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J M Galdeano

Publications and source records attributed to J M Galdeano.

At least 37 records · Page 2Linked to original sources
PubMed1992

[The double-chambered right ventricle: the surgical results in 28 cases].

Between May 1974 and June 1990, 28 double chambered right ventricle underwent surgical repair. Twenty-one (75%) had high obstructive anomalous muscle bundles and in seven (25%) the anomalous muscle bundles were in low position. A ventricular septal defect (VSD) was present in all cases and a subaortic stenosis in six. Longitudinal right ventriculotomy was performed in 15 (53.57%) patients and a combined pulmonary arteriotomy and right atriotomy was used in 13 (46.43%). In the group treated by ventriculotomy 2 patients died shortly after operation (one as a consequence of disseminated infection and one after a lung lobectomy); another patient developed patch dehiscence and reoperation was performed via right atrium a year after. In other 3 patients the Doppler revealed a residual gradient of 20 to 30 mmHg. There were no complications in the group of patients that underwent right atriotomy. In addition to resection of the anomalous muscle bundles, the associated cardiac anomalies were corrected in all patients. Follow-up of 5.5 +/- 3.8 years after operation showed that 26 (92.86%) patients were alive and asymptomatic. We conclude that double chambered right ventricle can be early repaired with good results using a combined procedure with right atriotomy and pulmonary arteriotomy.

Cardiac Catheterization↗
PubMed1991

[Fixed subaortic stenosis in childhood. The surgical correction of 28 cases].

Between January 1976 and December 1989, 28 patients with fixed subaortic stenosis underwent surgical correction. Twenty-one were male and seven female. The mean age when surgery was performed was 7.4 years (range 14 months to 14 years). Angiography was not done in 8 patients (28.5%). Fourteen had a subaortic stenosis due to a fibrous shelf and the other 14 to a fibromuscular one. Fifteen had associated anomalies, seven aortic stenosis, three aortic regurgitation and four mitral disturbances. Three surgical procedures were carried out: resection in 16 patients (57.1%), resection and myotomy in ten (35.7%), and resection with myectomy in two (7.1%). In 5 patients a residual stenosis was detected, one of whom required repeated surgery, and 2 other patients developed recidive of the stenosis (both required repeated surgery). Prosthetic valves (five aortic and one mitral) were inserted in 6 patients (21.4%). One of these required an aortic valve conduct. Pacemaker was placed in other 4 patients (two with prosthesis). No patient died and 20 (71.4%) are normal, nowadays, with a mean follow-up of 5.5 years. We conclude that fixed subaortic stenosis is a serious disease which requires correction at the time of diagnosis, independently of gradient. The type of surgical procedure influences in recidive. The older patients with the fibromuscular type and associated anomalies are candidates for a prosthetic valve.

Adolescent↗
PubMed1991

[Heart malformations in trisomy 13 and trisomy 18].

Congenital heart diseases were studied in children diagnosed of trisomy 13 and trisomy 18 in our hospital between January 1973 and July 1990. Twenty patients with trisomy 18 were diagnosed (18 females and two males). All had cardiac malformations. The findings were: ventricular septal defect in 16 cases (80%), valvular anomalies in 12 (63%), patent ductus arteriosus in nine (47%) and atrial septal defect or patent foramen ovale in 7 cases (36%). We found some complex congenital cardiac diseases: one atrioventricular canal, one tetralogy of Fallot, one hypoplastic left ventricle with mitral atresia and double outlet right ventricle, one case of univentricular heart with aortic outlet from a rudimentary cavity, a right ventricular atresia with pulmonary and tricuspid valves atresia. Nine cases of trisomy 13 were diagnosed (seven females and two males). We found: ventricular septal defect in 7 cases (77%), valvular disease in five (100% of the necropsy studies), secundum atrial septal defect in 4 patients (80%) and patent ductus arteriosus in two. Two cases presented hypoplastic left ventricle with aortic arch hypoplasia, one of them had subaortic stenosis and left superior vena cava being connected to the right atrium via coronary sinus; one case showed fibroelastosis. Our results have been similar to the previously reported and confirm the invariably presence of cardiac malformations in these syndromes. These malformations are an important sign of suspicion in fetal ultrasonography.

Chromosomes, Human, Pair 13↗
PubMed1990

Cross-sectional echocardiography in the diagnosis of atrioventricular septal defect.

Between 1983-1988 cross-sectional echocardiography was performed in 63 patients having an atrioventricular septal defect with common atrioventricular orifice. We excluded from this study all those patients with separate right and left orifices ("ostium primum" defects), those with isomerism of the right and left atrial appendages, those with univentricular atrioventricular connexions and those with discordant atrioventricular and ventriculo-arterial connexions. Parasternal long- and short-axis views, apical 4-chamber views and subcostal long-axis views were employed in all patients. In the last 26 cases, we also obtained the subcostal short-axis view. Nineteen patients showed ventricular dominance, with the right ventricle being dominant in 15. Ten patients had an associated defect in the oval fossa, while the atrial septum was partially or completely absent in the other 53. A ventricular septal defect was observed in all, but it was small in 10 and multiple in 2. Attachments of the superior and inferior bridging leaflets to the crest or the right side of the ventricular septum were seen in 32 cases. The inferior leaflet was hypoplastic in 19 patients. There was narrowing of the left ventricular outflow tract in 8 patients, and obstruction of the right ventricular outflow tract in 3. Abnormal attachment of the right portion of the common valvar orifice was present in 2 cases. A solitary papillary muscle supporting the left ventricular component of the common valve was seen in 6 cases producing a parachute-like arrangement. Our study shows that cross-sectional echocardiography is an excellent technique for the analysis of this anomaly.

Child, Preschool↗
PubMed1990

Absence of the aortic valve cusps with mitral atresia, normal left ventricle, and intact ventricular septum.

A case of a previously unreported anomaly is presented in which absence of the aortic valve cusps, mitral atresia, a normal left ventricle, and an intact ventricular septum were diagnosed by cross sectional echocardiography. The development of a normal left ventricle, rather than the hypoplastic ventricle usually associated with mitral atresia, is explained by filling of the ventricular cavity via the regurgitant aortic valve.

Abnormalities, Multiple↗
PubMed1990

[Right aortic arch with retro-esophageal aorta. Diagnosis by computerized axial tomography].

The case of a patient with right aortic arch and retro-esophageal aorta associated with a perimembranous ventricular septal defect with a mild fibrous subaortic stenosis is presented. The existence of the retro-esophageal segment of the aorta was confirmed by left ventriculography and computerized axial tomography. This patient is the first to be diagnosed by axial tomography in our country.

Adolescent↗
PubMed1990

[Multiple aneurysms of the left auricula, ascending aorta and sinuses of Valsalva with interventricular communication, fibromuscular subaortic stenosis and a single coronary artery].

We report the case of a male newborn infant with aneurysm of atrial appendage, ascending aorta and sinus of Valsalva associated to ventricular septal defect, fibromuscular subaortic stenosis and single coronary artery. The diagnosis was carried out by means of two-dimensional echocardiography and angiocardiography. This complex cardiac malformation has not been reported before.

Abnormalities, Multiple↗
PubMed1990

[Dilated myocardiopathy in children].

Between 1971-1988 we have studied 46 children with dilated cardiomyopathy. Twenty were males and 18 females, with a median age of 17 months (range from 1 day to 11 years). The incidence of 3.4 cases a year during the first nine years dropped to 1.3 cases a year in the following years. Two patients were siblings. Seventeen patients were studied with Eco-Doppler, cardiac catheterization and angiocardiography. The most frequent presentation was heart failure, present in 45 cases (98%). By bidimensional echocardiography it was observed that all patients had a dilated left ventricle, with a left atrial/aorta ratio of 1.5 +/- 0.3; the ejection fraction was diminished in 12 patients (11-36%) and the length of the left ventricle in the long parasternal axis view 4.2 +/- 0.7. All the patients studied had an elevated telediastolic pressure in the left ventricle, four with pulmonary artery pressure of 96 +/- 11 and seven with right atrial pressure of 24 +/- 5. There was mitral insufficiency in 4 patients and tricuspid insufficiency in three. Clinical course was favorable in 18 patients with median age at present of 112 months (range: 11 months to 15 years). The last 6 patients, treated with vasodilators, are living. In conclusion, dilated cardiomyopathy is a moderately frequent disease, with trend to diminish in incidence prognosis improved after treatment with vasodilator was introduced, and easily assessed with non-invasive methods.

Cardiomyopathy, Dilated↗
PubMed1990

[Aortic atresia with hypoplastic left ventricle. Bidimensional echocardiographic correlation. Anatomy of 14 cases].

Fourteen cases (10 males, 4 females) of aortic atresia with hypoplastic left ventricle are reviewed. All were studied by two-dimensional echocardiography, treated by prostaglandin E1 and proved by necropsy. Surgery was also performed in 3 cases by Norwood technique. A good echo-anatomical correlation was found in the size of pulmonary artery (1.14 +/- 0.17 and 1.28 +/- 0.33 respectively), mitral valve (0.4 +/- 0.3 and 0.33 +/- 0.24) and aortic diameter ring with atresic valve (0.38 +/- 0.12 and 0.31 +/- 0.1). However, echocardiography overestimated the diameter of ascending aorta (p less than 0.001) and tricuspid valve (p less than 0.001) and the length of the left ventricle. These differences may be related to the greater distension of the aorta in vivo and to the difficulty of determining the exact direction of the ultrasounds. We conclude that two dimensional echocardiography is of great value not only for the diagnosis but also for the selection of patients for surgery.

Aortic Valve↗
PubMed1989

Fixed subaortic stenosis: the value of cross-sectional echocardiography in evaluating different anatomical patterns.

We present a study using cross-sectional echocardiography in 39 patients (29 male and 10 female) with discrete subaortic stenosis. Five parameters were evaluated in the study: the morphology of the obstruction, the distance of the stenosis from the aortic valve, the type of insertion, the base of implantation, and any associated anomalies. The lesion could be divided into groups with either fibrous or fibromuscular shelves. In the group of 14 patients with fibrous shelves, the distances from the stenotic lesion to the aortic valve was less than 15% of the length of the left ventricle. The obstructive fibrous tissue was inserted on the septum and extended onto the aortic leaflet of the mitral valve (circumferential lesion) in 12 cases. The base of implantation was narrow in all 14 of them. In the 25 patients having fibromuscular lesions, the distance between obstruction and valve was greater than 18.4% of the length of the left ventricle. The insertion of the obstructive lesion was circumferential in 18 cases and its base of implantation was wide in 20 of the patients. Nineteen patients, 16 of whom had fibromuscular lesions, showed associated anomalies. Statistical analysis showed a good correlation between the type of stenosis and the base of implantation of the stenotic lesion (P less than 0.001) or associated anomalies (less than 0.01), but there was no distinction between the groups with regard to the type of insertion (less than 0.38). Twenty-five patients underwent surgical correction which was carried out between the ages of 4-14 years. Prosthetic valves (3 aortic and 1 mitral) were inserted in 4 patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

[Cardiovascular pathology in Marfan syndrome. Study of 11 children using two-dimensional echocardiography].

UNLABELLED: From 1983 to 1987 we have studied by two-dimensional echocardiography 11 pediatric patients with Marfan's syndrome. All of them presented cardiovascular lesions localized mainly in the aortic and mitral valves and in the ascending aorta. Nine patients had a dilated aortic ring in both transversal and longitudinal diameters 2.03 and 2.29 cm/m2 of body surface (bs), respectively. The average value of the aortic valvular area was 4.71 cm2/m2 bs. The 9 patients presented also dilatation of the ascending aorta (2.01 cm/cm2 bs). There was thickening of the mitral valve in 5 cases and a prolapse was present in 8 (73%). In 4 cases the prolapse was localized in anterior leaflet valve in 2 in the posterior and in 2 in both. The maximal mitral valve diastolic area was 3.25 cm2/m2 bs. None of them has needed during follow up valvular replacement. Considering the importance of this cardiovascular disease and knowing its unpredictable evolution we recommend, in the absence of valvular insufficiency, and annual echocardiographic reevaluation, and more often if valvular insufficiency is already present. IN CONCLUSION: two-dimensional echocardiographic is useful and necessary for the diagnosis and follow up of patients with Marfan's syndrome.

Adolescent↗
PubMed1989

[Scimitar syndrome in the newborn child and infant].

We present 10 symptomatic patients with scimitar syndrome. Their age was below 1 year and four were newborn babies. In 5 patients there was secundum atrial septal defect and in one there was a patent ductus arteriosus. Sixty per cent of the patients had pulmonary sequestration. The right lung was moderately or severely hypoplasic in 8 cases and seven had frequent respiratory infections. The anomalous venous drainage produced a left-to right shunt at atrium level which in our series had a value of 2.87 +/- 0.5. Five patients had pulmonary hypertension either moderate or severe. The severity of this disease in early infancy is related to the pulmonary hypertension (40%), requiring a prompt surgical correction. Eight patients were operated upon, the drainage being connected to the left atrium. The six surviving patients are asymptomatic at 12 years of follow-up. Our series is the biggest published in our country and the second in the world literature in infancy.

Abnormalities, Multiple↗
PubMed1989

[Double orifice mitral valve. Study with two-dimensional echocardiography].

Double orifice mitral valve is a rare congenital anomaly which is frequently associated with atrioventricular defects. According to its structure it is classified as central, commissural or valvar. Diagnosis by cross-sectional echocardiography was verified in 4 patients with a double orifice mitral valve of the central type. Age of the patients at the time of diagnosis ranged from 3 months to 17 years. Three of them had an associated ostium primum atrial septal defect. The defect was observed in parasternal long-short axis views and subcostal 4 chamber axis views. The parasternal short axis gave information on the central type but subvalvular structures of the double orifice and insertion of the chords in papillary muscle were best observed in parasternal long and subcostal four chamber axis views.

Adolescent↗
PubMed1986

[Mitral atresia. Anatomical study and surgical implications].

We present the pathological study of 17 cases of mitral atresia with patent aortic valve and their surgical implications. The study is based on the type of atrioventricular connection, presence or absence of ventricular septum, size of the left ventricle and relation of the aorta with the aforementioned ventricle. We have classified mitral atresia into two groups by assessing these data. Group A) Both ventricles and atrioventricular connections are present and there is ventricular septal defect. The aorta may connect with an either normal or hypoplastic left ventricle or it may emerge in double outlet from the right ventricle. Group B) Absent left ventricle and atrioventricular connection. The aorta emerges from the single ventricle or the rudimentary chamber. Thirteen cases belonged to group A and four to group B. The pathological structure of mitral atresia requires the decompression of the left atrium by atrioseptostomy during the neonatal period to enable survival. On a second stage a palliative correction should be carried out, which; depending on ventricular size and outlet of the vessels, will be a valvular prosthesis left atrium-left ventricle or the modified atriopulmonary technique connecting the new left atrium with the systemic ventricle and aorta after resecting the auricular septum and connecting the right atrium with the pulmonary artery.

Female↗
PubMed1985

[Isolated hypoplasia of the right ventricle. Study of 3 cases].

Right ventricular hypoplasia without additional congenital heart disease is an uncommon abnormality. It is characterized by partial absence of right ventricular inflow tract, both tricuspid and pulmonary valves being normally shaped. We report three cases; a newborn, an infant and a twelve years old boy. All of them had cyanosis and right atrial enlargement and both of the younger patients had electrocardiographic signs suggesting right ventricular hypoplasia. Right atrial mean pressure were raised. A differential diagnosis should be stablished with all sorts of right ventricular hypoplasia with cyanosis and with restrictive myocardiopathyes. Surgery for symptomatic patient should be palliative during first months of life and corrective from age one year onwards.

Cardiomegaly↗