Search PubMed⌕ Search

Biomedical subjects

M A Engle

Publications and source records attributed to M A Engle.

At least 91 records · Page 5Linked to original sources
PubMed1976

Cyanotic congenital heart disease.

This review describes the evolving concepts of diagnosis and management of patients with cyanotic congenital heart disease. Early palliative surgical procedures were followed by reparative operations and are now to a large extent replaced by these operations which are designed to relieve the problem. Collaboration of the team of cardiologists, surgeons, radiologists, anesthesiologists and nurses has made the many developments possible. The teamwork has not only widened the scope of what can be accomplished but has also extended the opportunities for beneficial reparative surgery down to the first weeks and months of life. Precise diagnosis and meticulous operative and perioperative care by the team are essential elements of success. Long-term follow-up and regular analyses of results have led to continuing improvements. Although these patients were born to be blue, their color and their outlook have been changed during these last 3 decades to something close to rosy.

Cardiomegaly↗
PubMed1976

The postpericardiotomy and similar syndromes.

A syndrome of pericardial and often pleural reaction with effusions and with fever occurs in three different settings. It bears the descriptive term of the condition which it follows: the postpericardiotomy syndrome, the postmyocardial infarction syndrome, and the postpericardial trauma syndrome. The manifestations, incidence, theories of etiology, treatment, and possibility of prevention were discussed. The syndrome is probably due to an immunologic response with an associated viral illness, since in a prospective study of children undergoing cardiac surgery in which the pericardium was entered, we found that the development of heart-reactive antibody in high titer and a significant rise in antiviral antibody occurred in patients with clinically evident syndrome.

Adolescent↗
PubMed1976

Pulmonary artery conduits in infants younger than six months of age.

Ten infants under 6 months of age with right ventricular-pulmonary artery discontinuity have undergone reparative operations. Five infants had either Type I or Type II truncus and 5 had pulmonary atersia with some discontinuity between right and left pulmonary arteries. There have been 4 survivors in each group. The one death in each category was due to pulmonary hypertension. The remaining 8 patients have low pulmonary vascular resistance. The survival rate after the reparative technique in infancy appears better than that with other forms of palliative treatment, such as banding of shunts, in these severly ill patients.

Angiocardiography↗
PubMed1975

Immunologic and virologic studies in the postpericardiotomy syndrome.

A prospective, triple-blind study was undertaken to determine whether antiheart antibody or a rise in titer to a virus occurred in patients after intrapericardial surgery and, if so, whether either was related to clinical evidence of the postpericardiotomy syndrome. In 257 patients, AHA in high titer appeared in 62 (24%), all of whom had the syndrome. None of the 102 patients with no AHA had the syndrome. In 137 subjects, a rise in titer to one or more viral agents occurred in 21 of 31 (68%) of those with AHA and PPS. This study suggests that an immunologic response and viral illness are related to PPS.

Adolescent↗
PubMed1975

Pulmonary lymphangiectasia demonstrated by lymphangiography in 2 patients with Noonan's syndrome.

Two cases of pulmonary lymphangiectasia associated with Noonan's syndrome are described. Chest films showed diffuse pulmonary intersitial infiltrates from infancy. Lymphangiograms demonstrated obstructive changes and collateral formation in the retroperitoneal, mediastinal, pulmonary, and cervical lymphatics and extensive opacification of the pulmonary and visceral pleural lymphatics. Possible mechanisms and causes of the lymphatic malformation are discussed.

Angiography↗
PubMed1975

Serum digitoxin concentrations in infants and children.

Serum digitoxin levels were measured in 18 infants (under two years) and in 23 children (aged 2-13 years) receiving maintenance therapy. Digitalization was carried out because of heart failure in 17 infants and 13 children and for control of dysrhythmia in one infant and 10 children. Mean maintenance dosage for infants was 0.0042 plus or minus 0.0008 (sd) mg/kg/day and for children was 0.0031 plus or minus 0.0012 mg/kg/day. The mean serum digitoxin level was not significantly different in infants (30 plus or minus 10 ng/ml, range 14-58) from that found for children (34 plus or minus 11 ng/ml, range 19-61). Both values were significantly different (P smaller than 0.001) from those determined in this laboratory for adults (mean 24 plus or minus 7 ng/ml, range 5-39). In four infants with electrocardiographic or other evidence of toxicity, the mean serum level was 71 plus or minus 2 ng/ml (range 68-72), and in four children with electrocardiographic or other evidence of toxicity, the mean serum level for digitoxin was 72 plus or minus 14 ng/ml (range 53-84). The data suggest that infants and children tolerate a higher serum digitoxin concentration without any evidence of toxicity and may require more digitoxin (mg/kg) for therapeutic effect than do adults. Serum digitoxin levels may serve as an important guide in determining the adequacy of digitalization and in the recognition and management of digitalis toxicity.

Adolescent↗
PubMed1975

Silent anomalies of the urinary tract and congenital heart disease.

Postangiocardiographic screening of infants and children with congenital heart disease for silent anomalies of the urinary tract yielded an incidence of 7.7 percent in 260 so studied. The incidence was 29 percent in 21 babies who came to autopsy and had been studied at catheterization but without this screening. Patients with atrial septal defect had the highest incidence of urinary tract anomalies, while those with ventricular septal defect and tetralogy had an average incidence. Some of the lesions discovered were potentially significant even though silent. They were found with sufficient frequency to warrant routine use of this screening technique at cardiac catheterization.

Abnormalities, Multiple↗
PubMed1974

Correction of transposition of the great arteries: Relationship of the coronary sinus and postoperative arrhythmias.

Between 1967 and 1973, 86 patients underwent total correction of transposition of the great arteries. There were 6 hospital deaths for an in-hospital survival of 93% with three late deaths. Seventy-two patients had repair with standard cardiopulmonary bypass and 14 infants were corrected with profound hypothermia and circulatory arrest. The incidence of postoperative dysrhythmia was less in the group in whom the coronary sinus was not incised but yet placed into the systemic venous return. Postoperative rhythm disturbance was greatest when the coronary sinus was widely opened and placed with the venous return. This observed decrease in incidence of atrial dysrhythmia may be related to not incising the coronary sinus and placing the sutures very superficial in the area between the sinus and the tricuspid valve.

Adolescent↗