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Biomedical subjects

F Attie

Publications and source records attributed to F Attie.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Double inlet left ventricle].

Twenty-five cases of double-inlet left ventricle, 23 in atrial situs solitus and 2 with dextroisomerism are described. Twenty had both atrioventricular valves and in 3 a common atrioventricular valve connected to the left ventricle. In rest, the left atrioventricular valve was straddling over the left-sided right ventricle in about 15%. The position of the rudimentary right ventricle varied from superior, anterior and to the right of left ventricle (6 with transposition and 9 with concordant ventriculo arterial connection), to superior anterior and to the left of left ventricle (10 cases, all with transposition). Five cases had stenosis of the left atrioventricular valve and 2 stenosis of the right one. In 11, the clinical presentation was dominated by cyanosis, reduced pulmonary blood flow and right to left shunt. The rest had cyanosis and congestive heart failure. Five patients with right ventricle on the left had complete atrioventricular block, 9 right AQRS orientation and all of them findings of left ventricle hypertrophy. Three cases showed initial Q wave in VI and one left bundle branch block. Cases with right ventricle on the right, had left QRS orientation, left ventricle hypertrophy and 2 complete atrioventricular block. Cross-sectional echoes showed in 13, two atrioventricular valves committed to the left ventricle; in 3 of them the right ventricle was visualized. In 22 cases angiography determined the type of atrioventricular connection. Double inlet left ventricle is one of the most challenging diagnosis in congenital heart disease. Considering its lack of clinical specificity and according to our results, the electrocardiogram, echocardiogram and angiographic findings are of great help for its identification.

Adolescent↗
PubMedDate not supplied

[Ebstein's anomaly in infants].

Ebstein's disease is a congenital malformation of the tricuspid valve that causes various hemodynamic alterations depending on the anatomic changes in the valve, presence or absence of atrial septal defect and reduction in the ventricular function. We present 19 patients with Ebstein's malformation of the tricuspid valve younger than 2 years of age. The long-term follow-up was from 1 week to 16 years with a mean of 40 months. Eight children died, 6 were lost in the follow-up and 5 survived. Early cyanosis with associated lesions give a bad prognosis. If the child survives the first year of life he has a better long term prognosis.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Echocardiographic diagnosis of the right tri-atrial heart].

In this report we describe the two-dimensional echocardiographic features of a case of cor triatriatum dexter. In this situation the right atrium is divided by a membrane in two chambers. Considering the anatomic characteristics of this case we added a new type in the classical classification proposed by Doucette et al.

Cardiac Catheterization↗
PubMedDate not supplied

[Applications of color-coded Doppler 2-dimensional echocardiography].

Conventional Doppler techniques have been used for sometime, but are limited by personal skill and experience, as well as by the fact that it can sample only one specific cardiac site at a time. The introduction of color-coded Doppler flow imaging systems allows by using multiple sample volumes an immediate display of intracardiac blood flow, spatially-oriented and super-imposed in two-dimensional echocardiography images, that not only increase temporal resolution, but which integrates anatomic and functional analysis. Likewise, the objective visualization of abnormal jet lesions permits the application of continuous-wave Doppler echocardiography with a high veracity for derived pressure gradients. Color-coded Doppler echocardiography emerges as the most promising, simple and non-invasive technique for obtaining confident quantitative information in diverse cardiac pathologic conditions and research.

Color↗
PubMedDate not supplied

[Anti-rubella IgM and IgG antibodies in congenital cardiopathy].

In utero infection by rubella virus is a well known cause of congenital heart disease. We look for prevalence of anti-rubella antibodies of IgM (primary response) or IgG (anamnestic response) classes in sera of 32 children with congenital heart disease and in 12 normal children of the same socioeconomic background. Only in a patient with a full congenital rubella syndrome we found high titers of IgG anti-rubella antibodies, there was no difference in prevalence of IgM nor IgG anti-rubella antibodies between normals and cardiac patients. There is no reason to look for anti-rubella antibodies in the isolated congenital heart disease.

Antibodies, Viral↗
PubMedDate not supplied

[Behavior and hemodynamics of ventricular communication in relation with the area of the septal defect].

We studied 32 cases of isolated intra-ventricular communication (IVC) in necropsy samples, and made correlations between the size of the failure and the data got from the haemodynamic study, specially the QP/QS, the sistolic pressure of pulmonary arteries (SPPA) and the vascular-pulmonar resistance (VPR). We found no correlation between the size of the orifice and the degree of short-circuit, and the last was no dependant on the SPPA. The SPPA figures were found to be in direct proportion with the failure's area. We found that the short circuit degree is managed by the VPR in inverse relation. We discuss here all the factors involved in the haemodynamic conduct to which we made reference in this paper.

Heart Septal Defects, Ventricular↗
PubMedDate not supplied

[Corrected transposition of great arteries. Surgical results].

Thirteen patients with congenitally corrected transposition of the great arteries underwent cardiac surgery between May 1964 and May 1984. Eleven cases underwent corrective surgery and two palliative treatment. Four cases had closure of the ventricular septal defect two had pulmonary valvotomy, two closure of atrial septal defect and three tricuspid valve replacement. Two patients developed atrioventricular dissociation, requiring pacemaker insertion. Two patients died, one in the immediate postoperative period in pulmonary edema, and another due to bacterial endocarditis 3 years after surgery. Our observations suggest that surgical treatment of corrected transposition can be achieved with acceptable risks. The long-term follow up in the survivors was excellent.

Adolescent↗
PubMedDate not supplied

[Natural history and surgical treatment of pulmonary stenosis. Review of 91 cases].

The natural history of valvular pulmonary stenosis is modified by the surgical treatment of these patients. In order to assess these changes we studied the clinical and hemodynamic features of 91 patients that were treated surgically. Hemodynamic studies were performed postoperatively in 62 of them. All patients had preoperatively a right ventricular systolic pressure above 70 mm Hg and were divided into three groups according to the transvalvular gradient. The first group had less than 50 mm Hg, the second group between 50 and 80 mm Hg, and the third group more than 80 mm Hg gradient. Correlation of these values with asymptomatic (49 patients) and with symptomatic (42 patients) cases showed significant values (p less than 0.001). Postoperatively only 2 patients remained with mild degree effort dyspnea. There was also a significant correlation (p less than 0.005) between the systolic gradient and the cardiothoracic ratio in the studied groups. The T wave in lead VF showed a predictive value in relation to the systolic gradient (p less than 0.001). Reduction of the systolic gradient after surgery showed very significant values when compared to the preoperative gradient (p less than 0.001). The overall mortality was 5.5%.

Adolescent↗
PubMedDate not supplied

[Mitral valve replacement in children with a Björk-Shiley prosthesis].

This report documents our experience with mitral valve replacement in children. Between 1978 and 1982, 30 replacements have been performed in patients under 15 years of age. Twenty seven patients (90%) with rheumatic heart disease and 3 (10%) had congenital disease. Their functional capacity prior to operation was as follows: Nine patients fell into class II, 18 into class III and 2 into class IV. Preoperative cardiac catheterization, was undertaken in 26 patients, the mean pulmonary arterial wedge pressure was 27.4 +/- 8 mmHg, the pulmonary artery mean pressure was 48 +/- 20 mmHg, the left ventricular end diastolic pressure was 11.7 +/- 5.6 mmHg. One child died in the operative period. Twenty six patients (90%) have been followed for a mean period of 22.7 months. Late mortality occurred in three patients (11%). Bacterial endocarditis, thromboembolism and valve maldisfunction were not present. The post operative NYHA functional class was as follows: twenty two children fell into class I, and one patient fell into class II. The actuarial survival rate 5 years after operation was 79%. We believe that the Björk-Shiley prosthesis offer excellent results in children when repair of the natural valve is not possible.

Adolescent↗
PubMedDate not supplied

[Double-outlet left ventricle].

Two cases of double-outlet left ventricle with ventricular septal defects and pulmonic stenosis are described. Both had atrial situs solitus, one with concordant and another with discordant atrioventricular connections. Considering the clinical behaviour of the malformation, the diagnosis is difficult. Although the echocardiographic findings suggest the abnormality, angiocardiography is the best procedure for the accurate diagnosis.

Angiocardiography↗
PubMedDate not supplied

[Pulmonary atresia with interventricular communication. Review of concepts].

The purpose of this paper is to clarify the definition and anatomic characteristics of pulmonary atresia with ventricular septal defect. This complex congenital cardiac malformation produces great controversy in the literature. We analyze some embryological aspects, the right ventricular outflow tract anatomy and pulmonary arterial pattern with the various patterns of collateral blood supply. A good understanding of these anatomic characteristics is of great importance in the hemodynamic and angiographic diagnostic procedures and in the planning of surgical correction. The differential diagnosis with other congenital heart diseases with single outlet from the heart is discussed.

Collateral Circulation↗