By Carole A. Warnes
Courses practising physicians within the sensible facets of the way to diagnose and deal with sufferers with congenital center diseaseReviews the commonest congenital cardiac anomalies noticeable in practiceFocuses on either scientific overview and diagnostic imaging modalities in addition to sensible administration concerns, in addition to whilst to refer sufferers to tertiary care centresEach bankruptcy is preceded via a case examine to exemplify the problems that could be tough in functional administration
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Additional info for Adult Congenital Heart Disease (American Heart Association Clinical Series)
Br Heart J 1987;58:136–41. 14. Park JH, Yoon YS, Yeon KM, et al. Percutaneous balloon valvuloplasty with a doubleballoon technique. Radiology 1987;164:715–8. 15. Mullins CE, Nihill MR, Vick GW 3rd, et al. Double balloon technique for dilation of valvular or vessel stenosis in congenital and acquired heart disease. J Am Coll Cardiol 1987;10:107–14. 16. Ali Khan MA, Yousef SA, Mullins CE. Percutaneous transluminal balloon pulmonary valvuloplasty for the relief of pulmonary valve stenosis with special reference to double-balloon technique.
A gradient of 80 mm Hg across the pulmonary valve was measured. Angiography revealed a doming pulmonary valve with a narrowed orifice and infundibular hypertrophy. The main pulmonary artery was massively dilated, measuring 6 cm (Fig. 4). Valvuloplasty was performed successfully by using a double-balloon technique. Post-procedure, the peak-to-peak transvalvular gradient was 14 mm Hg with a late-peaking dynamic gradient of 10 mm Hg (Fig. 5). The procedure was performed without complications, and the patient continues to do well, without hemodynamically significant pulmonary insufficiency, 1 year later.
Children with Down syndrome have a 40% incidence of congenital heart disease, and approximately 40% of these children will have an AVSD. Chest radiographs typically demonstrate cardiomegaly and increased pulmonary vascularity consistent with the large left-to-right shunt. Electrocardiographs typically demonstrate a superior frontal plane axis (extreme left-axis deviation) and voltage criteria for ventricular hypertrophy. Children with complete AVSD usually have surgical repair at 3–6 months of age, depending on issues with growth and development.