ABSTRACT
A fistula from the left aortic sinus to the left ventricle is reported that was successfully repaired using cardiopulmonary bypass. In addition, 175 cases of fistula to the heart from the aortic sinuses published in the English literature from 1839 through 1972 were studied, with particular emphasis on the 126 patients who underwent operative repair. The major cause of the fistulas (76%) was found to be rupture of a congenital aortic sinus aneurysm, usually during the third or fourth decade of life. The remainder of these fistulas to the heart consisted of simply a tract in an otherwise normal sinus. Ventricular septal defect was the most common associated defect and, when present, was nearly always related to a fistula arising from the right aortic sinus. Repair was successful in 86% of the 126 operated patients. The principles of operative treatment of these fistulas are reviewed.
Subject(s)
Aortic Aneurysm/congenital , Fistula/surgery , Heart Defects, Congenital/surgery , Aorta, Thoracic/abnormalities , Aortic Rupture/complications , Child , Female , Fistula/etiology , Heart Ventricles/abnormalities , HumansABSTRACT
An instrument for performing measurements in cardiac and vascular operations is described. This device is a modification of a vascular clamp that provides an accurate and simple method for making intracardiac measurements. The instrument is constructed to provide easy readout of even extremely small measurements.
Subject(s)
Cardiac Surgical Procedures/instrumentation , Surgical Instruments , Vascular Surgical Procedures/instrumentationABSTRACT
If radical correction of congenital heart disease can be performed with a low risk in the first year of life the advantages are obvious. Total correction avoids the latent risks of the underlying lesion and the risks of palliative surgery, and relieves the parents and family of the psychological pressure of a major illness. Palliative surgery, although offering survival, may include the long term problems of the palliative operation itself, and the possibility that cases may be lost to further treatment or follow-up examination after a successful palliative operation. For these reasons, to be desirable, a palliative operation should offer a survival chance that is at least 10% better than the corrective procedure in that patient at that time. That is, any corrective procedure with a mortality rate less than 10% is to be perferred at any age to a palliative operation. An accurate assessment of risk demands a complete diagnostic study, and a knowledge of the natural history of that form of congenital heart disease. The problems of infants with congenital heart disease are not primarily caused by age of size. The main problem is that of natural selection.
Subject(s)
Heart Defects, Congenital/surgery , Acute Kidney Injury/etiology , Brain Damage, Chronic/etiology , Cardiopulmonary Bypass , Heart Arrest, Induced , Heart Defects, Congenital/epidemiology , Heart Septal Defects, Ventricular/surgery , Humans , Hypertension, Pulmonary/surgery , Hypothermia, Induced , Infant , Methods , Palliative Care , Postoperative Care , Postoperative Complications , Prognosis , Tetralogy of Fallot/surgery , Transposition of Great Vessels/surgery , United StatesSubject(s)
Intubation, Intratracheal , Tracheotomy , Cardiac Surgical Procedures , Humans , Infant , Infant, Newborn , Intubation, Intratracheal/instrumentation , Laryngeal Diseases/etiology , Methods , Nose , Positive-Pressure Respiration , Respiratory Distress Syndrome, Newborn/therapy , Tracheal Stenosis/etiology , Tracheotomy/adverse effects , Tracheotomy/instrumentation , Tracheotomy/nursing , Ventilators, MechanicalSubject(s)
Anastomosis, Surgical , Heart Defects, Congenital/surgery , Postoperative Complications/diagnostic imaging , Pulmonary Atresia/surgery , Radiography, Thoracic , Female , Heart Defects, Congenital/diagnostic imaging , Humans , Infant, Newborn , Male , Pulmonary Artery , Pulmonary Atresia/diagnostic imaging , Treatment OutcomeSubject(s)
Cyanosis , Hypoxia/metabolism , Mitochondria, Muscle/metabolism , Myocardium/metabolism , Animals , Child , Cytochrome c Group/isolation & purification , Cytochromes/isolation & purification , Dogs , Female , Heart Defects, Congenital/surgery , Humans , Male , Mitochondria, Liver/metabolism , Oxygen Consumption , Spectrophotometry , Tetralogy of Fallot/surgery , Time FactorsSubject(s)
Heart Defects, Congenital/surgery , Pulmonary Veins/abnormalities , Angiocardiography , Cardiac Catheterization , Female , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/mortality , Heart Defects, Congenital/physiopathology , Hemodynamics , Humans , Hypertension, Pulmonary/etiology , Infant , Infant, Newborn , Male , Methods , Postoperative Care , PrognosisSubject(s)
Heart Defects, Congenital/surgery , Heart Septal Defects, Atrial/physiopathology , Pulmonary Veins/abnormalities , Angiocardiography , Cardiac Catheterization , Cardiac Output , Cardiac Volume , Child , Child, Preschool , Electrocardiography , Female , Follow-Up Studies , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/physiopathology , Heart Septal Defects, Atrial/diagnosis , Heart Septal Defects, Atrial/etiology , Humans , Infant , Male , MethodsSubject(s)
Transposition of Great Vessels/surgery , Tricuspid Valve Insufficiency/etiology , Adolescent , Adult , Angiocardiography , Arrhythmias, Cardiac , Cardiac Catheterization , Child , Child, Preschool , Heart Septal Defects, Ventricular/surgery , Heart Valve Prosthesis , Humans , Infant , Tricuspid Valve , Tricuspid Valve Insufficiency/surgerySubject(s)
Airway Obstruction/etiology , Mediastinum , Pneumonectomy , Respiratory Insufficiency/etiology , Acrylic Resins , Bronchoscopy , Child , Cysts/diagnostic imaging , Cysts/pathology , Humans , Lung/abnormalities , Lung/pathology , Lung Diseases/diagnostic imaging , Male , Mediastinum/diagnostic imaging , Postoperative Complications , Pressure , Pulmonary Artery , Pulmonary Circulation , Pulmonary Ventilation , Radiography , Respiratory Tract Infections/etiologySubject(s)
Pulmonary Veins/abnormalities , Transposition of Great Vessels/surgery , Adolescent , Angiocardiography , Cardiac Catheterization , Female , Heart Defects, Congenital/surgery , Heart Septal Defects, Atrial/surgery , Humans , Methods , Perfusion , Positive-Pressure Respiration , Postoperative Care , Prognosis , Pulmonary Circulation , Pulmonary Veins/surgerySubject(s)
Heart Aneurysm/congenital , Heart Atria/abnormalities , Child, Preschool , Extracorporeal Circulation , Female , Heart Aneurysm/complications , Heart Aneurysm/diagnosis , Heart Aneurysm/surgery , Heart Atria/surgery , Hemiplegia/etiology , Humans , Infant , Intracranial Embolism and Thrombosis/etiology , Male , PregnancySubject(s)
Airway Obstruction/etiology , Aortic Arch Syndromes/complications , Pulmonary Artery/abnormalities , Tracheal Stenosis/etiology , Age Factors , Aneurysm/complications , Barium Sulfate , Brachiocephalic Trunk/abnormalities , Brachiocephalic Trunk/surgery , Child , Child, Preschool , Ductus Arteriosus, Patent/diagnosis , Female , Heart Defects, Congenital/complications , Humans , Hypertension/etiology , Infant , Infant, Newborn , Male , Mediastinum , Pennsylvania , Pneumonectomy/adverse effects , Radiography , Tracheal Stenosis/diagnostic imaging , Tracheal Stenosis/mortality , Tracheal Stenosis/surgeryABSTRACT
Implants of lung from 18-day-old embryo BALB/c mice of an inbred strain were exposed to 3,4-benz(a)pyrene or 1,2,5,6-dibenzanthracene and introduced subcutaneously into 6-week-old mice of the same strain. Lung adenomata developed within 16 weeks.There was no evidence of an effect of either chemical carcinogen on the subcutaneous tissue of the host animal.
