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Management of portal hypertension in children
626
INTERNATIONAL
TRUNCUS BICAROTICUS. H&l Nathan and Gershon Gitlin. Thorax 23:266-269 (May) 1968. Stimulated by a case of right sided termination of the thoracic duct in a patient with retroesophageal aberrant right subclavian artery and truncus bicaroticus, the authors reviewed the literature concerning variations of the course of the thoracic duct associated with aortic arch anomalies. They conclude that the surgeon should exercise special attention to the course of the thoracic duct whenever aortic arch branches are anomalous.-W. K. Sieber.
HEART AND GREAT VESSELS THE SURGICAL RELIEF OF TRANSPOSITION OF THE GREAT VESSELS IN INFANCY. T. G. O’Donooan, C. N. Barnard, and M. S. Gotsman. Thorax 23: 256260 (May) 1968. A precise plan of managing infants with transposition of the great vessels is presented. A selective right ventriculogram demonstrates aortic position ventricular septal defects and the ductus arteriosis. Pulmonary or subpuhnonary stenoses are detected in the left ventriculogram. If arterial oxygen saturation is less than 65 per cent, a shunt procedure is indicated. Operation is done under hypothermia at 30” C., through a right thoracotomy-anterior lateral approach. A technic of producing a large interatrial septal communication by atriotomy with inflow occlusion is described. If the patient has a ventricular pulmonary artery is banded sure by one half. Seven of the eight infants, of age, when managed in result described as good; one
septal defect the to reduce the pres4 days to 13 weeks this fashion had a died.W. K. Sieher.
CONTRIBUTION TO SURGICAL TREATMENT OF DEFECTS OF THE AORTO-PULMONARY SEPTUM. I. Navr@ B. Bednafik, H. Kaniu, 0. Me& Vicky, and 0. Oleinik. Rozhl. Chir. 47, 166-169 (March)
1968.
In the surgical repair of an aortopulmonary fenestration the authors used a patch, sutured in place through an incision of the anterior common wall of both “great arteries” (aorta and P.A.). This method was successfully used in their fourth case of this anomaly-a boy of 2 years.-V. Kafka. CARDIAC VALVE REPLACEMENT IN CHILDREN. R. B. Bloodwell, Grady L. Ha&nun, and D. A. Coo&. Surgery 6Z77-89 (January) 1968. Thirty-one
patients
ranging
in age from
1%
to
ABSTRACTS OF PEDIATRIC SURGERY
16 years underwent cardiac valve replacement. Eighteen patients had mitral valve replacement, 12 patients had aortic valve replacement, and 1 patient had both valves replaced. There were 4 hospital deaths, all in high-risk patients and from progressive cardiac failure. There were 4 late deaths, 2 from prosthetic thrombosis, 1 from injury, and 1 from subacute bacterial endocarditis. The accumulative mortality was 26 per cent. Associated defects were repaired concurrently in 10 patients, all of whom recovered. A ball valve type prosthesis was used for aortic replacements. The low-profile lenticular valve type was used for the mitral replacements. There was a I5 per cent incidence of thrombotic or embolic complications which is comparable to that seen in adult cases. The average follow-up period was 10 months, and the results in the survivors have been good.-D. T. Cloud.
ALIMENTARY TRACT THE USE OF ARTERI~GRAPHY IN THE DIAGNOSIS OF THE ORIGIN OF ACUTE GASTROINTESTINAL HEMORRHAGE IN CHILDREN. J. L. Ternberg and P. R. Koehler. Surgery 63:686-689 (April) 1968. In 3 patients with gastrointestinal hemorrhage, selective arterial angiography was used to establish the location of gastrointestinal bleeding. The bleeding site was successfully localized in 2 of the patients. Percutaneous arterial catheterization was employed. X-rays are shown which demonstrate pooling of contrast material at the site of bleeding in the intestinal tract. The point is made that if angiography is to be combined with barium studies, the angiography should be done first to avoid difllculties in interpretation-D. T. Cloud. MANAGEMENT OF PORTAL CHILDHEN. C. C. Ferguson.
HYPERTENSION Surgery
IN
63:1042-
1044 (June) 1968. In this editorial the author proposes that aspirin may be the precipitating factor in bleeding from esophageal varices. If bleeding can be prevented by avoiding aspirin, portosystemic shunt may not be required.-D. T. Cloud. BLIND ESOPHAGEAL CATHETER. L.
COIN RE~IOVAL USING FOLEY P. Brown. Arch. Surg. 96931,
(June) 1968. This is an interesting case report concerning a 2-year-old child who was brought to the FE 1 Air Force Emergency Room shortly after having
INTERNATIONAL
TRUNCUS BICAROTICUS. H&l Nathan and Gershon Gitlin. Thorax 23:266-269 (May) 1968. Stimulated by a case of right sided termination of the thoracic duct in a patient with retroesophageal aberrant right subclavian artery and truncus bicaroticus, the authors reviewed the literature concerning variations of the course of the thoracic duct associated with aortic arch anomalies. They conclude that the surgeon should exercise special attention to the course of the thoracic duct whenever aortic arch branches are anomalous.-W. K. Sieber.
HEART AND GREAT VESSELS THE SURGICAL RELIEF OF TRANSPOSITION OF THE GREAT VESSELS IN INFANCY. T. G. O’Donooan, C. N. Barnard, and M. S. Gotsman. Thorax 23: 256260 (May) 1968. A precise plan of managing infants with transposition of the great vessels is presented. A selective right ventriculogram demonstrates aortic position ventricular septal defects and the ductus arteriosis. Pulmonary or subpuhnonary stenoses are detected in the left ventriculogram. If arterial oxygen saturation is less than 65 per cent, a shunt procedure is indicated. Operation is done under hypothermia at 30” C., through a right thoracotomy-anterior lateral approach. A technic of producing a large interatrial septal communication by atriotomy with inflow occlusion is described. If the patient has a ventricular pulmonary artery is banded sure by one half. Seven of the eight infants, of age, when managed in result described as good; one
septal defect the to reduce the pres4 days to 13 weeks this fashion had a died.W. K. Sieher.
CONTRIBUTION TO SURGICAL TREATMENT OF DEFECTS OF THE AORTO-PULMONARY SEPTUM. I. Navr@ B. Bednafik, H. Kaniu, 0. Me& Vicky, and 0. Oleinik. Rozhl. Chir. 47, 166-169 (March)
1968.
In the surgical repair of an aortopulmonary fenestration the authors used a patch, sutured in place through an incision of the anterior common wall of both “great arteries” (aorta and P.A.). This method was successfully used in their fourth case of this anomaly-a boy of 2 years.-V. Kafka. CARDIAC VALVE REPLACEMENT IN CHILDREN. R. B. Bloodwell, Grady L. Ha&nun, and D. A. Coo&. Surgery 6Z77-89 (January) 1968. Thirty-one
patients
ranging
in age from
1%
to
ABSTRACTS OF PEDIATRIC SURGERY
16 years underwent cardiac valve replacement. Eighteen patients had mitral valve replacement, 12 patients had aortic valve replacement, and 1 patient had both valves replaced. There were 4 hospital deaths, all in high-risk patients and from progressive cardiac failure. There were 4 late deaths, 2 from prosthetic thrombosis, 1 from injury, and 1 from subacute bacterial endocarditis. The accumulative mortality was 26 per cent. Associated defects were repaired concurrently in 10 patients, all of whom recovered. A ball valve type prosthesis was used for aortic replacements. The low-profile lenticular valve type was used for the mitral replacements. There was a I5 per cent incidence of thrombotic or embolic complications which is comparable to that seen in adult cases. The average follow-up period was 10 months, and the results in the survivors have been good.-D. T. Cloud.
ALIMENTARY TRACT THE USE OF ARTERI~GRAPHY IN THE DIAGNOSIS OF THE ORIGIN OF ACUTE GASTROINTESTINAL HEMORRHAGE IN CHILDREN. J. L. Ternberg and P. R. Koehler. Surgery 63:686-689 (April) 1968. In 3 patients with gastrointestinal hemorrhage, selective arterial angiography was used to establish the location of gastrointestinal bleeding. The bleeding site was successfully localized in 2 of the patients. Percutaneous arterial catheterization was employed. X-rays are shown which demonstrate pooling of contrast material at the site of bleeding in the intestinal tract. The point is made that if angiography is to be combined with barium studies, the angiography should be done first to avoid difllculties in interpretation-D. T. Cloud. MANAGEMENT OF PORTAL CHILDHEN. C. C. Ferguson.
HYPERTENSION Surgery
IN
63:1042-
1044 (June) 1968. In this editorial the author proposes that aspirin may be the precipitating factor in bleeding from esophageal varices. If bleeding can be prevented by avoiding aspirin, portosystemic shunt may not be required.-D. T. Cloud. BLIND ESOPHAGEAL CATHETER. L.
COIN RE~IOVAL USING FOLEY P. Brown. Arch. Surg. 96931,
(June) 1968. This is an interesting case report concerning a 2-year-old child who was brought to the FE 1 Air Force Emergency Room shortly after having