A four-year-old girl underwent complete correction of the association of interruption of the aortic arch (Type A, Celoria and Patton's classification), patent ductus arteriosus, and ventricular septal defect. The surgical procedure consists of establishment of a continuity between the ascending and descending aortas utilizing the patent ductus arteriosus and the anterior wall of the pulmonary arterial trunk, reconstruction of the rest of pulmonary arterial trunk with pericardium, and closure of the ventricular septal defect. Though the patient expired from cerebral complications, the hemodynamic result after repair was quite satisfactory. The procedure described makes total correction of this complex anomaly feasible at one operation through a median sternotomy and seems to be a method of choice for most patients with this association of anomalies, unless there is severe narrowing of the patent ductus arteriosus.

Angiocardiography↗

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Right ventricular hypertrophy in tetralogy of Fallot.

Histopathological studies were carried out on right ventricular myocardium in 104 patients with tetralogy of Fallot (T/F). Detailed analysis of the correlation between morphological and clinical data was performed. Right ventricular hypertrophy in T/F was found to initiate immediately after birth, and the diameter of right ventricular muscle fiber (D) increased with age (r = 0.74). There was a correlation between D and the hemoglobin level. There was, however, no correlation between D arterial oxygen saturation (SaO2), and pulmonary trunk/aorta diameter (PA/Ao) ratio. Histopathological alterations were related directly to D and to the age of the patient, and were unrelated to hemoglobin, SaO2, and PA/Ao ratio. Irreversible histopathological alterations were first observed when the D exceeded 15 micron, when most patients were four years old or more. From these findings, it is considered that the optimal age for corrective surgery to prevent irreversible alteration of the right ventricular muscle fibers in patients with T/F is less than three years.

Adolescent↗

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Effects of Catuaba extracts on microbial and HIV infection.

Pretreatment of mice with hot water and alkaline extracts of Catuaba casca (Erythroxylum catuaba Arr. Cam.) effectively protected them from lethal infection of Escherichia coli and Staphylococcus aureus. The extracts significantly inhibited both the human immunodeficiency virus (HIV)-induced cytopathic effect and the expression of HIV antigen in HIV-1HTLV-IIIB or HIV-2ROD infected human lymphotropic virus type I (HTLV-1) positive MT-4 cells. The 50% effective concentrations of the active fractions (21-263 micrograms/ml) were 1/4 - 1/43 of their 50% cytotoxic concentrations. Their anti-HIV activity was shown to be induced, at least in part, via the inhibition of HIV adsorption to the cells. The data suggest a medicinal potential of Catuaba extracts against opportunistic infection in HIV patients.

Animals↗

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Myocardial metabolism during prolonged selectived hypothermic coronary perfusion.

In the study discussed below, we assessed the myocardial protection provided by our method of selective hypothermic coronary perfusion. Using arterial and coronary venous blood samples, the following biochemical aspects of myocardial metabolism were calculated: 1) coronary arteriovenous (A-V) pH difference, 2) O2 difference, 3) CO2 difference, 4) respiratory quotient, 5) coronary A-V pyruvate difference, 6) lactate difference, 7) cardiac excess lactate, and 8) redox potential difference. Results indicate that, during coronary perfusion performed according to out method, metabolic changes are minimal and easily reversible shortly after coronary perfusion is terminated.

Adult↗

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Reoperation-free survival after closed mitral commissurotomy. A 28-year follow-up study in 469 patients.

We evaluated the long-term results in 469 patients who underwent closed mitral commissurotomy (CMC) between 1952 and 1972, and analyzed actuarial and reoperation-free survival rates together with the recurrence of symptoms necessitating reoperation after CMC. There were 36 operative deaths (7.6%) and 167 late deaths (36.8%) including 40 deaths following reoperation. One hundred and twenty patients (26%) required reoperation a mean of 13.8 years after CMC, with a range of one to 27 years. The actuarial survival rates were 75%, 58% and 38% at 10, 20 and 28 years after surgery, respectively. The reoperation-free survival rates were 70%, 42% and 15% at 10, 20 and 28 years, respectively. Untreated subvalvular changes and inadequate commissurotomy were definite factors adversely influencing the long-term results.

Actuarial Analysis↗

PubMedDate not supplied

Skin lesions during intravenous hyperalimentation: zinc deficiency. 1976.

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History, 20th Century↗

PubMedDate not supplied

Aortic valve replacement with homograft.

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Adolescent↗

PubMedDate not supplied

A radical operation for the Budd-Chiari syndrome associated with obstruction of the inferior vena cava. A report of six patients.

The Budd-Chiari syndrome is caused by an occlusion of the hepatic veins and is often associated with an obstruction in the hepatic portion of the inferior vena cava (IVC). Therefore, the various shunt operations done in an attempt to relieve the portal hypertension are often not effective. By using a radical surgical technique on six patients with Budd-Chiari syndrome, the liver was freed and a wide longitudinal incision was made in the hepatic portion of the IVC. The obstructed hepatic vein was reopened using a Fogarty catheter, and a pericardial patch reinforced with a Teflon prosthesis was secured over the incision. Two patients were still asymptomatic 3 and 4 years after operation. Two patients died postoperatively of pneumonia and hepatic insufficiency. The two other patients were discharged in fair condition, and one died 6 months postoperatively following hepatic failure.

Adult↗