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HARLEY HR. The radiological changes in pulmonary venous hypertension, with special reference to the root shadows and lobular pattern. BRITISH HEART JOURNAL 1998; 23:75-87. [PMID: 13711604 PMCID: PMC1017734 DOI: 10.1136/hrt.23.1.75] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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153
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ZAKY HA, EL-HENEIDY AR, FODA MT. Haemodynamic shunts in schistosomal cor pulmonale. BRITISH MEDICAL JOURNAL 1998; 1:367-9. [PMID: 14009704 PMCID: PMC1957580 DOI: 10.1136/bmj.1.5275.367] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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156
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Hopkins WE, Waggoner AD, Gussak H. Quantitative ultrasonic tissue characterization of myocardium in cyanotic adults with an unrepaired congenital heart defect. Am J Cardiol 1994; 74:930-4. [PMID: 7977124 DOI: 10.1016/0002-9149(94)90589-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Adults with nonrestrictive ventricular septal defects have chronic hypoxemia that may lead to alterations in myocardial structure and function. Ultrasonic integrated backscatter provides quantitative assessment of myocardial acoustic properties that are altered by myocardial ischemia, fibrosis, and edema. Sixteen patients (age 31 +/- 10 years) with a nonrestrictive ventricular septal defect were studied using 2-dimensional and M-mode echocardiography with integrated backscatter imaging to determine the cyclic variation of integrated backscatter in the right ventricular free wall, ventricular septum, and left ventricular posterior wall. Cyclic variation of integrated backscatter in the right ventricular free wall and interventricular septum in patients was significantly less than that in control subjects (4.1 +/- 0.8 vs 4.9 +/- 1.0 decibels [dB], p = 0.02, and 3.8 +/- 1.2 vs 4.8 +/- 1.1 dB, p = 0.004, respectively). There was no difference between mean cyclic variation of integrated backscatter in the left ventricular posterior wall in patients and that in control subjects (4.7 +/- 1.3 vs 4.8 +/- 1.1 dB, p = NS, respectively). However, values < 4.0 dB were noted in 38% of patients compared with 15% of control subjects. Biventricular systolic function was normal in all but 1 patient. There was no correlation between backscatter and either wall thickness or percent wall thickening from the 3 regions. Histologic analysis of myocardial tissue in 3 patients revealed interstitial and replacement fibrosis. Adults with nonrestrictive ventricular septal defects exhibit alterations in tissue-acoustic properties detectable by integrated backscatter imaging despite preserved systolic function and wall thickening.
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Affiliation(s)
- W E Hopkins
- Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri 63110
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Saha A, Balakrishnan KG, Jaiswal PK, Venkitachalam CG, Tharakan J, Titus T, Kutty R. Prognosis for patients with Eisenmenger syndrome of various aetiology. Int J Cardiol 1994; 45:199-207. [PMID: 7960265 DOI: 10.1016/0167-5273(94)90166-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The objective of this study was to determine the long-term survival pattern and variables affecting long-term survival and complications occurring during follow-up of patients with Eisenmenger syndrome. A retrospective study of patients diagnosed with Eisenmenger syndrome were followed up. A tertiary care centre was used and it provided superspeciality services in various disciplines. The subjects included 201 patients with Eisenmenger syndrome--diagnosed by a combination of echocardiography and a peripheral arterial oxygen saturation study and/or cardiac catheterisation with or without angiocardiography--worked up and followed up for variable duration over a period of 16 years from 1976 to 1992. One hundred nine patients were females and 92 were males--age of presentation varied from 3 months to 62 years (mean +/- standard deviation 19.23 +/- 12.62 years). A total of 12 different anatomic lesions were seen--the most common three being ventricular septal defect (33.33%), aterial septal defect (29.85%), and patent ductus arteriosus (14.23%). History, physical examination, chest skiagram and electrocardiogram established only the presence of pulmonary arterial hypertension except where differential cyanosis indicating ductus was discernible or the degree of splitting of second heart sound provided some clue to the level of shunt. Contrast echocardiography, completed in 25.4% established the level of shunt in all patients. In others the diagnosis was confirmed by cardiac catheterisation. Twenty patients died during a mean follow-up period of 54.6 +/- 54.47 months. Sudden cardiac deaths (30%), congestive heart failure (25%) and haemoptysis (15%) were the most predominant causes of death. Only one patient died during puerperium.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Saha
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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Wessel DL, Adatia I, Giglia TM, Thompson JE, Kulik TJ. Use of inhaled nitric oxide and acetylcholine in the evaluation of pulmonary hypertension and endothelial function after cardiopulmonary bypass. Circulation 1993; 88:2128-38. [PMID: 8222107 DOI: 10.1161/01.cir.88.5.2128] [Citation(s) in RCA: 287] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Increased pulmonary vascular resistance is common in congenital heart disease and is exacerbated by cardiopulmonary bypass (CPB). We investigated whether CPB is responsible for pulmonary endothelial dysfunction and contributes to postoperative pulmonary hypertension. METHODS AND RESULTS We infused the endothelium-dependent vasodilator acetylcholine (ACH) into the pulmonary circulation of pulmonary hypertensive children with congenital heart disease either before (n = 12) or after (n = 22) surgical repair on CPB. The dose response to ACH (10(-9) to 10(-6) M) was recorded for all hemodynamic variables. Nine additional postoperative patients were studied with ACH followed by inhalation of 80 ppm nitric oxide, an endothelium-independent smooth muscle relaxant. Plasma levels of cyclic GMP (cGMP) were measured before and after ACH and nitric oxide administration. Pulmonary vasodilation with 10(-6) M ACH was seen in all preoperative patients but was markedly attenuated in postoperative patients. Baseline pulmonary vascular resistance (5.6 +/- 1.0 U x m2) fell 46 +/- 5% in preoperative patients but declined only 11 +/- 4% from baseline (5.8 +/- 0.9 U x m2) in postoperative patients (P < .002). However, inhalation of 80 ppm nitric oxide after ACH infusion in postoperative patients lowered pulmonary vascular resistance by 33 +/- 4% (P < .0002 compared with postoperative ACH response) with minimal effects on the systemic circulation. This finding suggests that the capacity for smooth muscle relaxation and pulmonary vasodilation was present in postoperative patients but could not be induced by ACH. Plasma levels of cGMP in postoperative patients were unchanged after acetylcholine infusion but rose more than threefold during pulmonary vasodilation with nitric oxide (P < .0001). This finding is consistent with the purported role of cGMP as the second messenger effecting smooth muscle relaxation in this process. CONCLUSIONS CPB may be responsible for postoperative dysfunction of the pulmonary endothelial cell and may contribute to postoperative pulmonary hypertension in children. Inhaled nitric oxide is a potent pulmonary vasodilator after CPB with minimal systemic circulatory effects. It may have important diagnostic and therapeutic applications in patients with congenital heart disease.
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Affiliation(s)
- D L Wessel
- Department of Cardiology, Children's Hospital, Boston, MA 02115
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159
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Hopkins WE, Waggoner AD. Right and left ventricular area and function determined by two-dimensional echocardiography in adults with the Eisenmenger syndrome from a variety of congenital anomalies. Am J Cardiol 1993; 72:90-4. [PMID: 8517436 DOI: 10.1016/0002-9149(93)90225-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The Eisenmenger syndrome has been associated with right ventricular (RV) enlargement and systolic dysfunction. However, little attention has been directed toward potentially characteristic changes in left ventricular (LV) dimensions or function. Therefore, 2-dimensional echocardiography (short-axis-papillary muscle level) was performed in 24 adults (mean age 33 +/- 7 years) with Eisenmenger syndrome to evaluate RV and LV size and function. A significant correlation was found between RV and LV end-diastolic areas (r = 0.96; regression slope 1.06), and fractional area change (r = 0.88; regression slope 1.03) in patients with a nonrestrictive ventricular septal defect (VSD) (n = 15). In contrast, in patients with Eisenmenger syndrome but no VSD (n = 9), RV and LV end-diastolic areas (r = 0.68; regression slope 0.10), and fractional area change (r = 0.08; regression slope -0.09) were discordant. RV function was preserved in most patients with a VSD, and mean RV fractional area change was significantly greater than in those without a VSD (0.50 +/- 0.13 vs 0.18 +/- 0.08; p < 0.001). No significant difference was apparent in these 2 groups (patients with and without a VSD) with respect to age, pulmonary artery systolic pressure, partial arterial oxygen pressure or hematocrit. Thus, the results indicate a relation between biventricular chamber dimensions and systolic function that is dependent on the nature and locus of the primary intracardiac defect responsible for the Eisenmenger syndrome.
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Affiliation(s)
- W E Hopkins
- Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri 63110
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Schamroth CL, Sareli P, Pocock WA, Davidoff R, King J, Reinach GS, Barlow JB. Pulmonary arterial thrombosis in secundum atrial septal defect. Am J Cardiol 1987; 60:1152-6. [PMID: 3687745 DOI: 10.1016/0002-9149(87)90409-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Nineteen adolescent or adult patients with secundum atrial septal defect (ASD) underwent pulmonary arteriography to evaluate the presence of proximal pulmonary arterial (PA) thrombosis. This procedure demonstrated proximal PA thrombosis in 8 patients (group 2). These patients had a distinctive hemodynamic profile, consisting primarily of significant PA hypertension. None of the 11 patients with normal angiograms (group 1) had severe PA hypertension (p less than 0.0001). Proximal PA thrombosis appears to be the major factor in the development and progression of PA hypertension in adult patients with ostium secundum ASD. Pulmonary angiography should be undertaken in all adult patients with ostium secundum ASD who have at least moderate PA hypertension. Long-term anticoagulation is advocated for patients with PA thrombosis irrespective of a decision for surgical intervention.
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Okubo S, Nakai M, Tomino T. Relevance of location of defect and pulmonary vascular resistance to the intracardiac pattern of left-to-right shunt flow in dogs with experimental ventricular septal defect. Circulation 1986; 73:775-83. [PMID: 3948374 DOI: 10.1161/01.cir.73.4.775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Left-to-right (L-R) shunting across a ventricular septal defect (VSD) often involves a direct VSD-pulmonary arterial component (jet) that surges from the VSD immediately into the pulmonary artery. We used the thermodilution technique in dogs with acute experimental VSD to quantify this component. In dogs with supracristal VSD (n = 7), the direct component represented 76 +/- 4% (mean +/- SE) of the total L-R shunt on average, vs 39 +/- 7% (p less than .001) of the total in dogs with infracristal VSD and the same level of L-R shunting (n = 6). The direct component can be expected to impose additional hyperkinetic forces on the pulmonary artery since it is driven by the left ventricular pressure. Although not yet clinically proven, we speculate therefore that patients with supracristal VSD may be at greater risk of becoming jeopardized by late-onset pulmonary vascular obstructive disease. Since a part of the total shunt other than the direct component dropped into the right ventricle, the right ventricle bore only 24% of the total shunt in supracristal VSD, but 61% in infracristal VSD. We also found that the amount of direct component was decreased, and therefore another part must have increased, as the pulmonary vascular resistance was artificially raised. As a second speculation, therefore, we suggest that patients with supracristal VSD may have less enlargement of the right ventricle than those with infracristal VSD before pulmonary hypertension develops.
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163
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 42-1985. A 61-year-old man with worsening dyspnea and evidence of pulmonary hypertension. N Engl J Med 1985; 313:1003-12. [PMID: 4047097 DOI: 10.1056/nejm198510173131607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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164
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Dawkins KD, Jamieson SW, Hunt SA, Baldwin JC, Burke CM, Morris A, Billingham ME, Theodore J, Oyer PE, Stinson EB. Long-term results, hemodynamics, and complications after combined heart and lung transplantation. Circulation 1985; 71:919-26. [PMID: 3921277 DOI: 10.1161/01.cir.71.5.919] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
During the first 31/2 years of the Stanford heart-lung transplant program, 23 transplants have been carried out in 22 patients with severe pulmonary vascular disease. Actuarial survival curves predict 1 and 2 year survival rates of 71% and 57%, respectively, for all patients. As a result of increasing experience, the early mortality of 26% has been reduced, with only one early death occurring in the last eight patients; prior cardiac surgery was a contributing factor in three of the six patients suffering early deaths. Two late deaths occurred in the series 14 and 15 months after operation. One patient died suddenly as a result of an acute myocardial infarct and the other patient died because of respiratory failure. At autopsy, both patients had severe proliferative coronary atherosclerosis with obliterative bronchiolitis affecting the lungs. An additional patient required a retransplant for obliterative bronchiolitis 37 months after the initial procedure, and he too was found to have severe coronary artery disease. Hemodynamics and left ventricular function were normal in patients studied 1 and 2 years after undergoing the transplantation procedure. Thus, the early mortality and morbidity of combined heart and lung transplantation has been significantly reduced, but the long-term complications, particularly graft atherosclerosis and obliterative bronchiolitis, are yet to be fully controlled.
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165
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Cohen BA, Gale JT, Mendelson DS, Mitty HA. Computer tomography demonstration of pulmonary artery calcification in Eisenmenger's syndrome. THE JOURNAL OF COMPUTED TOMOGRAPHY 1985; 9:153-6. [PMID: 3987335 DOI: 10.1016/0149-936x(85)90012-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerotic change and pulmonary artery calcification is known to occur in patients with pulmonary artery hypertension. We present such a patient with Eisenmenger's syndrome. Computed tomography demonstrated atheromatous plaques and calcification of the pulmonary arteries.
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166
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Cherian G, Uthaman CB, Durairaj M, Sukumar IP, Krishnaswami S, Jairaj PS, John S, Krishnaswami H, Bhaktaviziam A. Pulmonary hypertension in isolated secundum atrial septal defect: high frequency in young patients. Am Heart J 1983; 105:952-7. [PMID: 6858843 DOI: 10.1016/0002-8703(83)90396-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Out of 709 consecutive patients with isolated secundum atrial septal defect, the pulmonary artery systolic pressure was greater than 50 mm Hg in 118 patients (17%). Pulmonary hypertension was present in 13% of patients under 10 years and in 14% aged 11 to 20 years. The Eisenmenger reaction was present in 9% of the 709 patients. The frequency of the Eisenmenger reaction was high in young patients and was not significantly different in patients in the first and second decades as compared to older patients. None of our patients with pulmonary hypertension resided at high altitude. The high frequency of pulmonary hypertension in our young patients cannot be satisfactorily explained. Autopsy studies suggest that in some, pulmonary hypertension is due to the persistence of the fetal pulmonary vascular pattern.
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167
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Gould L, Gopalaswamy C. Late survival of a patient with ventricular septal defect and Eisenmenger syndrome. Angiology 1982; 33:769-75. [PMID: 7181169 DOI: 10.1177/000331978203301201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A case of a 57 year old female with a large ventricular septal defect and delayed onset of Eisenmenger syndrome is presented. Possible explanations for the delayed onset of the Eisenmenger syndrome are discussed.
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168
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Abstract
The younger the patient with a large left to right shunt at the time of operation, the greater the likelihood that pulmonary vascular resistance will fall to normal thereafter. In older patients, the degree to which the pulmonary vascular resistance is elevated before operation is a critical factor determining operability and prognosis. Patients at particularly high risk for the development of significant pulmonary vascular obstruction early in life are those with certain forms of cyanotic congenital heart disease, such as complete transposition of the great arteries with ventricular septal defect and patent ductus arteriosus, and truncus arteriosus. Other conditions in which pulmonary vascular obstruction appears to progress rapidly include large ventricular septal defect, complete atrioventricular canal defect and left to right shunt lesions in an environment of high altitude or associated with unilateral pulmonary arterial absence of the Down's syndrome. In this report the framework is reviewed for recognizing that important pre- and postnatal modifiers of the pulmonary vascular bed may be lesion-dependent. Thus, the growth and development of the pulmonary vascular bed during fetal and early postnatal life, as well as the morphologic alterations described in detail by Heath and Edwards, are likely to determine the ultimate intensity and magnitude of pulmonary vascular obstruction. Commentary is also provided concerning the management of patients with high pulmonary vascular resistance during pregnancy and delivery, their response to exercise, and the possibility of medical treatment designed to reduce pulmonary vascular resistance, and perhaps prolong life and enhance its quality.
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169
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Tandon R. Caring for patients with congenital heart disease. Indian J Pediatr 1982; 49:237-8. [PMID: 7129574 DOI: 10.1007/bf02830758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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170
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Olerud JE, Robertson HT, Hossack KF, Nelp WB, Odland GF, Bowman WD, Finch CA. A patient with polycythemia. West J Med 1981; 135:375-82. [PMID: 7340131 PMCID: PMC1273256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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171
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Krovetz LJ. Eisenmenger's syndrome in pregnancy. N Engl J Med 1981; 305:588. [PMID: 7254264 DOI: 10.1056/nejm198109033051024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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172
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Weber RK, Buda AJ, Levene DL. General anesthesia in Eisenmenger's syndrome. CANADIAN MEDICAL ASSOCIATION JOURNAL 1977; 117:1413-4. [PMID: 589542 PMCID: PMC1880420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The anesthetic management of a woman with Eisenmenger's syndrome undergoing abdominal hysterectomy with general anesthesia is described. Proper anesthetic management of patients with this syndrome depends on a knowledge of the pathophysiologic process and associated complications. The potential problems of systemic hypotension, pulmonary embolism and infective endocarditis are outlined. Sudden death is a common and pregnancy is a major hazard.
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173
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Bernhard WF, Dick M, Sloss LJ, Castaneda AR, Nadas AS. The palliative Mustard operation for double outlet right ventricle or transposition of the great arteries associated with ventricular septal defect, pulmonary arterial hypertension, and pulmonary vascular obstructive disease. A report of eight patients. Circulation 1976; 54:810-7. [PMID: 61824 DOI: 10.1161/01.cir.54.5.810] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Five patients with double outlet right ventricle, ventricular septal defect, pulmonary arterial hypertension and pulmonary vascular obstructive disease and three patients with complete d-transposition of the great arteries, ventricular septal defect, pulonary arterial hypertension and pulmonary vascular obstructive disease underwent an elective Mustard baffle operation. The ventricular septal defect was not closed. A large patent ductus arteriosus was divided in three patients. Seven of the eight patients are alive five to 32 months after surgery; one patient died 11 months after surgery. Cyanosis, dyspnea on exertion, and exercise limitation improved initially in all and has persisted in the survivors. In pre and postoperative hemodynamic studies in four patients, systemic arterial oxygen saturation and effective pulmonary blood flow increased from mean values of 70% to 90% and 1.7/min/m2 to 3.3 L/mon/m2, respectively. Absolute systemic and pulmonary flows, and pressures and resistances, were not significantly altered. Criteria for selection of patients with transposition of the great arteries of double outlet right ventricle who would benefit from a palliative Mustard procedure (Mustard atrial baffle without closure of the ventricular spetal defect) are: 1) severe symptoms; 2) pulmonary arteiral hypertension (75% systemic) with pulmonary vascular obstructive disease; and 3) pulmonary artieral oxygen saturation greater than systemic (ascending aorta) arterial oxygen saturation by approximately 10%.
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174
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175
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Mcllroy MB. Commentary. Am J Cardiol 1972. [DOI: 10.1016/0002-9149(72)90202-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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176
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Davies H. Commentary. Am J Cardiol 1972. [DOI: 10.1016/0002-9149(72)90205-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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179
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Tikoff G, Echegaray HM, Schmidt AM, Kuida H. Patent ductus arteriosus complicated by heart failure. Classification based on clinical and serial hemodynamic studies. Am J Med 1969; 46:43-51. [PMID: 4951425 DOI: 10.1016/0002-9343(69)90056-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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182
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Oakley CM, Goodwin JF. The current status of pulmonary embolism and pulmonary vascular disease in relation to pulmonary hypertension. Prog Cardiovasc Dis 1967; 9:495-521. [PMID: 6046731 DOI: 10.1016/s0033-0620(67)80007-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Somerville J. Clinical assessment of the function of the mitral valve in atrioventricular defects related to the anatomy. Am Heart J 1966; 71:701-11. [PMID: 5935863 DOI: 10.1016/0002-8703(66)90323-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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186
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187
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Farrar JF, Blomfield J, Reye RD. The structure and composition of the pulmonary circulation in congenital heart disease. THE JOURNAL OF PATHOLOGY AND BACTERIOLOGY 1965; 90:97-105. [PMID: 5843962 DOI: 10.1002/path.1700900110] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Abstract
It is now possible to synthesize the natural history of ventricular septal defect. Size is fundamental, and stemming from it, the smaller defects (groups 1 and 2) separate from the larger (groups 3, 4, and 5) immediately at birth. Apparent size may differ from real size, for defects may become partially closed by tricuspid valve leaflets, or be gradually obstructed by an enlarging aneurysm of the sinus of Valsalva. One instance has been observed in which a muscular defect was obstructed by a large papillary muscle. The reverse may also occur, i.e., a partially obstructed defect may enlarge as a blocking tricuspid leaflet detaches or tears.
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190
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WILLIAMS TC. PERSISTENCE OF THE FOETAL TYPE OF PULMONARY ARTERY STRUCTURE IN THE SINUS VENOSUS DEFECT. BRITISH HEART JOURNAL 1964; 26:437-40. [PMID: 14156093 PMCID: PMC1018159 DOI: 10.1136/hrt.26.3.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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191
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192
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LANSING AM. THE DIFFERENTIAL DIAGNOSIS OF CONGENITAL HEART DISEASE. Pediatr Clin North Am 1964; 11:107-38. [PMID: 14119652 DOI: 10.1016/s0031-3955(16)31517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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193
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DOWNING SE, VIDONE RA, BRANDT HM, LIEBOW AA. THE PATHOGENESIS OF VASCULAR LESIONS IN EXPERIMENTAL HYPERKINETIC PULMONARY HYPERTENSION. THE AMERICAN JOURNAL OF PATHOLOGY 1963; 43:739-65. [PMID: 14075012 PMCID: PMC1949772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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194
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ROSENBLUM R. A Classification of congenital heart disease. Am J Cardiol 1963; 12:126-8. [PMID: 14042515 DOI: 10.1016/0002-9149(63)90164-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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195
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SAMET P, BERNSTEIN WH, FERNANDEZ L, DE VICTORIA W. The effect of intracardiac acetylcholine infusion upon right heart dynamics in patients with rheumatic heart disease studied at rest. Am J Cardiol 1962; 9:32-42. [PMID: 14496597 DOI: 10.1016/0002-9149(62)90095-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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LYNFIELD J, GASUL BM, ARCILLA R, LUAN LL. The natural history of ventricular septal defects in infancy and childhood, based on serial cardiac catheterization studies. Am J Med 1961; 30:357-71. [PMID: 13764566 DOI: 10.1016/0002-9343(61)90046-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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