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Biomedical subjects

L M Gerlis

Publications and source records attributed to L M Gerlis.

At least 55 records · Page 3Linked to original sources
PubMed1986

Persistent right umbilical vein--case report and review of literature.

Persistence of the proximal portion of the right umbilical vein is described in a premature infant. Infracardiac total anomalous pulmonary venous connexion and unilateral renal agenesis with ipsilateral phocomelia and unicornuate uterus were associated anomalies. The mother had received carbamazepine therapy for epilepsy. Previously reported cases of persistent proximal right umbilical vein have shown a variety of other malformations but a single umbilical artery has been the most consistent.

Abnormalities, Multiple↗
PubMed1986

Abnormalities of the mitral valve in congenitally corrected transposition (discordant atrioventricular and ventriculoarterial connections).

Abnormalities of the mitral valve were found in 16 (55%) of 29 necropsy specimens of hearts with congenitally corrected transposition of the great arteries (discordant atrioventricular and ventriculoarterial connections). These abnormalities were most commonly of cusp number (21%) and tension apparatus (21%). Dysplasia of the valve was less common (10%), and other abnormalities identified included common valve, stenosis, and cleft valve. Some of the cases showed more than one morphological abnormality. The median age at death in those cases with mitral valve abnormalities was significantly higher than those without. More females than males had valves affected (ratio 2:1). Malformations such as ventricular septal defect and tricuspid or pulmonary valve anomalies were represented in similar proportions in cases with and without mitral anomalies.

Abnormalities, Multiple↗
PubMed1985

An unusual type of anomalous pulmonary venous drainage associated with a complex left heart hypoplasia and a variety of divided left atrium ("cor triatriatum").

A previously unreported complex congenital cardiac malformation was noted in which a vestigial left atrium consisted of two completely separate portions, one of which was connected to the pulmonary veins but had no outlet orifice. The pulmonary venous drainage was through an anomalous intrapulmonary vein within the displaced right lung into the inferior caval vein above a deformed diaphragm. The left atrioventricular connexion was absent. Some points of terminology are considered.

Abnormalities, Multiple↗
PubMed1985

Cardiac malformations in spontaneous abortions.

A detailed examination of 247 spontaneously aborted foetuses, under the age of 24 weeks gestation, showed 38 instances of cardiac malformation (15.4%). Very early specimens were not included. There was a bimodal relationship with maternal age and parity and a higher incidence in summer conceptions, but there was no apparent association with maternal blood groups. There were more male foetuses and they had proportionately more malformed hearts than the females. There was a marked inverse relationship with foetal age; in early foetuses, less than 25 mm, cardiac malformations were present in 68%. A wide variety of morphological abnormalities was encountered; these are listed. No cardiac malformations occurred in 72 threatened abortions which went to full-term delivery.

Abortion, Spontaneous↗
PubMed1985

Placental and fetal pathology in Coxsackie virus A9 infection: a case report.

A 27-year-old patient contracted a Coxsackie virus A9 meningitis at 33 weeks gestational age. Two weeks later a macerated female stillborn infant was delivered. The placenta showed a diffuse perivillous fibrin deposition with villous necrosis and inflammatory cell infiltration and yielded Coxsackie virus A9 on culture. Post-mortem examination of the fetus showed only minimal inflammatory changes in the cardiac connective tissue and the subarachnoid space.

Adult↗
PubMed1985

Pre-excitation due to accessory sinoventricular connexions associated with coronary sinus aneurysms. A report of two cases.

Ventricular pre-excitation occurred in two cases in which the accessory pathways between the atria and the ventricles were histologically identified as being associated with aneurysmal malformations of the coronary sinus. In one case the connexions were in the posterior wall of the coronary sinus aneurysm and were not related to the atrioventricular annulus; in the other, a connexion was situated in the anterior wall of the aneurysm in close apposition to the annulus and superficially resembled a Kent fibre. These connexions were considered to be of sinus venosus origin and to represent a modification of the muscular sheath that normally surrounds the coronary sinus but does not continue along the coronary veins. One of the posterior wall connecting bundles was composed of abnormally large Purkinje-like fibres; this may have played some role in the manifestation of the pre-excitation by reducing any mismatch impedance.

Adolescent↗
PubMed1985

Mechanism of late failure of the Alvarez disc valve prosthesis.

An Alvarez disc valve prosthesis had been implanted in the mitral and tricuspid positions in 15 patients between 1964 and 1967 in this hospital. Of these 15 patients, only three survived longer than 10 years, all three dying unexpectedly between 16 and 18 years postoperatively. Two deaths were a direct result of disruption of the Alvarez prosthesis. The third patient was not examined at necropsy, but in retrospect the history was highly suggestive of valve malfunction. Cross sectional and pulsed Doppler echocardiography made valuable contributions to the diagnosis in both cases of valve disruption and, when available, should be part of the primary investigation of suspected prosthetic heart valve failure. The Alvarez valve prosthesis is liable to erosive wear which may cause late detachment of the disc from the valve ring with abrupt and catastrophic haemodynamic consequences.

Adult↗
PubMed1984

Atrioventricular valve diverticulum--an unusual congenital malformation.

A previously unreported congenital malformation was noted in an infant with right atrial isomerism ("asplenia syndrome"). The superior bridging leaflet of a common atrioventricular valve was attached to a band of muscular tissue spanning the atrioventricular junction. A large ventricular diverticulum extended into the substance of this band, possibly due to traction during fetal life.

Abnormalities, Multiple↗
PubMed1984

Duplication of the left atrioventricular valve in double inlet left ventricle: a triple inlet ventricle?

A heart is described with double inlet left ventricle, rudimentary right ventricle and ventriculo-arterio discordance. The lesion was complicated by a malformation of the left atrioventricular valve. The valve was divided into two distinct orifices. The major orifice connected to the morphologically left ventricle along with the right atrioventricular valve. The minor orifice opened predominantly into the rudimentary right ventricle but in part to the dominant left ventricle. The problems such a lesion produces in terms of nomenclature are discussed with regard to sequential segmental analysis.

Aorta, Thoracic↗
PubMed1984

Endocardial fibroelastosis and hypoplasia of the left ventricle in neonates without significant aortic stenosis.

Endocardial fibroelastosis in neonates with hypoplasia of the left ventricle is usually associated with severe aortic stenosis or atresia. In this study three hearts were examined, in which severe hypoplasia of the left ventricular cavity with myocardial hypertrophy and endocardial fibroelastosis were associated with small but non-stenotic subaortic outflow tracts and aortic valves. These features were contrasted with those of neonatal left heart hypoplasia in aortic stenosis and atresia. The index cases were examples of the very rare contracted form of endocardial fibroelastosis.

Aortic Valve↗
PubMed1984

Valvar stenosis in truncus arteriosus.

Twenty three morphological specimens of truncus arteriosus were examined for evidence of stenosis of the semilunar valve. One third showed good evidence of stenosis as judged by careful measurement of the valve orifice, the valve ring, and the maximum diameter of the truncus. Correlation with measured pressure gradients was poor, but angiography and cross sectional echocardiography were better predictors of stenosis. Stenosis was invariably associated with cusp dysplasia and was more common in valves with two or four cusps.

Angiocardiography↗
PubMed1984

Left ventricular bands. A normal anatomical feature.

Discrete delicate fibromuscular structures crossing the cavity of the left ventricle were identified on morphological examination in 329 (48%) of 686 hearts from patients of all ages with congenital heart disease, acquired heart disease, or normal hearts. These structures were also present in 151 (95%) of 159 hearts from animals of six species. Cross sectional echocardiographic findings compatible with these structures were obtained in 39 (21.7%) of 179 children reviewed retrospectively and in three of 800 (0.4%) adults studied prospectively. These structures appear to be a normal anatomical finding.

Adult↗
PubMed1984

Coronary sinus orifice atresia and persistent left superior vena cava. A report of two cases, one associated with atypical coronary artery thrombosis.

Fourteen previously reported cases of atresia of the coronary sinus ostium, in which the coronary venous flow entered the right atrium by a persistent left superior vena cava, the innominate vein, and the right superior vena cava, are reviewed and two new cases reported. The first new case was in a 43 year old woman with atypical chest pains in whom investigations for suspected ischaemic heart disease, including coronary arteriography, yielded normal results. She died suddenly from massive myocardial infarction due to extensive old thrombotic occlusion of a major coronary artery without any appreciable underlying disease of the vessel wall. Exercise testing is considered to be advisable in symptomatic patients with normal coronary angiograms and attention to the venous phase might be informative. The second new case occurred in a child with an atrial septal defect and complete transposition of the great arteries, who died aged 1 month.

Adult↗
PubMed1983

Calcification of glutaraldehyde-preserved porcine and bovine xenograft valves in young children.

Eight children (mean age, 7.6 years) had xenograft prosthetic valves inserted. All developed evidence of prosthetic valve obstruction requiring reoperation 18 to 55 months after insertion (mean, 32 months). At operation, all the valves were found to be heavily calcified. There were two perioperative deaths. Of two patients who had a second xenograft valve inserted, one died suddenly 12 months later. Gross calcification of the xenograft was found at postmortem examination. The other patient had evidence of mild xenograft calcification at follow-up 19 months postoperatively. Four of the ten calcified xenograft valves were of bovine origin (Ionescu-Shiley type); in these the calcific obstruction occurred significantly earlier than in the six porcine (Hancock) valves.

Aortic Valve Stenosis↗