Search PubMed⌕ Search

Biomedical subjects

A Wennevold

Publications and source records attributed to A Wennevold.

At least 55 records · Page 3Linked to original sources
PubMed1979

The diagnostic challenge of left atrial myxoma. Importance of echocardiographic screening.

Left atrial myxomas are extremely difficult to diagnose since their variable manifestations mimic a host of clinical entities more commonly seen, e.g. mitral stenosis, endocarditis, rheumatic fever, cardiomyopathy or mesenchymosis. At the same time, early diagnosis followed by prompt surgical removal are mandatory to prevent mutilating or lethal complications of the tumor. Six cases of left atrial myxoma were diagnosed in our hospital during 2 1/2 years. We present the case histories, diagnostic procedures and surgical findings, consolidating the unique role of echocardiography in detecting left atrial myxomas. We propose the use of echocardiography as a screening examination for atrial myxomas in the following settings: suspected mitral obstructive disease, suspected endocarditis with negative blood cultures, peripheral embolism or thrombosis in young patients, unexplained cardiac failure and mesenchymosis with uncharacteristic presentation.

Adult↗
PubMed1979

DC-conversion of atrial fibrillation after mitral valve operation. An analysis of the long-term results.

In a prospective study comprising 43 patients with atrial fibrillation after mitral valve surgery, an evaluation was made of the prognostic significance of clinical, radiological, haemodynamic and operative factors for the maintenance of sinus rhythm after DC-conversion. Atrial fibrillation with a duration of less than 12 months proved to be the only single factor of significance for sustained sinus rhythm after 12 months and it is suggested as a simple clinical criterion for selection of patients for DC-conversion after mitral valve operation.

Adult↗
PubMed1979

Anomalous pulmonary venous drainage from the left lung to the right atrium. Successful surgical treatment in an 11-year-old girl.

An 11-year-old girl with anomalous pulmonary venous drainage from the left lung to the right atrium was corrected by anastomosing the anomalous trunk to the left auricular appendage. Postoperatively she developed a left-sided chylothorax which resolved on medical treatment. A postoperative angiocardiography one year after surgery showed a well-functioning anastomosis.

Cardiac Catheterization↗
PubMed1979

Mitral valve replacement in infective endocarditis as prophylaxis against embolism. Identification of patients at risk by 2-dimensional echocardiography.

A 36-yr-old woman and a 46-yr-old man had infective endocarditis of the mitral valve. Examination by 2-dimensional dynamic echocardiography demonstrated large mobile vegetations in both patients, and the display pointed to an ominous risk of embolism. Heart surgery with valve replacement was performed, the main indication being prophylaxis against embolism; the operative findings seemed to justify the assumption of imminent risk of embolism. It is suggested that the display of dynamic morphology of valvular vegetations by 2-dimensional echocardiography can be useful in identifying a subset of patients at high risk of embolism during infective endocarditis. However, more experience is needed before definite conclusions can be drawn regarding the role of early operation as prophylaxis against impending embolism.

Adult↗
PubMed1979

Cervical aortic arch with ventricular septal defect. A differential diagnosis from interrupted aortic arch.

A case of right cervical aortic arch with a large ventricular septal defect and a bicuspid aortic valve is reported. The angiographic diagnosis was interruption of the aortic arch type II, with aberrant right subclavian artery, a closed ductus arteriosus and retrograde vertebral-subclavian flow to the descending aorta. The cervical arch, demonstrated post mortem, was located high and deep in the neck. This differential diagnosis may have potential importance, as reported experience shows that a surgical aortic anastomosis is not required in cervical aortic arch.

Aortic Arch Syndromes↗
PubMed1979

Coarctation of the aorta operated upon in infancy. Long-term follow-up.

A long-term follow-up study was performed in 14 patients, operated for coarctation of the aorta in infancy. The median age at operation was 4 mth. Mean and median age at follow-up were 16 yr, and the follow-up time varied between 7 and 22 yr (mean and median 15 yr). At follow-up recoarctation was or had been present in 6 patients; there was no relation between the development of recoarctation and the age at operation. Concomitant aortic valve anomaly had been overlooked at the initial investigation in 3 patients. The systolic and diastolic blood pressure at follow-up was significantly elevated above the mean of normals; 2 of 8 patients without recoarctation clearly had diastolic hypertension. It seems as if even operation in infancy does not prevent hypertension later in childhood or adolescence in some of the patients, and it hardly seems justified to perform elective operations for coarctation of the aorta in infancy with the appreciable risk of recoarctation, until more long-term follow-up results are known. The patients should not be lost to follow-up.

Adolescent↗
PubMed1978

Congenital apical aneurysm of the left ventricle: surgical removal in two infants.

The case histories are described of 2 infants, representing either type of congenital apical left ventricular aneurysm. Case 1 had a finger-like, pulsatile, actively contracting aneurysm which was associated with a split distal end of the sternum and a ventral hernia. In contrast to most of the 55--60 cases hitherto described, no other cardiovascular anomalies were detected at heart catheterization with angiocardiography. The aneurysm was resected at the age of 23 days. Postoperative angiocardiography demonstrated a normal-sized left ventricle with good contractions and no residual aneurysm. He was last seen at the age of 15 mth, doing well. Case 2 had a noncontractile aneurysm and congenital pyloric stenosis, which hitherto has not been found in association with this type of aneurysm in the about 20 reported cases. The aneurysm was resected at the age of 9 mth; the estimated reduction of the left ventricular cavity was 20%. 1 yr after operation the patient was doing well, but the chest roentgenogram was unchanged and at angiocardiography the left ventricular appearance was largely unchanged compared to the preoperative findings. He was last seen at the age of 2 yr, doing well. The long-term prognosis in the latter type of aneurysm has still to be elucidated.

Angiocardiography↗
PubMed1978

Natural history of valvular pulmonary stenosis in children below the age of two years. Long-term follow-up with serial heart catheterizations.

18 patients with mild and moderate valvular pulmonary stenosis diagnosed by heart catheterization before the age of 2 yr (mean 11.6 mth) were followed for 5 to 21 yr without operation. 15 cases had a repeat catheterization study after a mean interval of 10.7 yr. Of 7 cases with an initial right ventricular peak systolic pressure (RVSP) of 50 mm Hg or below, 6 had a decrease and 1 a moderate increase in RVSP. Of 8 cases with an initial RVSP of greater than 50 mm Hg 2 had a decrease, 2 had no change and 4 had a significant increase in RVSP; the latter subsequently underwent operation. Electrocardiography yielded some information, but neither roentgenography nor history was of any help in evaluating the severity of the stenosis at follow-up. As mild and moderate valvular pulmonary stenosis in infants and children below the age of 2 may progress and require operation a repeat heart catheterization is usually to be recommended later in childhood.

Adolescent↗
PubMed1977

The prognosis in Ebstein's disease of the heart. Long-term follow-up of 22 patients.

A follow-up study of 22 patients with Ebstein's anomaly has been performed. Nine patients died 1-21 years (mean 9) after the initial admission while the 13 patients alive at the end of the observation period had been followed for 5-26 years (mean 15). Clinical, ECG, radiological, and haemodynamic features were analyzed with reference to their prognostic significance. The presence or absence of cyanosis due to right-to-left shunt through an atrial septal defect (ASD) distinguished best between a good and poor prognosis. Right-sided heart failure and dyspnoea at rest, often associated with palpitations, precordial pains and syncopes, were grave prognostic findings. After the initial signs of heart failure there was a rapid deterioration, death ensuing within a few years. Operation with insertion of a prosthetic valve (and closure of the ASD) should be seriously considered at the appearance of heart failure.

Adolescent↗
PubMed1977

Natural history of vascular ring with clinical manifestations. A follow-up study of eleven unoperated cases.

A clinical follow-up study was performed in 11 unoperated patients with symptoms due to vascular ring. The age at diagnosis was 2-48 months (mean 13 months); 7 of the patients were less than 12 months old. The follow-up time varied between 1 and 22 years (median 7 years). Nine patients were entirely free of symptoms, which they had outgrown in the course of 1-2 years after the diagnosis was made; none of these 9 had symptoms after the age of 4 years. Two patients had symptoms due to either oesophageal compression or to severe associated neuromuscular lesions; the follow-up time was 3 and 1 years, respectively. Our findings lead us to support a conservative attitude regarding surgery, at least if only mild symptoms are present, If the patients can be satisfactorily treated medically, they seem to outgrow their symptoms in early childhood.

Aortic Arch Syndromes↗
PubMed1977

Paroxysmal ventricular fibrillation in children. Long-term follow-up of three cases treated with beta-blocking agents.

A long-term follow-up report is given on three children with stress-induced bursts of ventricular activity, occasionally proceeding to ventricular fibrillation causing syncope. All patients were treated with a beta-blocking agent as prophylaxis for 12, 10 and 6 years, respectively. Case 1 has no signs of organic heart disease. She has been followed from the age of 8 years and had her last syncope in 1974. She was last seen in Nov. 1976, doing well at the age of 20. Case 2 started having syncopes after an attack of measles at the age of 8 years, at which time she probably acquired some damage to her myocardium. She had persistent bradycardia but no other signs of heart disease. She had an uneventful pregnancy and delivery in 1973 and gave birth to a normal child. She died suddenly in 1974, at the age of 22, four years after her last syncopal attack. Case 3 had cardiomyopathy with increasing heart size and exertional dyspnoea and marked ischaemic ECG changes during exercise. He was followed from the age of 7 years. He died suddenly in 1974 at the age of 16, four years after his last syncope.

Adolescent↗
PubMed1976

The natural history of small atrial septal defects; long-term follow-up with serial heart catheterizations.

Thirty-nine patients with a small ASD of the secundum type were followed clinically for 5 to 21 years (mean 11.6 years); no evidence of deterioration was found. In 26 of these cases recatheterization was carried out with a mean follow-up period of 9.8 years. No significant changes were found in most patients; in four patients, however, the left-to-right shunt had increased significantly. Our recommendations are that we will continue to advise surgery in patients with large ASD's, whereas we still do not recommend surgery in patients with small ASD's; the latter patients should be followed for longer periods to ensure that no deterioration occurs. The decision as to whether an ASD should be regarded as large or small in our opinion not only should be based on a chosen limit of pulmonary-to-systemic flow ratio, but clinical factors such as diastolic flow murmurs, ECG changes, the heart size, and the pulmonary vascular markings should also be taken into consideration.

Adolescent↗
PubMed1976

Acute aortic regurgitation and abscess of sinus of Valsalva due to fulminating ulcerative endocarditis. Report of three fatal cases in children.

Acute aortic regurgitation due to ulcerative endocarditis developed in 3 children aged 10, 6, and 7 years, respectively. All had congenital aortic valve lesions. Intractable congestive heart failure ensued about 2 weeks, 1 week, and a few days, respectively, after onset of infection. Two patients were operated on in the acute stage, and in both, perivalvular spread of the infection was found with abscess formation of the right sinus of Valsalva perforating through the interventricular septum to the right ventricle; valve replacement and repair were performed, but both patients died. The correct diagnosis was missed in the third patient, who was thought to have myocarditis and who died one week after onset of infection: at autopsy a perforation of a bicuspid aortic valve and an aneurysm of the sinus of Valsalva were found.

Abscess↗