diâmetro transverso 8,24 ± 0,42 mm. O ventrículo esquerdo mediu 9,95 ± 0,37 mm para o diâmetro ântero-posterior e 9,20 ± 0,40 mm para o diâmetro transverso. CONCLUSÃO: O conhecimento dos dados morfométricos do coração do feto é de grande importância para o diagnóstico ecocardiográfico de possíveis malformações cardíacas.

OBJECTIVE: To evaluate the diameter, perimeter and area of atrioventricular valves as well thickness of ventricular walls and diameter of ventricular cavity of fetal hearts. MATERIALS AND METHODS: Twenty fetal hearts at gestational age between 28 and 36 weeks were dissected. A paquimeter with 1/10 mm accuracy was utilized for the following morphological measurements: anteroposterior and transverse diameters, mitral and tricuspid valves areas and perimeters. RESULTS: Anteroposterior and transverse diameters of the left atrioventricular valve measured 10.35 ± 1.62 mm and 9.90 ± 1.79 mm, respectively; and anteroposterior and transverse diameters of the right atrioventricular valve measured 10.98 ± 1.90 mm and 9.51 ± 1.81 mm, respectively. Mitral valve area and perimeter were, respectively, 84.06 ± 25.09 mm² and 29.87 ± 3.96 mm. Tricuspid valve area and perimeter were, respectively, 84.49 ± 26.79 mm² and 28.44 ± 3.85 mm. The thicknesses of the anterior and posterior right ventricular walls were, respectively, 5.00 ± 1.70 mm and 3.83 ± 0.91 mm. The thicknesses of the anterior and posterior left ventricular walls were, respectively, 4.25 ±0.87 mm and 4.14 ± 0.89 mm. The thickness of the interventricular septum measured 4.10 ± 1.13 mm. The anteroposterior diameter of the right ventricle was 9.25 ± 0.85 mm, and the transverse diameter was 8.24 ± 0.42 mm. The anteroposterior diameter of the left ventricle measured 9.95 ± 0.37 mm, and transverse diameter measured 9.20 ± 0.40 mm. CONCLUSION: The role of morphometric data of fetal atrioventricular valves is highly significant in the echocardiographic diagnosis of possible congenital cardiac malformations.

Anesthesiologic considerations in a pediatric patient with cornelia de lange syndrome: A case report / 대한마취과학회지

Cornelia de Lange syndrome (CdLS) is a relatively uncommon, multiple malformation syndrome involving neurodevelopmental, craniofacial, cardiac, musculoskeletal and gastrointestinal systems. Anesthetic management of a patient with CdLS may pose a serious problem mainly from difficult tracheal intubation, aspiration complications and cardiac malformation. We report our successful experience in anesthetic management of a 15-month-old male patient with CdLS who underwent orchiopexy for bilateral cryptochidism.

Results for cardiac intervention in National Hospital of Pediatrics

Background:The progress of the cardiac intervention technique has been changed the doctors' viewpoint in the treatment for congenital cardiac. In the past years, treatment for congenital cardiac needed to surgery but nowadays, the cardiac intervention technique are being applied in many Cardiac Centers with very good results. This technique also helped to prevent the complication in cardiac operation. Objectives:This study aims to report the results for cardiac intervention in National Hospital of Pediatrics. Subjects and method:A prospective study was conducted on 298 children diagnosed with patent ductus arteriosus, atrial septal defect (ASD), ventricular septal defect, coarctation, pulmonary stenosis (PS), aortic stenosis (AS), small patent ductus arteriosus (PDA) infant with pulmonary atresia - ventricular septal defect (VSD) and Dextro- transposition of the great arteries (d- TGA) with intact ventricular septum at National hospital of Pediatric between June 2004and October 2006. Results: Transcatheter closure of PDA, ASD by Amplatzer or Coil was safe and effective. Critically ill children diagnosed with PS, AS and Coarctation may be saved by valvuloplasty and angioplasty procedures. Catheter interventions avoided the needs for surgery without scars. Catheter interventions had low complications. Conclusion: The hospitalized duration was short so the expenditures reduced.

Experimental Study for the Teratogenic Effect of Gamma-ray on the Heart of Chick Embryo

PURPOSE: To investigate the teratogenic effect of gamma-ray on the heart of chick embryo. METHODS: 50 rad, 100 rad, 150 rad, 200 rad, 250 rad, and 300 rad of gamma-ray were used to irradiate three days old chick embryos. The control group was not irradiated. After three weeks, the embryos were sacrificed and examined for cardiovascular malformation. RESULTS: The survival rate of the gamma-ray irradiated group was significantly lower than that of the control group(33.3-63.3% vs 76.4%, P=0.001). The cardiac malformation rate of the experimental group was 11.0%. In the control group, no congenital cardiac malformations were observed. The experimental groups had a significantly higher malformation rate(P=0.001). The types of malformation were ventricular septal defect, tricuspid atresia, Ebstein anomaly and aortic arch anomaly. In the gamma-ray irradiated group, the cardiac malformations were : 14 small ventricular septal defects (VSDs), five large VSDs, two tricuspid atresias, and one Ebstein anomaly. The higher the dose of radiation applied, the higher the incidence of cardiac malformation was noted. CONCLUSION: Gamma-ray irradiation of 3 days old chick embryos increased the rate of death and the rate of cardiac malformation significantly.