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61.
干下漏斗部室间隔缺损的外科治疗 总被引:9,自引:0,他引:9
46例干下漏斗部室间隔缺损,占同期室缺手术治疗的23.2%(46/198)。缺损位于肺动脉瓣下34例,漏斗部12例。用带垫片褥式缝合修补21例,补片修补25例。全组无死亡。术后直接缝合组有主动脉关闭不全2例、残余分流2例,残留杂音3例。笔者认为,适时手术,选择适当的进路、应用补片修补、正确判断和处理主动脉瓣病变及对合并肺动脉狭窄者予以流出道补片加宽,是提高本病手术疗效的关键。 相似文献
62.
James K. Hartsfield Bryan D. Hall Arthur W. Grix Boris G. Kousseff Jose F. Salazar Scott M. W. Haufe 《American journal of medical genetics. Part A》1993,45(5):552-557
We report on 7 patients (6 M, 1 F) with Coffin-Lowry syndrome who have a sensorineural hearing deficit in addition to developmental delay and characteristic facial changes. One of the patients also had a history of premature exfoliation of primary teeth. These are previously unappreciated clinical signs that may aid in the early diagnosis of Coffin-Lowry syndrome. Early diagnosis and recognition of a hearing deficit in the patient can lead to the use of hearing aids to help the patient achieve his or her full potential. These “;new”; clinical manifestations expand the phenotype of Coffin-Lowry syndrome and constitute an additional indication of pleiotropy. © 1993 Wiley-Liss, Inc. 相似文献
63.
Brigden Geoffrey Zanelli Giussepe Lahiri Avijit Raftery Edward 《European journal of nuclear medicine and molecular imaging》1990,16(11):795-799
A new, single bolus method of in vivo blood pool imaging using a technetium Tc99m phosphine isocyanide complex (DEPIC) which binds to pre-albumin was evaluated in volunteers (n=4) and patients (n=20). DEPIC was assessed for its safety and possible drug interactions. Its duration of action and quality of ventriculography were compared with imaging using standard in vivo red cell labelling (PYP) during two 3-h scanning periods 1 week apart. DEPIC had a mean plasma halflife of 3.3 h. The count rate over the left ventricle was initially 42% higher with DEPIC than with PYP. However, removal of DEPIC by the liver resulted in equivalent count rates by 1 h, and by 3 h PYP count rates were 22% higher than DEPIC. Immediately post injection mean (SD) difference in the left ventricular ejection fraction between the two methods was 2.4% (7.7%). Satisfactory DEPIC scans were obtained up to 2 h post injection, but by 3 h there was a mean difference of 13% (11.3%). DEPIC was found to be a safe alternative to red all labelling for blood pool angiography, suitable for routine work. The single bolus methodology and high initial count rates offer improved efficiency and a capability for truly emergency scanning. 相似文献
64.
我院治疗66例心间隔缺损的病例中,有4例合并哑性动脉导管未闭(简称PDA),发生率6%。全组病例术前均无PDA临床体征,1例术前再次复查心脏彩超时发现,其余3例均漏诊。1例先处理PDA,3例在纠正心内畸形同时处理PDA。心间隔缺损合并哑性PDA容易漏诊,但有其临床特点,手术可先处理PDA,或在体外循环下处理PDA。 相似文献
65.
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67.
Sintov Amnon Scott William A. Gallagher Kim P. Levy Robert J. 《Pharmaceutical research》1990,7(1):28-33
Epicardial antiarrhythmic drug administration was studied as a therapeutic approach for experimental ventricular tachycardia (VT) in an open-chest dog model. Lidocaine-polyurethane matrices (28%, w/w) were formulated as a model system. Matrices were placed on the left ventricular epicardium in each of 23 anesthetized open-chest dogs with ouabain-induced VT, to evaluate effectiveness in restoring sinus rhythm. Conversion occurred in all animals treated with matrices containing 300 mg or more of lidocaine after 1.5 to 7.0 min. The matrix lidocaine content correlated linearly with the time required for conversion to sinus rhythm (r = 0.75, P = 0.0002); irrespective of matrix size the myocardial/plasma lidocaine ratio was 20.1 ± 4.2 (mean ± SD) at the time of conversion. In a separate series of five dogs without ventricular tachycardia, systolic wall thickening measured with sonomicrometers after 5 min of controlled-release lidocaine administration (500- to 1000-mg matrix lidocaine content, 7.48 ± 3.49-mg/kg dose) was only minimally diminished (–14.1%) and this effect was observed only at the site of matrix placement on the anterior-apical epicardium. In contrast, intracoronary injection of 0.3 or 1.0 mg/kg of lidocaine-HCl resulted in complete elimination of wall thickening or replacement by systolic thinning. Thus epicardial administration of lidocaine from polyurethane matrices was an effective means of treating ouabain-induced ventricular tachycardia. Regional myocardial function in the vicinity of the matrices was modified to a very limited degree, supporting the view that the matrices can be used safely, without serious risk to ventricular contractile performance. 相似文献
68.
通过42例重型肺心病、7例轻型肺心病、16例肺心病伴发冠心病患者和30例正常人在静息状态下的左右心脏射血分数及其临床资料的分析表明,重型肺心病患者在病情的急性发作期,存在有不同程度的左心功能不全,而轻型肺心病患者则无左心功能不全的表现。表明慢性肺心病仅在病程晚期,才由以右心为主的疾病发展成为全心病。本文还对重型肺心病与肺心病伴发冠心病患者的左心功能进行比较,结果表明,肺心病伴发冠心病患者左室功能受损程度更为明显,双重病因导致的左室功能减退,常造成心肌更严重的损害而且不容易恢复。 相似文献
69.
为了评价冠状动脉旁路术 (CABG)术前左室射血分数 (LVEF)及左室短缩分数 (LVFS)对术后室性心律失常 (VA)预测的准确性 ,采用术前及术后 2周心脏彩超EF、FS值 (面积长轴法 )、心室晚电位 (VLP)、心肌酶、持续心电监测的方法 ,对我院 1 5 0例行CABG术的患者进行分析。结果 :1 )术前心肌梗死 (MI)、室壁瘤、VA及VLP阳性患者EF、FS值明显减低 ;2 )术前左心功能不全 (LVD)患者术后EF、FS值明显改善 ;3 )术前LVD、VA、VLP阳性及室壁瘤患者术后VA发生率明显高于其他患者。提示 :1 )面积长轴法EF、FS值是反映左心功能的敏感指标 ;2 )术前LVD患者术后短期左心功能明显好转 ,获益最大 ;3 )非LVD患者术后因心肌顿抑导致近期心功能暂时下降 ;4 )EF≤ 4 0 %和(或 )FS≤ 2 4 %是预测术后VA的独立指标 ,FS较EF更能准确地反映心脏收缩功能 ;5 )LVD、VLP、室壁瘤等综合指标分析有助于提高对术后VA预期的敏感性、特异性和准确性 相似文献
70.
S. Aziz L. A. Soine S. L. Lewis A. P. Kruse W. C. Levy K. M. Wehe D. P. Fishbien M. D. Allen 《Transplant international》1997,10(6):446-450
A review of factors contributing to early mortality after cardiac transplantation revealed that up to 25 % of deaths were
due to primary graft dysfunction unrelated to rejection or infection. In light of this finding, evaluation of a donor heart
with regard to its suitability for transplantation takes on added importance. In an effort to screen the suitability of donor
hearts in the region covered by the Northwest Organ Procurement Agency (USA), all donors are evaluated by two-dimensional
transthoracic echocardiography as part of the initial evaluation. A total of 110 donor echocardiograms were reviewed and an
attempt was made to correlate the 30-day outcome with the parameters measured. An unexpected finding was that the presence
of left ventricular hypertrophy in the donor heart was associated with an increase in the incidence of donor heart dysfunction
compared with donors with normal echocardiographic profiles (33 % vs 3 %, P = 0.007).
Received: 12 February 1996 Received after resision: 27 June 1997 Accepted: 14 July 1997 相似文献