| 1. |
- Hanséus, Katarina, et al.
(författare)
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Analysis of atrioventricular plane movements by Doppler tissue imaging and m-mode in children with atrial septal defects before and after surgical and device closure.
- 2002
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Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 23:2, s. 152-159
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Tidskriftsartikel (refereegranskat)abstract
- Our objective was to compare the effects of surgical and device closure of atrial septal defects (ASDs) on atrioventricular plane function. In healthy individuals, both short- and long-axis motion contribute to ventricular pump function. Short-axis function (i.e., the amplitude and velocity of atrioventricular plane movements) may be evaluated by M-mode and Doppler tissue imaging. The study group consisted of 19 children with ASD of the secundum type before and after surgical (n = 12) or device (n = 7) closure and 10 healthy controls. Surgical and device closures were uncomplicated and all defects were completely closed. Registrations of atrioventricular plane systolic and diastolic amplitude and velocity were made from the tricuspid and the mitral annulus and from the septum in the apical four-chamber view. Comparisons were made between examinations before and after closure, between the two subgroups of patients treated by surgical and device closure, respectively, and between the patient group and the control groups. Before ASD closure, all measurements were normal or near normal. After surgery, systolic amplitudes and velocities of the tricuspid annulus and in the septum decreased significantly, whereas no changes were seen in the device group. Less marked changes were seen in diastolic measurements. However, in the surgical group significant decrease to subnormal values were found in the tricuspid annulus and in the septum, which may indicate a decreased diastolic function postoperatively. Mitral valve annulus amplitude and velocity were not affected by the treatment. Atrioventricular function is normal in children with right ventricular volume overload. The decrease to subnormal values after open-heart surgery is not seen after device closure of the ASD, indicating that surgery affects right ventricular function.
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| 2. |
- Hellström-Westas, Lena, et al.
(författare)
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Long-distance transports of newborn infants with congenital heart disease
- 2001
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Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 22:5, s. 380-384
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Tidskriftsartikel (refereegranskat)abstract
- Little has been published about specific problems that may occur during long-distance transports of newborn cardiac patients. During a 4-year period after centralization of pediatric heart surgery in Sweden, 286 transports were prospectively investigated. A majority (77.3%) of the transports were carried out by nonspecialized teams. Ten severe adverse events, including the death of 1 infant, occurred during the 286 transports (3.5%). Another infant died later of cerebral complications from hypoxia, rendering a transport-related mortality of 0.7%. Twenty-two infants (7.7%) were severely hypoxic (oxygen saturation < or =65%) at arrival, and 12 of these infants suffered from transposition of the great arteries. During the second 2-year period increased use of intravenous prostaglandin E1 and transportation from tertiary-level units was associated with better transport outcome. During the same time period, overall 30-day postoperative mortality for pediatric cardiac surgery decreased from 4.0% to 1.2% in our hospital. When highly specialized treatment is centralized for quality reasons it is also important that risks associated with transport are considered and that the quality of transport is high. For some cardiac malformations antenatal diagnosis and referral of the mother for delivery to a center with pediatric cardiac surgery would probably further increase the chance of healthy survival in some infants.
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| 3. |
- Holmqvist, Catarina, et al.
(författare)
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Collateral flow in coarctation of the aorta with magnetic resonance velocity mapping: correlation to morphological imaging of collateral vessels.
- 2002
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley. - 1522-2586 .- 1053-1807. ; 15:1, s. 39-46
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To correlate quantification of collateral flow in aortic coarctation with the morphological visualization of the collateral vessels and to compare different approaches to measurement of collateral flow. MATERIALS AND METHODS: Thirteen children with coarctation were examined with T1-weighted spin-echo (T1-W SE) imaging and 3D contrast-enhanced magnetic resonance angiography (MRA). MR velocity mapping was performed at four levels in the descending aorta. RESULTS: The flow immediately above and below the coarctation did not differ significantly. Measuring within the coarctation resulted in flow overestimation. The increase of flow from proximal to distal aorta was 12 +/- 21% in patients with no or uncertain collaterals and 69 +/- 55% in patients with pronounced collaterals. Spin-echo images and MRA were comparable in visualizing collateral vessels. The visual estimation of collaterals correlated reasonably well with flow quantification MR velocity mapping. CONCLUSION: Collateral flow assessment with MR velocity mapping is an accurate technique for evaluating the hemodynamic importance of a coarctation and is recommended if abundant collaterals are not visualized with spin echo or MRA.
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