ABSTRACT
A mother presented with a fetus at 22±1 weeks of gestation with a sustained supraventricular tachycardia (SVT) at initially 186 beat per minute (bpm). The fetal M-mode echocardiography showed a 1/1 atrio ventricular ratio (with short atrioventricular (AV) interval and a long ventriculo-atrial (VA) interval, suggesting a Persistent junctional reciprocating tachycardia (PJRT) . Upon initial present no signs of heart failure or hydrops were noted and treament was initiated with amiodarone and digoxin . Fetus heart rate slowed .Postnatal electrocardiogram Confirmed the diagnosis of PJRT New born was put on amiodarone and proparonal). Sinus rhythm was rapidly achieved 9 days later .The patient doing well at 10 months of age with maintain of sinus rhythm. Conclusion: our case report illustrates a particular form of JRT diagnosed prenatal PJRT , characterized by a good clinical tolerance, its absence of evolution towards cardiomyopathy and its rapid and unusual response to antiarrhythmics.
Subject(s)
Anti-Arrhythmia Agents/therapeutic use , Fetal Diseases , Tachycardia, Ectopic Junctional/diagnosis , Tachycardia, Ectopic Junctional/drug therapy , Tachycardia, Reciprocating/diagnosis , Tachycardia, Reciprocating/drug therapy , Adult , Amiodarone/administration & dosage , Digoxin/administration & dosage , Drug Therapy, Combination , Echocardiography , Electrocardiography , Female , Fetal Diseases/diagnosis , Fetal Diseases/drug therapy , Gestational Age , Heart Rate, Fetal , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Trimester, Second/drug effects , Pregnancy Trimester, Second/physiology , Tachycardia, Ectopic Junctional/congenital , Tachycardia, Reciprocating/congenital , Ultrasonography, PrenatalABSTRACT
Between January 1990 and September 2003, 62 patients underwent anatomic repair of a transposition of the great arteries. Mean operative age is 40 days. Transposition of the great arteries was simple in 38 cases and associated to a large ventricular septal defect in 24 cases. 44 patients have had an atrial septostomy of Rashkind and 45 an infusion of prostaglandin E 1.5 patients with simple transposition of the great arteries have had left ventricular retraining before arteriel switch. In association to arterial switch, were performed closure of ventricular septal defect in 24 cases, cure of coarctation of the aorta in 4 cases and cure of an abnormal partial pulmonary venous return in 1 case. Early mortality was 6,45%. After a mean follow up of 3 years, one patient died suddenly (late mortality is 1.72%) and one patient had to have 2 reoperations. Results of anatomic repair are now excellent. Late mortality is essentially related to coronary complications so that a careful follow-up is mandatory.
