Heart surgery in the first year of life

791

ABSTRACTS

nosis

in this group

is similar

to that

in older

four

The participants discussed mainly problems of severe malformations, i.e., defects which are not compatible with a survival of more than I mo unless surgical therapy is attempted within this period. In 1971 and 1972, a total number of 454 infants with congenital heart disease were admitted to cardiologic centers in Switzerland. This means that per year only 227 cases are reported, which is only about one-third of the expected number, as the incidence of congenital heart disease is placed at about eight per thousand births. One hundred

criteria: the origin, localization, type of communication with esophagus and trachea, and the vascular supply (which is almost impossible

twenty of these infants survived without therapy for more than I mo, the others had to be considered as having severe malformations. Of

to determine). According to these criteria he describes four types of malformation: enterogenic cysts, bronchogenic cysts, intralobar and extralobar pulmonary sequestrations (or accessory lungs). It is of interest, that even in typical digestive duplications, the histology may reveal islets of respiratory epithelium.-G. Egli

these, 67 died before surgery could be attempted, 12 died in spite of surgical intervention, and in 28 surgery was successful. Thus, mortality of surgically treated defects is 3p,” whereas over-all mortality of severe malformations is 74%. It is an interesting fact that most infants with congenital heart disease who are admitted to the cardiologic centers come from

Purulent Pericarditis Due Esophagus With Foreign

large centers. This probably means that a great number of infants born in smaller clinics never

patients.--Thomas

M. Holder

Diagnosis of lntrathoracic Duplications in Children. N. Genton and C. Bozic, Helv. Chir. Acta 40: 735-741 (December), 1973. Three children

cases of intrathoracic duplications are reported. The authors then

in cite

Gras and Skandalakis, “Embryology for Surgeons” giving an interesting key to the identification

of

such

A. Saylam

formations,

based

on

to Perforation of Body. A. Y. Bozer. and U. Ersoy. J. Thorac. Cardio-

vast. Surg. 67: 590-592

(April),

A patient developed purulent pericarditis and later empyema and, finally, constrictive pericarditis over a 2-mo period as a result of a fishbone perforation M. Holder

HEART

of the

esophagus.-Thomas

AND GREAT

VESSELS

Heart

Surgery in the First Year of Life. A. Senning, Schweiz. Med. Wochenschr. 103: l7681770 (December), Heart

stage.

surgery

Thanks

1973. in infants

to special

is in a transitional baby

heart-lung

benefit

from

the

and surgery.-G.

1974.

ma-

chines primary palliative surgery is giving way to early total correction. The possibility of early correction of different congenital malformations is discussed such as ventricular septal defect, Fallot’s tetralogy, transposition of the great arteries, total abnormal pulmonary venous drainage, and stenoses of pulmonary and aortic valves.~G. Eg/i Severe Congenital Heart Disease: Round Table Discussion About Children Hospitalized in Switzerland. Th. Mottu, F. Real, F. Stocker, J. Weber and F. Wyler. Schweiz. Med. Wochenschr. 103: 1766-1767 (December), 1973.

Late

Results

possibility

of intensive

care

Egli

of Palliative

Operations

for Fal-

lot’s Tetralogy. L. Brock. J. Thorac. Cardiovast. Surg. 67:5l l-518 (April), 1974. Lord Brock presents his experience with the Brock procedure for tetralogy of Fallot in 294 patients, Operative mortality was 15.3”/, and of the survivors, 140/g were late deaths. In 106 patients treated by Blalock shunt procedure between 1947 and 1952, there was a mortality of 137; and a late death rate in the survivors of 42vd. In Brock’s two series, the Brock procedure gave better long-term palliation than the Blalock procedure and had a comparable mortality. Direct repair of the right ventricular outflow obstruction allows for growth of the right ventricular outflow tract and pulmonary arteries, It also allows for left ventricular growth. All of these factors, according to the author, make the Brock procedure the better palliative procedure for tetralogy of Fallot.-Thomas M. Holder

Long-Term Follow-Up After Surgical Correction of the Partial Form of Common Atrioventricular Canal (Ostium Primum). S. Levy. P. Blondeau and C. Dubost. J. Thorac. Cardiovasc. Surg. 67:353-363 (March), 1974. One hundred

patients,

ages 6 to 56 yr, whose