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Biomedical subjects

A Shem-Tov

Publications and source records attributed to A Shem-Tov.

At least 37 records · Page 2Linked to original sources
PubMed1982

Criss-cross heart--a case with horizontal septum, complete transposition, pulmonary atresia and ventricular septal defect.

Criss-cross heart is a recently described anomaly in which the systemic and pulmonary blood streams cross at the atrioventricular (AV) level, without mixing. A case of criss-cross heart is described in which the right atrium, in a solitus position, communicated with a left-superior positioned, morphologically right ventricle, and the left atrium communicated with a normally located, morphologically left ventricle. The interventricular septum occupied a horizontal plane. Associated defects were complete d-transposition of the great arteries with l-positioned aorta, pulmonary atresia, ventricular septal defect, atrial septal defect, and patent ductus arteriosus. To the best of our knowledge this is the first angiocardiographic demonstration of this rare combination of lesions. The literature on criss-cross heart and horizontal septum is reviewed. It is stressed that regardless of whether the criss-cross phenomenon is an anatomical fact or an angiocardiographic illusion, it is an established angiocardiographic entity and should be recognized as such.

Angiocardiography↗
PubMed1982

Transatrial repair of double-outlet right ventricle in infants.

In three infant cases of double outlet right ventricle (DORV), two with normally related great arteries (NGA) and one with side-by-side great arteries, a transatrial repair was carried out. In all three cases, the results were excellent. It is concluded that in the small baby with DORV with NGA and in DORV with side-by-side great arteries with a hypoplastic crista, a transatrial repair should be successful. This is dependent on the VSD being in the perimembranous (and, therefore, subaortic) location and on the absence of infundibular pulmonary stenosis. In all other varieties of DORV the repair should probably be done through the ventricle.

Adolescent↗
PubMed1982

Clinical presentation and natural history of mild discrete subaortic stenosis. Follow-up of 1--17 years.

We report 21 patients with discrete subaortic stenosis (DSS) causing mild obstruction with a peak systolic left ventricular outflow pressure gradients less than 50 mm Hg. They were followed 1--17 years (mean 6.5 years), and eight were recatheterized before surgery, 2--17 years after the first cardiac catheterization. Three patients (14%) had subacute bacterial endocarditis. Ten (48%) had aortic insufficiency, one of whom had no pressure gradient across the left ventricular outflow tract. In three of the 10 patients, aortic insufficiency was found only at the second catheterization. Nine patients (43%) had hyperactive, asymmetric left ventricular contraction; in three, this finding was present only at the second catheterization. Seven of the eight patients who were recatheterized (33% of the entire group) showed an increase in gradient. The increase was from a mean gradient of 35.2 mm Hg to 76.7 mm Hg. Seventeen patients (81%) had at least one of these four features. In view of these data, we suggest that surgical indications for DSS might be expanded, although definitive recommendations are not possible. All cases of DSS should be carefully followed. Surgery should be performed if signs of progressive complications develop.

Adolescent↗
PubMed1982

Coarctation of the aorta with congenital hemangioma of the face and neck and aneurysm or dilatation of a subclavian or innominate artery. A new syndrome?

Congenital cutaneous hemangioma associated with congenital heart disease is extremely rare. We report four infants with congenital cavernous hemangioma of the face and neck and coarctation of the aorta. Three also had congenital aneurysm of a subclavian or innominate artery. One patient also had mild congenital valvular aortic stenosis. The unusual combination of lesions may represent a new syndrome.

Aneurysm↗
PubMed1982

Impeded coronary flow in anatomic correction of transposition of the great arteries: prevention, detection, and management.

Six infants and a 3-year-old boy underwent primary anatomic repair (arterial switch) of their dextro-transposition of the great arteries (d-TGA). Three died: one on the operating table because of an irreducible kink in the left main coronary artery, one because of postoperative bleeding and tamponade, and one because of a postoperative management error. In the four survivors the preoperative left ventricular-to-right ventricular systolic pressure interrelationships were 35 to 115, 54 to 73, 30 to 80, and 70 to 90 mm Hg. While left ventricular inability to take over the systemic pressure did not appear to be a problem in any of our cases, reduced coronary perfusion seemed to be the rule rather than the exception in this operation. One approach to the problem of obstructed coronary flow is first to construct continuity of the "new" aorta, unclamp it, and mark the appropriate places for coronary anastomoses on the fully distended aorta. It is our conviction that further improvement in the operative technique and better understanding of the risk factors will eventually make the primary anatomic repair of d-TGA the operation of choice for most dextro-transpositions.

Child, Preschool↗
PubMed1981

"Complete-transposition-like" coronary arterial pattern in single ventricle with inverted infundibulum and transposition of the great arteries.

In 19 out of 28 cases of single ventricle with inverted infundibulum and 1-transposition of the great arteries the right coronary artery arose from the posterior aortic sinus, the right anterior aortic sinus being the noncoronary one. This coronary arterial pattern was described before only in association with d-transposition of the great arteries. We suggest that angiocardiographic demonstration of this coronary arterial pattern in association with an 1-positioned aorta favors the diagnosis of single ventricle.

Angiocardiography↗
PubMed1981

Correction of tetrad of Fallot with reduced incidence of right bundle branch block.

In 20 patients who underwent a modified surgical repair of tetrad of Fallot complete right bundle branch block developed in only 8 (40 percent). Standard and intraoperative conduction studies indicated that in these patients the right bundle branch block was due to injury of the right bundle branch near the ventricular septal defect (proximal right bundle branch block). The modified operative technique is aimed at minimizing the injury to the right ventricle and it includes a significantly shorter than usual ventriculotomy incision and avoidance of the septal (moderator) band during infundibulectomy. Intra- and postoperative hemodynamic studies of these patients revealed that relief of the right ventricular outflow obstruction was optimal.

Adolescent↗
PubMed1981

Subaortic stenosis: an unrecognized problem in transposition of the great arteries.

Right ventricular (subaortic) obstruction has only rarely been described in complete transposition of the great arteries. five patients with complete transposition of the great arteries in whom subaortic stenosis was angiocardiographically demonstrated were studied. All had a pressure gradient of 30 to 55 mm Hg across the aortic outflow tract. Two of the patients manifested mild tricuspid insufficiency, and another two had coarctation of the aorta. The etiologic, anatomic, hemodynamic and prognostic aspects of this unusual anomaly are discussed. An angiocardiographically demonstrated series of this anomaly has not been reported on before.

Angiocardiography↗
PubMed1981

Normal mean manifest electrical qRS in dysplastic pulmonary valve associated with hypertrophic non-obstructive left ventricular cardiomyopathy.

Dysplastic pulmonary valve is usually associated with extreme right axis deviation. A mean manifest electrical QRS axis of + 160 degrees or less was present in 11 of 30 cases of DPV studied by us. In 9 of these cases associated left ventricular hypertrophic non-obstructive cardiomyopathy was found. We suggest that a normal mean manifest electrical QRS axis in the presence of dysplastic stenotic pulmonary valve indicates the presence of associated cardiomyopathy.

Adolescent↗
PubMed1981

Coronary arterial pattern in superoinferior ventricular heart. Implications on significance of morphogenesis of this anomaly.

The coronary arterial pattern was studied in two patients with superoinferior ventricular heart and haemodynamically complete transposition. In one of them the aorta was dextro-positioned and in the other laevo-positioned. In both the right coronary artery arose from the posterior aortic sinus and the left coronary artery from the left aortic sinus. This pattern is similar to the common coronary arterial pattern in complete transposition of the great arteries. The similarity supports the theory that in the superoinferior ventricular heart the connections between the ventricles and the great arteries (concordant or discordant) area those of the basic condition--complete transposition or corrected transposition. The angiocardiographic findings indicate that relations are not always as expected for a given connection.

Child, Preschool↗
PubMed1981

Interruption of the aortic arch with complete transposition of the great arteries. Clinical and angiocardiographic diagnosis at the age of one day.

The association of complete transportation of the great arteries and complete interruption of the aortic arch is very rare. This combined lesion was diagnosed clinically in a 1-day-old infant in whom it caused cyanosis of the upper half of the body. The diagnosis was confirmed angiocardiographically. We believe this is the youngest patient in whom this diagnosis was made in vivo.

Aorta, Thoracic↗