ABSTRACT
A-V fistulae of the lungs are almost invariably congenital malformations; depending on their size, they may lead to the picture of a right-to-left shunt with hypoxia, cyanosis and polycythaemia. Chest x-rays, tomograms and CT demonstrate larger fistulae. In order to demonstrate small fistulae, and for pre-operative investigation, angiography is required. DSA is able to replace conventional pulmonary angiography. A patient with five A-V fistulae is described, in whom three could only be seen with the help of DSA.
Subject(s)
Angiography/methods , Arteriovenous Fistula/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/diagnostic imaging , Subtraction Technique , Adult , Humans , Male , Tomography, X-Ray ComputedABSTRACT
A new indication for the External Conterpulsation (ECP) is demonstrated. Due to the venous augmentation a "pulse wave" is created in the V. cava inferior and in the right atrium and the ECP acts as a "peripheral pumpventricle", thus increasing pulmonary blood flow and left ventricular enddiastolic pressure. This new application of ECP is of valve in cases with low output syndrome after physiological repair of tricuspid atresia as demonstreated in a case report.
Subject(s)
Heart Defects, Congenital/surgery , Tricuspid Valve/abnormalities , Adolescent , Child , Electrocardiography , Female , Heart Atria , Humans , Male , Pulmonary Circulation , Pulse , Vena Cava, InferiorABSTRACT
The levo-atrial systemic vein is a special type of persistent left superior vena cava and is associated with other intracardiac lesions most often. Hemodynamically there is a right to left shunt. The operative procedure may consist in a ligature in relation to the anatomic situation. The intraatrial correction intends a drainage to the right atrium. Of 7 cases four times a intracardiac rerouting was achieved but two times a ligation was performed.
Subject(s)
Vena Cava, Superior/abnormalities , Child , Child, Preschool , Heart Defects, Congenital/surgery , Humans , Ligation , Methods , Vena Cava, Superior/surgeryABSTRACT
Complex forms of transposition of great vessels necessitate different approaches to correction. In a case of double outlet right ventricle with d-transposition and atrioventricular concordance and a subvalvular pulmonary stenosis an intraventricular conduit with a 16 mm Dacron vascular prosthesis was used. This was anastomosed in an acute angular manner with the muscular margins of the VSD and routed to the base of the aorta. Surgical and anatomic implications are discussed.