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Biomedical subjects

F Attie

Publications and source records attributed to F Attie.

99 records · Page 6Linked to original sources
PubMedDate not supplied

[Oral enalapril in patients with symptomatic ventricular septal defects].

Experimental and clinical studies have demonstrated that the inhibitors of angiotensin-converting enzyme may reduce the left-to-right shunt over a ventricular septal defect (VSD). The objective of the study is to evaluate the effects of enalapril on short and medium follow-up in patients with symptomatic VSD and Qp/Qs ratio > 1.5 and compare the results with conventional anti-congestive treatment in children. Twenty-four patients with ages from 3 months to 8 years were studied, dividing them in 3 groups of 8 patients each. Group I received treatment with enalapril, group II with furosemide an digoxin, and group III was treated with a combination of the three medicaments. Patients were evaluated after one, three and six months. Evaluation considered clinical signs of congestive failure, weight, heart rate, blood pressure, cardiothoracic index, and with echocardiography the dimensions of the cardiac chambers, size of the VSD and hemodynamic parameters as Qp/Qs, pulmonary artery pressure (PAP), systolic pressure gradient over the VSD, EF and SF. Statistic analysis was done for each group and was compared the three groups. The results demonstrated significant weight gain (p > 0.05) in the three groups. A decrease in heart rate, Qp/Qs and PAP was observed in group III, however without statistic significance. No side effects were observed. The use of enalapril in combination with furosemide and digoxin may have beneficial effects in patients with symptomatic VSD, awaiting surgery.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

[Value of the PLE and Q-PV in the diagnosis of atrioventricular disorders].

The values of the PLE and the Q-PV in the diagnosis of atrioventricular discordances are studied. In 9 patients precordiograms were registered in both ventricles and in 5 the intraventricular pressure curve was obtained by right or atrial retrograde catheterization. Statistical calculations were made in order to learn the similarities and limitations between the two different methods. In all of the cases the PLE of the anatomic left ventricle was less than in the right ventricle. The same was observed in the Q-PV intervals of both ventricles. The values of the p and r showed significantly high results.

Atrioventricular Node↗
PubMedDate not supplied

[Study of the heart conduction system in atrioventricular disorders].

A His electrogram was registered with a Castillo tripolar catheter in seven patients with atrio-ventricular discordance and transposition of the great arteries (corrected transposition). They all had ventricular septal defect, six had pulmonary stenosis. two had atrial septal defect, and only one patient presented first degree AV block. The QRS was of normal duration, 4 had RBBB morphology in the left precordials. Two with ASD and VSD had a prolonged P/A interval. In one, the His recording was polyphasic with a prolonged H-V (55 msec) and two others showed a wide polyphasic His potential (25 and 26msec), with a prolonged H-V. These 3 cases with prolonged His had a minor degree of RBBB. The remaining 3 showed normal AV conduction. In all, the Purkinje electrogram was registered. The duration of the Pu potential and the Pu-V were normal. Corrected transposition shows a high incidence of slow AV conduction, frequently not detectable in the usual electrocardiogram in agreement with previous anatomo-pathological studies. The distal block would explain the frequency of complete AV block with low cardiac output and frequent sudden death in this type of heart disease. The distal block would compel us to take e more agressive steps in its treatment. Atrial septal defect with slowing of the intra-arial conduction is not detected in the electrocardiogram.

Electrocardiography↗
PubMedDate not supplied

[Fontan surgery in tricuspid atresia. Experience at the National Institute of Cardiology "Ignacio Chávez"].

A retrospective analysis is presented of all patients under 18 years of age with tricuspid atresia and concordant ventriculo-arterial connection who underwent a Fontan procedure in the National Cardiology Institute "Ignacio Chávez", México-City, between January 1989 and December 1995. In this period Fontan procedure was performed in 22 patients with a mean age of 6.52 +/- 1.4 years. 14 of them were females. Thirteen patients had previous palliative procedure. Age of palliation was 10 +/- 12 months with period of 5 +/- 2 years between palliative and Fontan procedure. Overall mortality was 31% (7 patients); with a mortality of 42% between 1989 and 1992, of 22% between 1992 and 1995 and of 17% since 1994 with all 5 patients operated in 1995 surviving. Mean pulmonary pressure was 13.9 +/- 4.15 mmHg, mean pulmonary vascular resistance 1.66 +/- 0.57 U.W/m2, left ventricular end diastolic pressure 7.5 +/- 2.46 mmHg, ejection fraction 58 +/- 11% and Nakata and McGoon indexes 219 +/- 56 mm2/m2 and 2 +/- 0.1 respectively. No significant differences were found survivors and non-survivors, with exception of the left ventricular end-diastolic pressure (p < 0.05). Causes of death were multiple organ failure in 2, ventricular fibrillation in 3 and septic shock in 2.

Child↗
PubMedDate not supplied

[Tetralogy of Fallot in adults].

We present the clinical and hemodynamic profile of 33 patients, older than the 18 year with tetralogy of Fallot. Cardiac catheterization and selective angiocardiography were performed in all cases. We excluded patients with valvular pulmonary atresia associated with tetralogy of Fallot. Most of the patients were in functional class II or IV of the New York Heart Association and all presented with cyanosis. In the electrocardiogram of 23 patients we found right bundle branch block. None had significant cardiomegaly, 19 of 20 cases had reduced pulmonary blood flow and reticular pattern in the lung fields as observed in the chest X-ray. We did not find correlation between the age and the degree of cyanosis, but the level of arterial desaturation correlated with the functional class. The right ventricular systolic pressure was elevated in all patients. In all cases but one the pulmonary arterial systolic pressure were normal of slightly increased. One case with mild pulmonary infundibular stenosis had pulmonary systolic pressure similar to the systemic pressure. Multivariate analysis for functional class showed significant value for cyanosis. Systemic-pulmonary shunt was performed in 10 patients with hypoplastic pulmonary arteries plus reduced pulmonary blood flow, with one postoperative death. We did not find postoperative mortality in patients who underwent corrective surgery. The anatomic and functional behavior of patients who underwent surgery, allowed better tolerance to their heart defects.

Adolescent↗
PubMedDate not supplied

[Radiofrequency ablation in the treatment of supraventricular arrhythmias in pediatrics. Experience with 203 consecutive patients].

We report the results of radiofrequency catheter ablation in 203 patients under 18 years of age with supraventricular tachyarrhythmias between April 1992 and June 1997. The presence of an accessory pathway caused the tachyarrhythmia in 181 patients (89.1%) with a total of 187 accessory pathways; atrioventricular nodal reentry caused the arrhythmia in 18 patients (8.8%) and atrial flutter in only 4 patients (1.9%). We eliminated the accessory pathway in 171 patients (91.4%), 23 patients showed recurrence of the tachycardia and we had complications in 4 patients (2.1%). The procedure was successful in the treatment of the atrioventricular nodal reentry in the 18 cases, with ablation of the slow pathway in 17 cases and in only one patient of the fast pathway, one patient showed total A-V block, and recurrence of the arrhythmia in 3 cases (16.6%). Finally the procedure was successful in the 4 cases of atrial flutter with one recurrence (25%). In the total of the series, the radiofrequency catheter ablation was successful in 193 patients (95%), with recurrence of the arrhythmia in 27 cases (13.3%) and with complications in only 5 patients (2.6%). Radiofrequency catheter ablation is a safe and effective procedure for the definitive treatment of supraventricular tachyarrhythmias in children.

Adolescent↗
PubMedDate not supplied

[Endocarditis due to an alga of the genus Prototheca sp. A saprophyte of water and of tree sap?].

We report a case of a preterm neonate with very low birth weight (775 grs), He stayed 77 days in a neonatal care unit due to respiratory distress syndrome, with respiratory support for 27 days, and complications in gastrointestinal and nervous systems. In a structural normal heart, he developed infective endocarditis that was treated with good bacteriologic results. An echocardiogram showed the persistence of a mass in the right atrium, the mass was a thrombus and it was resected. Histopathological analysis and cultures of the thrombus reported Prototheca sp. that is an algae. The patient received medical treatment with amphothericin B with satisfactory clinical evolution. He is doing well 6 months later. This is the first report of literature of an algae causing endocarditis.

Amphotericin B↗