A patient's condition was initially diagnosed as constrictive pericarditis, but an echocardiogram revealed the presence of an intracardiac tumor. The tumor was a slow-growing leiomyosarcoma that originated in the left internal iliac vein, extended into the inferior vena cava, and reached the right ventricle. This tumor was considered to be a recurrent uterine leiomyosarcoma that had been resected 4 years before. After a second resection of this tumor, the patient was living a normal life 61/2 years postoperatively, in spite of recurrence in the pelvis and lung. We reviewed 12 cases of leiomyosarcoma in the world literature that reached the heart through the inferior vena cava. We added our case and evaluated the clinical features of all 13. This is the first successfully resected case of leiomyosarcoma of this nature so far as we could determine.

Adult↗

PubMed1981

[Measurement of adenosine deaminase (ADA) activity in pleural effusion with special reference to carcinomatous and tuberculosis pleuritis (author's transl)].

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Adenosine Deaminase↗

PubMed1981

Corrective surgery for tetralogy of Fallot without or with minimal right ventriculotomy and with repair of the pulmonary valve.

Thirty-six of 42 consecutive patients who underwent corrective surgery for tetralogy of Fallot were operated upon without or with minimum right ventriculotomy and with repair of the pulmonary valve. The other six patients underwent conventional right ventriculotomy primarily because they required external valved conduits for repair. One of the 36 patients (2.8%) died 11 days postoperatively. Postoperative hemodynamic and angiocardiographic studies were performed randomly in eight patients. The results were compared with those obtained from 21 control patients who underwent conventional corrective surgery with right ventriculotomy and without repair of pulmonary valve. There were no differences in the degree of residual pulmonary stenosis. Moderate-to-severe pulmonary regurgitation occurred in none of the patients who underwent the new procedures and in 24% of the controls. Cardiac and stroke volume indexes at rest measured postoperatively did not differ significantly between the two series of patients. The cardiac index for both series of patients increased significantly during isoproterenol infusion, measuring 7.29 +/- 1.97 l/min/m2 for the present series of patients (p less than 0.005) and 5.76 +/- 1.64 l/min/m2 for the controls (p less than 0.001). These two values were significntly different (p less than 0.05). Stroke volume index in the present series of patients increased significantly during isoproterenol infusions., from 37 +/- 5 ml/m2 to 45 +/- 15 ml/m2 (p less than 0.05), whereas that for the controls decreased significantly, from 43 +/- 10 ml/m2 to 38 +/- 12 ml/m2 (p less than 0.01). These differences in the response to isoproterenol infusion in the two series of patients indicated that right ventricular function after corrective surgery for tetralogy of Fallot was well maintained in patients who underwent the new method of operation. The two series of patients did not differ with respect to the development of right bundle branch block.

Adolescent↗

PubMed1981