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Biomedical subjects

P Zielinsky

Publications and source records attributed to P Zielinsky.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Role of the atrioventricular septum and mitro-aortic separation in the pathogenesis of fixed subaortic stenosis].

PURPOSE: To analyze, by cross-sectional echocardiography, morphological features of the atrial atrioventricular and ventricular septum potentially involved in the genesis of fixed subaortic stenosis. METHODS: Forty three children with fixed subaortic stenosis were compared with 86 normal children, matched by age, sex and body surface, and 43 children with congenital heart defects without fixed subaortic stenosis. RESULTS: The groups did not differ in as age, sex or body surface. The atrioventricular septum was significantly smaller in children with subaortic stenosis than in normal children or patients with other congenital heart diseases. The ventricular septum was significantly more aligned with the atrial septum in cases than in normal children and in patients with other congenital heart diseases. The odds ratio for the development of fixed subaortic stenosis was statistically significant in the presence of a short atrioventricular septum and with alignment of the ventricular and atrial septum, when analyzed in isolation or when controlled by perimembranous ventricular septal defect. CONCLUSION: It was concluded that in fixed subaortic stenosis the atrioventricular septum length is decreased and that this alteration may be a risk factor for its development.

Aortic Valve↗
PubMed1995

[Prenatal echocardiographic study of septum primum redundancy and its relationship to the genesis of atrial extrasystole in the fetus].

PURPOSE: To test the hypothesis that the redundancy of the septum primum is more pronounced in fetuses with atrial premature beats than in normal fetuses. METHODS: Twenty-five consecutive fetuses with atrial premature beats detected by prenatal echocardiography as the sole alteration at a mean gestational age of 34 +/- 3.3 (26 to 38) weeks and a mean maternal age of 27 +/- 6.5 (18 to 39) years made up the study group. The control group was formed by 50 consecutive fetuses without rhythm disturbances and normal prenatal echocardiography, examined at a mean gestational age of 33.9 +/- 3 (26 to 39) weeks and a mean maternal age of 31 +/- 5.8 (18 to 43) years. A redundancy index (RI) was obtained as a ratio between the maximal septum primum excursion and the maximal left atrium diameter during atrial diastole, at the 4-chamber projection. Statistical analysis utilized the unpaired Student-Fisher's "t" test. RESULTS: The RI in the study group varied from 0.50 to 1.00 (mean = 0.758 +/- 0.127) and in the control group in ranged from 0.29 to 0.67 (mean = 0.449 +/- 0.080). These differences were statistically significant for p < 0.0001. CONCLUSION: Septum primum is more redundant in fetuses with atrial premature beats than in those with normal regular rhythm. Although it is still speculative that this feature may have a cause-effect relationship, the measurement of the RI during routine fetal echocardiography may allow detection of a potential risk factor FOR developing atrial arrhythmias.

Adolescent↗
PubMed1992

[Infection of polytetrafluorethylene prosthesis in modified Blalock-Taussig anastomosis].

A 16 month-old baby submitted to systemic-pulmonary shunt with a polytetrafluorethylene prosthesis, who presented hyperthermia, radiologic signs of pulmonary opacifications and positive culture for staphylococcus aureus. Reoperation disclosed a prosthesis pseudoaneurysm, with disconnection of the anastomosis and evidences of infection. This complication has a low diagnostic rate and a high mortality and should always be suspected when signs of systemic infection become apparent in the postoperative period of polytetrafluorethylene systemic-pulmonary shunt.

Female↗
PubMed1992

Incorporating knowledge to databases--a solution to complex domains.

This paper describes the design of an integrated environment to handle information on congenital heart disease patients. A three-layer model that integrates a database, a knowledge-base and a graphical user-interface is presented. The role of each layer and its connections is discussed. The advantages of using a hypertext front-end system to present and retrieve complex data are also addressed. The current status of the project and its future developments are described in the final section.

Artificial Intelligence↗
PubMed1991

Role of prenatal echocardiography in the study of hypertrophic cardiomyopathy in the fetus.

The increased incidence of hypertrophic cardiomyopathy in children of diabetic mothers has already been demonstrated, but its prenatal diagnosis has not yet been extensively studied. The purpose of this prospective study was to evaluate the frequency, severity, and echocardiographic features of fetal hypertrophic cardiomyopathy in a population with several indications for prenatal echocardiography. From March 1987 to April 1991, 283 fetuses were submitted to comprehensive prenatal echocardiography, including M-mode measurements, cross-sectional imaging, Doppler studies, and color flow mapping. One hundred seventy-six were pregnancies complicated by previous or gestational diabetes. The diagnosis of disproportionate septal hypertrophy was made in 39 fetuses (mean septal thickness 7.12 +/- 1.6 mm), at a mean gestational age of 32 weeks. Diabetes mellitus was present in 36 of these pregnancies (92.3%). In four cases, nonimmune hydrops was detected. A systolic anterior motion of the mitral valve was present in three fetuses, but only one showed a gradient across the left ventricular outflow tract. Postnatal echocardiographic examination in 27 babies did not show false positivity. In ten cases, spontaneous regression of the septal hypertrophy was shown. There were three neonatal deaths, unrelated to the myocardial disease. We concluded that transient hypertrophic cardiomyopathy is a frequent entity, especially when associated with diabetes during gestation, being a potential cause for nonimmune hydrops. Fetal echocardiography is the method of choice for its prenatal diagnosis and should always be indicated in diabetic mothers.

Adolescent↗
PubMed1987

Subaortic fibrous ridge and ventricular septal defect: role of septal malalignment.

The purpose of this study was to test the hypothesis that the presence of a subaortic ridge associated with a ventricular septal defect (VSD) is related to a malaligned ventricular septum caused by anterior or posterior deviation of the infundibular septum with or without obstructive lesions of the aortic arch. Thirty-two of 295 patients in whom a diagnosis of VSD was made by two-dimensional echocardiography and who were studied from June 1983 to April 1985 presented with a subaortic shelf. Every patient (p less than .00001) had a malalignment type of defect; the defect was produced by anterior deviation of the outlet septum (without compromise of the right ventricular outflow tract) in 28 and by posterior deviation of the infundibular septum in four. The prevalence of a subaortic shelf in the malalignment VSD group was 82% (32/39). Among the 28 patients with a subaortic ridge and anterior deviation of the outlet septum only three had aortic coarctation, but all four patients with subaortic stenosis and posterior infundibular malalignment had obstructive lesions of the aortic arch--coarctation in three and interruption of the aortic arch in one (p less than .001). We conclude that a malalignment type of VSD may be a consistent feature in patients with VSD and associated discrete subaortic stenosis. We also noted a high prevalence of subaortic ridge in the presence of a malalignment VSD and therefore speculate that there may be a common morphogenesis for malalignment VSD, subaortic shelf, and obstructive lesions of the aortic arch.

Adolescent↗