[Efficacy of external cardiac massage in a patient in the prone position]. / Efficacité du massage cardiaque externe chez une patiente en décubitus ventral.

This paper reports a case of successful CPR performed in a female patient in the prone position during the excision of a cerebellar meningioma. It was realised by means of an external, posterior thoracic compression below the left shoulder-blade, without any anterior compression as described in two previous reports.

[Infusion of prostaglandin E1 in ductus-dependent congenital heart diseases. Analysis of 47 cases]. / Infusão de prostaglandina E1 em cardiopatias congênitas canal-dependentes. Análise de 47 casos.

Prostaglandin E1, used since 1975, has changed favorably the clinical and surgical prognosis of neonates with congenital heart defects, mainly those with a variety of ductus-dependent defects. Due to recent modifications that have been observed with this drug as far as dosage, side effects, duration of venous infusion and the response of the different cardiac anomalies, this study was undertaken on 47 neonates evaluated with drug infusion between December 1985 and April 1988. The ages of the patients varied from 12 hours to 70 days (median age of 10.3 days), body weight ranged from 1990 to 4430 g (median of 3005 g). The average dose corresponded to 0.021 mcg/kg/min, varying between 0.013 to 0.0089 mcg/kg/min. The therapy was considered effective in 36 (76.5%) patients, evaluated by clinical improvement, increase of arterial oxygen saturation greater than 15 vol. O2% and increased ductus diameter measured by echocardiographic study. In the correlation between the therapeutic result and the patient age, the greatest elevation of arterial oxygen saturation occurred until 21 days of age, especially up to 7 days of age where the elevation in this period was of 24.5 vol. O2%. The cardiac defects that best responded to PGE1 were pulmonary atresia with or without ventricular septal defect, Ebstein's anomaly, tricuspid atresia, pulmonic stenosis, double outlet right ventricle, and those that the arterial oxygen saturation increase was less than 10 vol. O2% such as the hypoplastic left heart syndrome, tetralogy of Fallot and transposition of the great arteries. (ABSTRACT TRUNCATED AT 250 WORDS)

Aortic origin of right pulmonary artery: early detection by cross-sectional and color-Doppler-echocardiography in two infants submitted to successful surgical repair.

The aortic origin of the right pulmonary artery was recognized in two infants by cross-sectional echocardiography. The sub-costal short axis view was sufficient to make the diagnosis. The Doppler and color-Doppler techniques were useful in adding the hemodynamic information to the anatomical diagnosis. Early surgical correction was performed in the infants with success without needing to resort to cardiac catheterization.

Cross-sectional echocardiographic features of "absent" pulmonary valve. Report of two cases.

"Absence" of the pulmonary valve was recognized by cross-sectional echocardiography in two infants having relatively atypical clinical manifestations for this cardiac malformation. Both had associated lesions: tetralogy of Fallot and ventricular septal defect, respectively, which were also detected by this non-invasive technique. The findings which strongly suggested the diagnosis were the presence of a ridge of rudimentary pulmonary valvular tissue at the level of the pulmonary annulus and the aneurysmal dilation of the pulmonary arteries. The short axis view at the level of the great arteries was the best approach for visualization of these anatomical abnormalities. The parasternal long axis and sub-costal four-chamber views were also helpful in detecting the associated lesions. In both cases the diagnoses were confirmed at autopsy.