RESUMO
Six patients were seen with complete left-sided juxtaposition of the atrial appendages (LJAA) in a series of 366 consecutive Mustard operations for transposition of the great arteries. All 6 patients had situs solitus of the viscera and atria with concordant atrioventricular relationship. D-transposition was present in 3 patients and L-transposition in the other 3; all 6 had associated cardiac anomalies. The diagnosis of LJAA was first made at operation, although angiocardiographic recognition is possible. The size of the right atrium is small in the presence of this anomaly, and direct cannulation of the venae cavae and enlargement of the pulmonary venous atrium are therefore recommended.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Cardiopatias Congênitas/cirurgia , Transposição dos Grandes Vasos/cirurgia , Angiocardiografia , Pré-Escolar , Feminino , Átrios do Coração/anormalidades , Cardiopatias Congênitas/diagnóstico por imagem , Defeitos dos Septos Cardíacos/diagnóstico por imagem , Defeitos dos Septos Cardíacos/cirurgia , Humanos , Hipotermia Induzida , Lactente , Recém-Nascido , MasculinoRESUMO
Thirty-two new cases of colon interposition for esophageal reconstruction are presented. Only one late death occurred in this series, which was unrelated to the colon interposition. Fifteen severe complication were observed in five patients with preexisting esophageal atresia and previously complicated courses following disastrous primary esophageal repairs. The most common complication was pneumonia which occurred 13 times. Five late strictures responded well to dilatation or revision. Long-term weight gain was compared between a group of colon transplant patients and a group of patients with repaired esophageal atresia. Although the esophageal atresia group followed the 25th percentile and the colon interposition group followed the 3rd percentile on the growth curve, no significant difference existed in weight gain over 12 yr.
Assuntos
Colo/transplante , Esofagoplastia , Pré-Escolar , Esofagoplastia/efeitos adversos , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Complicações Pós-Operatórias , Transplante AutólogoRESUMO
Hiatal hernia should be included in the differential diagnosis of all children with emesis and failure to thrive, since early diagnosis is imperative to prevent the irreversible esophageal damage from long-standing peptic esophagitis. The Nissen fundoplication as described in this paper appears to be far superior to gastropexy in preventing recurrence of gastroesophageal reflux. Colon interposition should be reserved for those cases in which hiatal herniorrhaphy is technically impossible. Successful repair of the hiatal hernia results in rapid improvement in the nutritional status of these children.
Assuntos
Hérnia Diafragmática/cirurgia , Hérnia Hiatal/cirurgia , Adolescente , Criança , Pré-Escolar , Colo/cirurgia , Junção Esofagogástrica/cirurgia , Esôfago/cirurgia , Feminino , Humanos , Lactente , Masculino , Métodos , Complicações Pós-Operatórias , Estômago/cirurgia , Deiscência da Ferida OperatóriaRESUMO
43 patients with congenital lobar emphysema were treated surgically at the Thoracic Unit, Hospital for Sick Children, Great Ormond Street, London, between 1954 and 1974. Nearly half of the infants had additional congenital anomalies. 7 children died after operation.
