Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
24 巻, 4 号
選択された号の論文の20件中1~20を表示しています
  • Angiographic Correlation with the Severity of Coronary Artery Disease
    Lorenzo DECAPRIO, Sergio CUOMO, Carlo VIGORITO, Anna GIUNTA, Massimo R ...
    1983 年 24 巻 4 号 p. 489-502
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    We correlated the incidence and degree of exercise induced ventricular arrhythmias (EIVA) with the angiographic severity of coronary artery disease (CAD) in 162 patients with a history of stable effort angina, all showing a positive exercise stress test for myocardial ischemia and a≥70% stenosis of a major coronary artery. Patients were grouped according to the following criteria: presence of electrocardiographic evidence of old transmural myocardial infarction (MI), number of significant coronary stenoses and number of left ventricular (LV) areas showing abnormal segmental wall motion (ASWM).
    The incidence of EIVA in patients with multivessel CAD was higher than in patients with single vessel CAD, but this difference was not statistically significant. The number of LV areas with ASWM was better correlated with the frequency of EIVA, which was 20.0% in patients with normal LV wall motion, 31.2% in patients with 1 area of ASWM, 54.0% in patients with 2 areas of ASWM (p<0.005 vs normal LV wall motion), 74.1% in patients with 3 or more areas of ASWM (p<0.001 vs normal LV wall motion and 1 area of ASWM), and 81.8% in patients with LV aneurysm (p<0.001 vs normal LV wall motion and 1 area of ASWM, p<0.005 vs 2 areas of ASWM). Patients with old MI showed a significantly higher incidence of EIVA than those without MI (p<0.001), but this difference was due to the more severe LV asynergy in the MI group.
    In conclusion, our results show that, in a selected population of patients with CAD, the incidence of EIVA correlates better with the extent of LV segmental wall motion abnormalities than with the number of diseased coronary arteries or the presence of an old transmural MI.
  • Keizo FURUKAWA, Kazuo NISHIDA, Chihiro YAMADA, Shunpei NIKI, Hiroki SU ...
    1983 年 24 巻 4 号 p. 503-514
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    To investigate left ventricular size and performance during graded submaximal exercise, 14 normal subjects with a mean age of 21 years exercised in a supine position to achieve the target heart rate. Using two-dimensional echocardiography, we recorded and analysed the left ventricular (LV) cross-sectional area and internal dimension at the level of the tips of the mitral valve at rest and during mild, moderate and severe exercise. The heart rate and systolic blood pressure increased substantially from rest to peak exercise (71±11 to 162±10 beats/min, 122±10 to 204±22mmHg). The end-diastolic cross-sectional area and internal dimension (EDA & EDD) increased by 1.1-2.2cm2 (7-13%) and 0.2-0.3cm (4-7%), respectively, from mild to moderate exercise, (p<0.05-0.001). At peak exercise, however, these decreased and showed no statistically significant difference from the values at rest. The end-systolic cross-sectional area and internal dimension (ESA & ESD) decreased by 1.1 to 1.6cm2 (14-20%) and 0.2-0.3cm (7-10%), respectively, from moderate to severe exercise (p<0.01-0.001). However, the end-systolic values during mild exercise were not significantly different from those at rest. The stroke area (EDA-ESA) and dimension (EDD-ESD) increased by 1.6-2.6cm2 (19-31%) and 0.2-0.6cm (25-38%), respectively, during all levels of graded exercise (p<0.05-0.001). The percent change of LV cross-sectional area and internal dimension during systole increased gradually from rest to moderate exercise (51.0±7.1 to 61.9±4.4%, 35.4±3.9 to 45.0±3.7%), respectively, and showed no further increase during peak exercise. The mean circumferential fiber shortening velocity increased sharply from rest to peak exercise (1.27±0.14 to 2.25±0.21circ/sec).
    These results suggest that the Frank-Starling mechanism operates during mild to moderate exercise, and contractility increases markedly at moderate to severe exercise levels as cardiac performance is augmented during graded submaximal exercise.
  • Observations during the Early Stage of AMI
    Yoshihiko SEINO
    1983 年 24 巻 4 号 p. 515-528
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    Since little is known concerning the effect of different types of cardiac dysfunction on the peripheral circulation in acute myocardial infarction, cardiac and peripheral circulatory hemodynamics were measured simultaneously and sequentially in the Coronary Care Unit in 40 patients with acute myocardial infarction (AMI) using a Swan-Ganz catheter and venous occlusion plethysmography.
    Patients were classified by clinical assessment (Killip) and into four hemodynamic subsets (HS) according to pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) measures obtained by invasive central hemodynamic monitoring (Forrester): uncomplicated AMI, HS-I (PCWP≤18mmHg, CI>2.2L/min/m2) 15; pulmonary congestion, HS-II (PCWP>18mmHg, CI>2.2L/min/m2) 15; peripheral hypoperfusion, HS-III (PCWP≤18mmHg, CI≤2.2L/min/m2) 4; cardiogenic shock, HS-IV (PCWP>18mmHg, CI≤2.2L/min/m2) 6.
    Measurements taken within 48 hours after the onset of AMI showed significantly lower calf blood flow (p<0.05) and calf venous capacitance (p<0.01) and higher calf vascular resistance (p<0.05) in all AMI classifications compared to 10 normal subjects.
    In uncomplicated AMI group (Killip I and HS-I) calf blood flow and venous capacitance were significantly reduced while calf vascular resistance remained unchanged from normal. In AMI complicated by pulmonary congestion (Killip II and HS-II), in addition to reduced calf venous capacitance, calf blood flow was further significantly reduced (p<0.05) due, in part, to a rise in calf vascular resistance (p<0.05). In AMI complicated by severe heart failure and shock (Killip III, VI and HS-IV), mean changes in the periphery were not statistically different from those seen in patients with pulmonary congestion alone. In patients with AMI complicated by poor peripheral perfusion (HS-III), the peripheral changes did not show significant differences from those seen in uncomplicated AMI (HS-I).
    Significant correlations were found between calf blood flow and PCWP (r=-0.37, p<0.05) and CVP (r=-0.31, p<0.05); calf vascular resistance and PCWP (r=+0.36, p<0.05) and systemic vascular resistance (r=+0.43, p<0.01).
    Sequential daily peripheral hemodynamic changes in 14 H-I patients not requiring specific therapy showed that calf blood flow took 5 days, calf vascular resistance 3 days and calf venous capacitance 7 days to return to within normal levels.
    Our results show that 1) resistance vessel constriction is greater with higher PCWP and CVP, 2) maximum constriction of capacitance vessels occurs even in the absence of forward or backward failure, and 3) the constriction of capacitance vessels is more prolonged than that of resistance vessels in uncomplicated AMI.
  • Ying-Shiung LEE, Fan-Yu LEE, Ar-Huey LU, Chau-Hsiung CHANG, Hsiu-Chin ...
    1983 年 24 巻 4 号 p. 529-538
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    Biochemical analyses and electron microscopy of mitral valve collagen were carried out in 29 patients with various mitral valve diseases. They were divided into 3 groups: (1) rheumatic heart disease (15 patients), (2) isolated rupture of chordae tendineae (8 patients), and (3) floppy mitral valve (6 patients). Normal mitral valves obtained at necropsy from 6 patients who died from extracardiac causes were used for control observations. Results of the electrophoretic analysis of the collagen of normal and diseased valves showed that all valves contained collagen types I, III, and AB collagen with similar electrophoretic patterns. Electron microscopic observations and comparisons of the segment-long-spacing crystallites of each type of collagen revealed similar band patterns, irrespective of the normal or diseased valves sources. It is concluded that the composition and primary molecular structure of mitral valve collagen are usually not altered in a wide variety of disease processes affecting the mitral valve.
  • Koon Ong LIM, Derek R. BOUGHNER, D. Garth PERKINS
    1983 年 24 巻 4 号 p. 539-548
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The ultrastructure and mechanical properties of chordae from a surgically removed myxomatous tricuspid valve were examined. Transmission and scanning electron microscopy showed the internal structure of the abnormal chordae to consist of a loose and relatively sparse network of disorganized collagen fibrils, with no well defined collagen bundles present. The abnormal tissue was found to be more extensible than normal and it ruptured at a stress that was only about 6% of the breaking stress for normal chordae. Chordal rupture, a common complication in this disorder, can be attributed to this decrease in chordal strength. At high strains, a decreased elastic modulus was also observed, which may be attributed to tissue changes and an alteration in collagen fibril structure and/or composition.
  • An Immunologic and Autopsy Study
    P. CHOPRA, R.K. DATTA, A. DASGUPTA, S. BHARGAVA
    1983 年 24 巻 4 号 p. 549-556
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    Large segments of the aorta and its major branches were found to be diseased in 14 autopsied cases of aortoarteritis. Both renal arteries and the left subclavian artery were frequently affected. Superior vena cava thrombosis and thickening of the inferior vena cava were noted in one case each. Tuberculosis was present as small foci in only 3 of the 14 cases.
    Angiographic evaluation also revealed thickening and narrowing of diseased segments. The descending thoracic and abdominal aorta and renal arteries were frequently involved. Aneurysmal lesions were infrequent.
    Antiaorta antibodies were investigated using 4 different parameters. None of our cases showed their presence. The role of tuberculosis and/or autoimmunity appears unlikely in the etiopathogenesis of aortitis.
  • Carlo LONGHINI, Tiziano TOSELLI, Guido MASOTTI, Enrico BELLOTTI, Lucia ...
    1983 年 24 巻 4 号 p. 557-561
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The fast Fourier transform (FFT) was employed to analyze the frequency spectra of the second heart sound in 19 healthy subjects. The data obtained show that the second heart sound is mainly composed of low-frequency vibrations, and that the frequency vs. amplitude spectra for the various filters do not exceed 150Hz. The different spectra obtained can represent a useful reference to compare with pathological acoustical findings.
  • A Cause of Silent Mitral Stenosis
    Abdolhamid SHEIKHZADEH, Homayoon MOGHBELI, Parviz GHABUSSI, Siavosh TA ...
    1983 年 24 巻 4 号 p. 563-570
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The diastolic rumbling murmur of mitral stenosis (MS) may be attenuated in the presence of low cardiac output, right ventricular enlargement, Lutembacher's syndrome, pulmonary emphysema, and obesity. In this report we would like to stress that the presence of tricuspid stenosis (TS) is an additional significant cause of silent MS.
    The clinical material consisted of 73 patients with rheumatic TS who had undergone cardiac surgery. Five of these cases had clinical findings of TS without auscultatory findings of MS. They were found to have severe MS at the time of operation and to require mitral valve surgery. At cardiac catheterization the mean diastolic gradient (MDG) across the mitral valve (MV) was less than 3mmHg and pulmonary arterial systolic pressure was 29-42mmHg. The MDG across the tricuspid valve was 6-17mmHg.
    In conclusion, TS can mask clinical and hemodynamic findings of MS. The reason for this is the mechanical barrier imposed by TS proximal to the MV.
  • An Ultrastructural Study
    P. CHOPRA, V.K. SHARMA
    1983 年 24 巻 4 号 p. 571-580
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    Electron microscopic observations of 4 excised cardiac myxomas were made. All were present in the left atrium and all but one had a stalk. The hearts were otherwise normal. Several types of mesenchymal cells in varying stages of differentiation were identified. Cells having some features of smooth muscle, fibroblasts, and endothelium were observed. Some cells having features of both smooth muscle and fibroblasts namely, myofibroblasts were also encountered. Macrophages, lymphocytes and plasma cells were also seen in small numbers. Hematopoietic foci and calcification were not seen in any of our cases. Ultrastructurally, fine electron dense granules and only stray collagen fibres were noted in the matrix.
    Myxomas possibly represent either hyperplasia or a true neoplasm of the subendocardial multipotential cells that are capable of differentiating into various types of mesenchymal elements.
  • Veena RAIZADA, Jonathan ABRAMS, Neale D. SMITH, Kenneth B. DESSER, Alb ...
    1983 年 24 巻 4 号 p. 581-586
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The phonocardiographic characteristics of the porcine bioprosthesis in the aortic position were evaluated in 24 asymptomatic patients. A medium to high frequency early systolic sound (AO) was present in 16 of 24 patients; abrupt "halting" of the stiff cusps of the porcine bioprosthesis during early left ventricular ejection seems to be the likely mechanism for the genesis of this sound. An unusually high amplitude aortic closing sound (AC) was present in all patients. A high frequency crescendo-decrescendo systolic murmur in early to mid systole was present in 22 patients. Possible mechanisms for the systolic murmur include: 1) altered resonating properties of the cusps, 2) functional bioprosthetic stenosis, and 3) the presence of a flexible stent.
    An early systolic opening sound preceding a short systolic murmur and a loud closing sound are common phonocardiographic findings of an uncomplicated porcine bioprosthesis in the aortic position. Therefore, absence of the aortic opening sound, alterations in the amplitude of the aortic closing sound, or an increase in the length of the systolic murmur may suggest bioprosthetic malfunction.
  • Toshiro FUJITA, Hiroshi NODA
    1983 年 24 巻 4 号 p. 587-593
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    To evaluate the therapeutic efficacy of a new calcium antagonist, nicardipine in hypertension, the cardiovascular effects of chronic therapy were determined by echocardiography in 10 patients with uncomplicated mild to moderate hypertension. Significant declines were recorded in mean blood pressure (average; 11.7±0.8%) and total peripheral resistance (22.0±2.0%), accompanied by an increase in cardiac index (13.6±2.2%). In spite of the considerable degree of blood pressure reduction, heart rate and body weight were unchanged. The magnitude of the decline in total peripheral resistance was directly correlated to both the decrease in mean blood pressure (r=0.701, p<0.02) and the increase in cardiac index (r=-0.953, p<0.01). These findings suggest that the hypotensive effect of this new calcium antagonist is due to peripheral vasodilation, and it appears to represent an effective adjunct for the treatment of mild to moderate hypertension.
  • Naomi NAKAMURA, Yasufumi SASAI, Youichi TAKEYAMA, Takashi KATAGIRI
    1983 年 24 巻 4 号 p. 595-606
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    1. Alterations in the localization and the intensity of acid phosphatase activity were studied electron microscopically in acute ischemic myocardial cells in the dog, in relation to processes of cellular degradation.
    2. In normal myocardial cells, the acid phosphatase activity was concentrated in the terminal cisternae, the longitudinal elements and the subsarcolemmal cisternae of the sarcoplasmic reticulum and the primary lysosomes. Activity was moderate in the secondary lysosomes, residual bodies and Golgi apparatus.
    3. As early as 15min after coronary ligation the intensity of acid phosphatase activity increased in the enlarged lysosomes and the sarcoplasmic reticulum of the ischemic myocardial cells. Fine deposits of the reaction product were distributed in the sarcoplasm around lysosomes and the sarcoplasmic reticulum after 30min, and the activity began to decrease in lysosomes and in the sarcoplasmic reticulum. One to 3 hours after ligation, intramitochondrial dense deposits appeared, and the reaction product decreased both in lysosomes and the sarcoplasmic reticulum. The fine reaction product, which leaked from lysosomes and the sarcoplasmic reticulum, was scattered in the sarcoplasm and was accompanied by fine structural changes indicating cellular necrosis.
    4. From these findings it is strongly suggested that acid hydrolases in lysosomes and the sarcoplasmic reticulum are closely related to the necrotic process in ischemic myocardial cells.
  • Fatemeh REYHANI, Iraj NAZARIAN, Jami SHAKIBI
    1983 年 24 巻 4 号 p. 607-614
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    To investigate the teratogenic effects of influenza virus on cardiac development two strains of influenza virus (Ty/Calif/5142/66 and Ty/Calif/64/M. Meleagrium) were injected into the yolk sac of fertile white Leghorn eggs during stage 23. Eggs injected with normal saline served as controls. The number of live embryos was significantly reduced in eggs injected with the 5142 strain, whereas the Meleagrium strain did not affect the number of live embryos in a significant manner. Serial sections of the live embryo hearts, extracted during stage 35, showed no cardiac anomalies in control groups. However, cardiac malformations were increased significantly in the embryos infected with the influenza viruses. A comparison of the two viral strains showed that the 5142 strain produced significantly more abnormal hearts than the Meleagrium strain. We conclude that (1) influenza infection during critical stages of embryonic development can lead to the cardiac anomalies, and (2) the virulence of a viral strain has a significant bearing on its teratogenic potential, at least in chick embryo hearts.
  • Aortic Lesions Induced by a Serine Protease
    Shigenori MOROOKA
    1983 年 24 巻 4 号 p. 615-622
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The etiology of aortitis syndrome (Takayasu's arteritis) is unknown. This study was designed to show whether aortic and pulmonary artery lesions might be induced by a small dose of protease in the circulating blood of rabbits.
    Serum trypsin activity was increased transiently but significantly by an intravenous infusion of the enzyme at the rate of 1000 IU/min for 100min. The aortic wall was significantly thickened. Marked edema and focal tears were seen in the intima and media and a mild inflammatory reaction in the adventitia of rabbits sacrificed 2 weeks following trypsin infusion. The lesions were also present in rabbits sacrificed at 6 weeks. They were observed in 7 of 8 rabbits given the same dose of chymotrypsin-A4, but not in control rabbits infused with saline alone.
    The lesions were observed frequently in the ascending aorta and arch, but were rare in the descending aorta. The main pulmonary artery showed similar lesions in about half of the studied rabbits.
    These results show evidence that a diffuse lesion of the aorta and pulmonary artery may be induced by a small dose of serine protease in the circulating blood.
  • Masao ISHII, Atsuo GOTO, Kenjiro KIMURA, Yasunobu HIRATA, Minoru YAMAK ...
    1983 年 24 巻 4 号 p. 623-631
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The chronic effects of oral administration of an angiotensin converting enzyme inhibitor (captopril, 63-80mg/Kg/day) on blood pressure and the renin-angiotensin-aldosterone system were-studied in normotensive male Wistar rats. Blood pressure (BP), plasma renin activity (PRA), plasma renin concentration (PRC), plasma renin substrate concentration (PRS), plasma aldosterone concentration (PAC) and renal renin content (RRC) were measured after 2, 9, 19, 29 and 58 days of captopril administration. BP was determined in awake rats and blood samples were obtained by decapitation. In addition, BP responses to bolus injections of angiotensin I (AI, 80ng/Kg), angiotensin II (AII, 80ng/Kg) and bradykinin (BK, 10μg/Kg) were examined in conscious rats which had received captopril for 20 days. The BP of the rats which had been given captopril for 9 days or longer was significantly lower than that of the control rats. PRA and PRC were markedly increased, and both PRS and PAC were decreased in the captopriltreated rats. RRC, which was reduced after 2 days of captopril administration, was substantially increased thereafter. Although the pressor responses to AII were similar in the captopril treated and the control rats, the responses to AI were reduced to 50% of those to AII in the former. The depressor responses to BK in the captopril-treated rats were 2.3 times as large as those in the control rats. Our results show that long-term use of captopril lowers BP in normotensive rats on a normal sodium intake. They also suggest that the rises in PRA, PRC and RRC in the captopril-treated rats may be related to the effects of both the BP reduction and interruption of the negative feedback mechanism of All on renin release and synthesis, and that the decline in PRS is due to its increased consumption and probably also to the decreased rate of hepatic substrate synthesis induced by the fall in plasma AII.
  • Atsuo GOTO, Masao ISHII, Tadanao TAKEDA, Satoru MURAO
    1983 年 24 巻 4 号 p. 633-640
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The inhibition of renin release by angiotensin II (AII) is well documented. However, the interaction of this short loop feedback mechanism of AII with the sympathetic nervous system is still unclear. This study was designed to investigate the possible functional relationship between AII and the beta-adrenergic receptors with respect to renin release in vivo. First, the effect of propranolol on captopril-induced renin release was examined in conscious . rats. Secondly, the effect of AII on isoproterenol-induced renin release was determined. Captopril (1mg/Kg) increased plasma renin activity (PRA) from 1.6±0.3ng/ml/hr to 4.5±0.6ng/ml/hr (p<0.01). In contrast, there was no significant change in PRA in rats which received both captopril and propranolol (before 0.9±0.2ng/ml/hr, after 1.3±0.3ng/ml/hr). Thus, propranolol attenuated the increase in PRA caused by captopril.
    Isoproterenol infusion (0.1μg/Kg/min) provoked a significant increase in PRA (before 1.3±0.4ng/ml/hr, after 6.6±1.7ng/ml/hr, p<0.01). AII infusion in combination with isoproterenol also increased PRA from 1.6±0.4ng/ml/hr to 5.2±0.3ng/ml/hr (p<0.01). AII in this dose did not suppress isoproterenol-induced renin release. These results suggest that the beta-adrenergic receptor mediating renin release is functionally located distal to the AII receptor in the short loop mechanism controlling renin release.
  • Yasumi UCHIDA, Satoru MURAO
    1983 年 24 巻 4 号 p. 641-647
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    The effects of a stable prostaglandin I2 analogue, ZA 36374, on recurring reduction of blood flow in the partially constricted canine coronary artery were compared with those of prostaglandin I2. Intravenous bolus injections of 0.3μg/Kg ZK 36374 and 0.15μg/Kg prostaglandin I2 eliminated the recurring reductions. Intravenous infusion of 0.1μg/Kg/min ZK 36374 and 0.01μg/Kg/min prostaglandin I2 also eliminated the recurring reductions. The results indicate that although weaker than prostaglandin I2, ZK 36374 is effective in eliminating recurring reduction in coronary flow related to coronary vasospasm and/or thrombosis.
  • Miyoharu KOBAYASHI, Masahiro SHIMOTORI, Shigetoshi CHIBA
    1983 年 24 巻 4 号 p. 649-655
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    We studied the direct effects of digitalis on sinoatrial conduction time (SACT), atrial rate (AR) and developed tension (DT) in isolated atrial muscle, using an isolated dog atrial preparation perfused with heparinized blood from the carotid artery of an anesthetized donor dog.
    After digoxin or deslanoside (100μg or 200μg/Kg) was given intravenously to the donor dog, SACT, AR and DT of the isolated atrium were continuously measured. Following administration of 100μg/Kg of digoxin, an immediate sinus bradycardia followed by various kinds of ventricular arrhythmias was observed in the donor dog, and the DT of the isolated atrium was augmented without any effects on the SACT and AR in all 3 experiments. With 200μg/Kg of digoxin or deslanoside, ventricular fibrillation was induced in all 5 donor dogs within 75min after digitalis administration. In these cases, the DT of the isolated atrium was immediately increased to over 200% of control DT, but SACT and AR were not affected until 20min later, at which time increases in SACT and AR were finally induced.
    From these results, it is concluded that a large amount of digitalis has no distinct direct effect on SA nodal pacemaker activity and SA conductivity. Moreover, extremely large doses of digitalis which cause ventricular fibrillation might also induce a prolongation of SACT in addition to sinus tachycardia.
  • A New Type of Presentation
    Jorge R. BÜCHLER, Heitor G. CARVALHO, Nilzo RIBEIRO
    1983 年 24 巻 4 号 p. 657-663
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    A post-mortem heart with double outlet left ventricle was studied and a new type was described. An enlarged right atrium was divided by a large Eustachian valve and an atrial septal defect type ostium II, was present. The tricuspid valve was hypoplastic and the intercordal spaces were completely fused, similar to a tricuspid atresia. The right ventricle was hypoplastic. The aorta and pulmonary artery were totally related to the left ventricle with no conus beneath either. A sub-aortic ventricular septal defect secondary to malalignment of the septum was present. Subpulmonary and valvular pulmonary stenosis were observed with a hypoplastic main pulmonary artery. The left pulmonary artery was atretic and was filled by a patent ductus arteriosus. This type of double outlet left ventricle is amenable to total surgical correction if a correct prior diagnosis is made.
  • Iraj Aryanpur-KASHANI, Luke C. YU, Ching C. TI, Charles B. HIGGINS
    1983 年 24 巻 4 号 p. 665-668
    発行日: 1983年
    公開日: 2008/12/09
    ジャーナル フリー
    A single film portable aortogram through a highly placed umbilical artery catheter suggested aortic atresia, but subsequent study revealed a normal aorta and a patent ductus arteriosus. This demonstrates the importance of proper catheter placement in single film portable aortography, which is a reliable diagnostic tool in the evaluation of distressed neonates.
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