Fate of pericardium utilized for the closure of ventricular septal defect; postoperative ventricular septal aneurysm

ABSTRACTS

433

The two patients with noncorrectable died.~ Thomav M. Holder

disease

Congenital

Heart

in

Earliest

of life.

Age

Defects

in

Children

the

M.

VoiiikovO, M. 5om&nek, 5. Tumo, 6. Hutin, 8. Fiier, J. Goetzovo, V. /irob&&, F. Proisk);, ond H. Padovcovtr. Cesk. Pediatr., 29: 2644267. 1974. A total of 958 children with congenital heart defects were examined in the cardiologic clinic of the IInd Children’s Clinic. Faculty of Pediatrics, Prague, between 1963 and 1972. The percentage of infants is increasing. A group of 365 patients were evaluated in detail on the basis of clinical examination. heart catheterization, and angiography before completion of their second year of life. Most of them (278) were infants and 61 were newborns. The most frequent heart anomalies in the first 3 mo of life were severe cyanotic malformations. In 48 infants there were transposition of the great arteries, 31 had a balloon septostomy performed, I I children had 17 palliative procedures. The late mortality was 70”,,. Fallot’s tetralogy was diagnosed in 48 children, and 34 of them were treated surgically with three deaths, All eight newborns with pulmonary atresia died. Out of nine newborns with trtcuspid atresia. four are alive. Symptomatic coarctation of the aorta was found in 18 infants. Four of them had a postligamentous type of coarctation and are alive. Fourteen infants had complicated forms of coarctatton (leftto-right shunt, fibroelastosis, preductal form of coarctation). The over-all mortality was SS’,,. Aortic arch anomalies were diagnosed in five infants, three of them survived. Between the 3rd and 6th months of life the most frequent anomalies were a left-to-right shunt. There were 104 babies with VSD and 25 with PDA. The banding of the pulmonary artery was performed in 29 children with six late deaths. All 21 infants with isolated PDA survived. Severe bronchopneumonia occurring in early life was the main cause of death in this group of patients (17”,,). -B. Hucin

the pericardium and one on the right atrium. When there was less than 0.5 cm between the clips on postoperative x-rays, there was negligible amounts of blood in the per,cardium. One centimeter or more between the clips signify an excessive amount of blood ot clot in the pericardium. The authors found the clips of value in distinguishing tamponade from heart failure in the early postoperattvc period. Thomas M Holder on

Fate

of Pericardium

Ventricular tricular

Utilized

Septal Septal

junct

to

Epicardial-Pericordial the

Differential

pericardium,

Pericardial

mory

Cardiac-Output

Law

Clips,

Diagnosis

of

Tamponode,

An

Ad-

Hemoand

Syndrome

Pri-

Closure

Aneurysm.

of

Ven-

Y.

Kowoshimo, S. ond H. Surg. 68:209-218

K. Sob,

Nine patients had ventricular septal defects patched with autogenous pericardium. In three, an aneurysm developed protruding into the right ventricle. In one. the aneurysm ruptured into the right ventricle. All three were SUCcessfully repaired. In two additional patients there was prominent bulging of the patch into the right ventricle. The large patches were more prone to develop aneurysms.Thoma\ M Holder Transposition tricular

of

Septal

the

Great

Defect.

Vessels

With

Ven-

F. S.

fdriss, J. Auberf, .M. Paul, H. Nikoidoh, M. Lev, and E. A. Newfeld. J. Thorac. Cardiovosc. Surg. 68:732-741 (November), 1974. Thirteen of 71 patients (18”,,) who underwent correction of the great arteries at the Children’s Memorial Hospital in Chicago also had an associated ventricular septal defect. In two. the ventricular septal defect was not repatred at the time of the Mustard procedure because of irreversible pulmonary hypertension. One of these patients died; the other had good palliation. In the other I I patients the VSD w.rs repaired through the tricuspid valve at the time of open insertion of the intra-atrial baffle. Thmere were no deaths in this latter group. A detailed of the ventricular

defect in patients with transposition arteries

is presented

from

mortem

specimens.

Thomas

septul

of the great

a study of 94 postM. Hcllder

After

Open-Heart

Surgery. C. V. Meckstroth and S. M. Cottaneo. J. Thoroc. Cardiovasc. Surg. 68:447454 (September), 1974.

Patients undergoing open heart surgery two metallic clips placed in juxtaposition,

the

Postoperative

Nakono, M. Koto, M. Donno, Monobe. J. Thoroc. Cardiovosc. (August), 1974.

study of the location Juxtaposed

for

Defect;

had one

Obstruction ing

the

to Systemic

Mustard

the Great

Venous

Operation

Arteries.

Return

Follow-

for Transposition

of

J. Stork, E. D. Silove, J. F. N. Toylor, and G. R. Graham. J. Thorac. Cordiovosc. Surg. 68:742-749 (November), 1974.