ABSTRACT
Two cases of congenital trabecular hypoplasia of the right ventricle are reported. In the first, the neonatal diagnosis was missed and the child did well until the 13th month of life when a modified Blalock-Taussig shunt was done because of increasing cyanosis. Outcome was good until the 4th year of life when symptomatic atrioventricular block was detected in an emergency situation. A bidirectional Glenn anastomosis and pacemaker implantation were successfully carried out after clinical establization and the child is doing well up to now. The second case presents the disease with its worst features: severe cyanosis and acidosis in the first day of life. A modified Blalock-Taussig shunt was performed and death occurred soon after the operation.
Subject(s)
Cyanosis/etiology , Heart Ventricles/abnormalities , Electrocardiography , Female , Heart Ventricles/surgery , Humans , Infant, NewbornABSTRACT
PURPOSE: To evaluate the efficacy of left ventriculectomy, on a short term basis, as a treatment for patients with end-stage heart failure. METHODS: From February to June 1995, 7 patients with end-stage heart failure underwent partial left ventriculectomy. Before the surgical procedure, 7 (100%) patients were in functional class IV. Three (42%) patients needed inotropic support for hemodynamic stability. The mean daily dose of furosemide was l48.67 +/- 128.27 mg, of captopril 87.50 +/- 95.20 mg and of digoxin 0.23 +/- 0.04. Mean left ventricular diastolic dimension determined by 2-D echocardiography was 78.29 +/- 12.63 mm, mean left ventricular ejection fraction, determined by radionuclide ventriculography, was 0.15 +/- 0.05 whereas mean transpulmonary gradient and pulmonary vascular resistance in Wood units, determined by right heart catheterization, were 16.80 +/- 8.80 and 6.57 +/- 3.22, respectively. RESULTS: Sixty days after the surgery, the mean functional class was 1.71 +/- 0.48 (p = 0.009), the mean left ventricular diastolic dimension 64.67 +/- 11.41 mm (p = 0.02) and the mean left ventricular ejection fraction 0.22 +/- 0.04 (p = 0.02). CONCLUSION: The left ventriculectomy is a promising treatment for patients with end-stage heart failure.
Subject(s)
Cardiac Surgical Procedures/methods , Heart Failure/surgery , Heart Ventricles/surgery , Echocardiography, Doppler , Humans , Male , Postoperative Period , Radionuclide Ventriculography , Stroke Volume , Treatment OutcomeABSTRACT
The description of hemolytic anemia after mitral valve repair has been infrequent. The present paper presents this complication, discussing its diagnosis and surgical aspects, such as the association with the use of teflon felt for posterior annuloplasty. This complication happened in two children at our institution, one treated medically with supplementation of folic acid and ferrous sulfate and another requiring surgery for replacement of the teflon felt using a piece of heterologous pericardium for a new annuloplasty and leaflet advancement.
Subject(s)
Anemia, Hemolytic/etiology , Mitral Valve Insufficiency/surgery , Postoperative Complications/etiology , Adolescent , Anemia, Hemolytic/drug therapy , Child , Ferrous Compounds/therapeutic use , Folic Acid/therapeutic use , Hematocrit , Hemoglobins/analysis , Humans , Male , Methods , Postoperative Complications/drug therapy , ReoperationABSTRACT
The case of a 74 year old woman with pseudo-false aneurysm of the left ventricle after a silent myocardial infarction stimulating left pulmonary neoplasm is presented. Special emphasis in given to the uncommon aspects of the case, its rarity and the association of the pseudo-false aneurysm with a true aneurysm of left ventricle.