OBJECTIVE Prospective audit of the first year of implementation of a modified approach to palliation for infants with hypoplastic systemic ventricle and severe systemic outflow obstruction. SETTING Tertiary referral centre for neonatal and infant cardiac surgery. PATIENTS AND METHODS 17 of 19 infants (aged < 35 days) presenting to Birmingham Children's Hospital in 1993 with hypoplastic syst...

Pulmonary artery growth after a systemic-pulmonary shunt was angiographically evaluated in 19 out of 35 patients. The mean age of the subjects at the time of the initial operation was 18+/-18 months including 12 patients under a year old. The preoperative diagnosis was tetralogy of Fallot (TOF) in 10 patients, TOF plus pulmonary atresia in five and transposition of great arteries in four. A Bla...

Two children underwent interventional closure of a modified Blalock-Taussig shunt using a new detachable coil system (Duct-Occlud). This procedure has advantages over currently available materials to occlude these and other communications between the systemic and pulmonary circulations.

An 8 year old child with tricuspid atresia had developed right sided pulmonary arteriovenous malformations following a previous classic Glenn procedure. These became clinically manifest immediately after Fontan conversion because of severe systemic desaturation. The pathophysiology and postoperative medical management of this case is described and related to current understanding of the aetiolo...

Eisenmenger syndrome refers to reversal of shunt and central cyanosis due to pulmonary hypertension induced by congenital heart disease with a large systemic-to-pulmonary shunt. We report a case of a 17-year-old man with Eisenmenger syndrome who presented with gradual deterioration in visual acuity and was diagnosed with advanced secondary open angle glaucoma. There have been reports of patient...

THERE HAS BEEN inereasinog interest in the physiologic rather than the anatomic disturbances in tetralogy of Fallot." 2 Accordingly, the degree of pulmonary stenosis and the size of the ventricular septal defect are the factors of physiologic importance in this congenital anomaly. The dextroposition of the aorta is functional due to the high ventricular septal defect, and the right ventricular ...

This report presents a new, simple and reliable method of quantitating left-to-right shunts from arterial dilution surves. When indicatior (e,g., indocyanine green) is injected centrally (right venticle or pulmonary artery) and blood is withdrawn rapidly from either the aorta or other central systemic artery, in the presence of a left-to-right shunt to recorded indicator-dilution curve usually ...

The presence of systemic left-to-right shunt and increased pulmonary blood flow can result in right heart failure and pulmonary arteriopathy. Correction of left-to-right shunt has been shown to improve cardiac function and physical performance. However, the cardiopulmonary remodeling processes following cessation of left-to-right shunt have yet to be reported. In this experimental study, excess...

Congenital heart lesions resulting in increased pulmonary blood flow are common and if unrepaired often lead to pulmonary hypertension and heart failure. Therefore, we hypothesized that increased pulmonary blood flow without changes in pressure would result in remodeling of the pulmonary arterial wall. Furthermore, because the vasodilator nitric oxide is produced by the lung, is regulated by fl...