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  • Title: [Long-term follow up of surgically-treated congenital heart disease: interauricular communication, aortic coarctation, tetralogy of Fallot].
    Author: Gérard R, Matina D, Mouly-Bandini A, Lévy S.
    Journal: Ann Cardiol Angeiol (Paris); 1983 Oct; 32(6):387-92. PubMed ID: 6421221.
    Abstract:
    Based on data from the literature and their own experience, the authors study the long-term clinical course of patients with interatrial communications (IAC), coarctation of the aorta (CAo) and tetralogy of Fallot (TF) who have been operated. According to data from the literature and 50 cases which were reviewed an average of 11 years after the operation, operated cases of IAC are at risk of developing arrhythmias or conduction disturbances, especially if the operation was performed after the age of 20, in cases with cardiomegaly, with a mean pulmonary artery pressure of more than 20 mmHg and a pulmonary flow/systemic flow ratio due to the shunt greater than 1.5. Surgery for CAo carries a risk of long-term residual hypertension (HT). According to the majority of authors and a study of 55 cases. HT is present in 3 to 6% of cases operated between the ages of 1 and 10 years. This percentage is much higher for the older age groups. The increase in blood pressure on effort and the demonstration of a gradient between the upper limb and the lower limb are the methods of detecting post-operative hypertension and residual stenosis. Cardiac failure and coronary occlusion can occur in the cases which were operated late. Following complete correction of TF, severe ventricular arrhythmias can arise in the long term. From a study of 59 patients at least 3 years after the operation, the authors outline the elements which favour the development of these arrhythmias. The cases at highest risk are those which were operated after the age of 2 years with significant residual lesions, cardiomegaly and ventricular extrasystoles on the resting trace.(ABSTRACT TRUNCATED AT 250 WORDS)
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