Effects of persiting myocardial sinusoids on left ventricular performance in pulmonary atresia with intact ventricular septum

AbstractA patient with pulmonary atresia and intact ventricular septum was found to have a right ventricular-dependent coronary circulation. In this infant both coronary arteries lacked their normal proximal connection with the aorta, perhaps the most egregious form of this prejudicial coronary circulation. Even more interesting was a direct collateral vessel originating from the descending thoracic aorta and connecting with the coronary circulation. This patient has undergone bilateral modified Blalock-Taussig shunts, and left ventricular function seems preserved.

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The superiority of mitral E point-ventricular septum separation to other echocardiographic indicators of left ventricular performance

Clinical Cardiology ◽

10.1002/clc.4960020210 ◽

1979 ◽

Vol 2 (2) ◽

pp. 140-145 ◽

Cited By ~ 24

Author(s):

I. A. D'Cruz ◽

G. G. Lalmalani ◽

V. Sambasivan ◽

H. C. Cohen ◽

G. Glick

Keyword(s):

Left Ventricular ◽

Ventricular Septum ◽

Left Ventricular Performance ◽

Ventricular Performance

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Morphologic and functional analysis of myocardial status in pulmonary atresia with intact ventricular septum—an angiographic, histologic and morphometric study

Cardiology in the Young ◽

10.1017/s1047951100007952 ◽

1992 ◽

Vol 2 (4) ◽

pp. 361-366 ◽

Cited By ~ 7

Author(s):

Luciano Daliento ◽

Roldano Scognamiglio ◽

Gaetano Thiene ◽

Anita Hegerty ◽

Siew Yen Ho ◽

...

Keyword(s):

Myocardial Ischemia ◽

Pulmonary Atresia ◽

Systolic Pressure ◽

Left Ventricular ◽

Ventricular Septum ◽

Morphometric Study ◽

Control Group ◽

Intact Ventricular Septum ◽

Significant Difference ◽

Percentage Area

SummaryWe studied 11 patients with pulmonary atresia and intact ventricular septum who died at ages ranging from one day to three years. All but two neonates died after surgery. Pre-surgical catheterization with left and right cineventriculography was performed in nine patients, and quantitative parameters were calculated. By histologic examination of transverse transmural sections, the incidence and extent of myocardial ischemia or infarction were determined, as well as the percentage area per field occupied by vessels, myocytes orientated longitudinally or transversely, interstitial space, and disarrayed fibers. Comparable sections were obtained from six normal neonates to constitute a control group. Myocardial ischemia or infarction were frequent complications. Morphometric analysis demonstrated a significant difference between the control group and the patients with regard to the percentage of myocytes (longitudinal and transverse), the percentage of area occupied by myocardial disarray, and the presence of fibrosis. The highest values for the proportion of disarray were seen in those patients with small right ventricles. The percentage of myocytes varied, but the highest degree of disarray always correlated with the lowest percentage of myocytes. The highest percentage value of left ventricular disarray was associated with the lowest ratio of left ventricular mass to end diastolic volume (inadequate hypertrophy). The lowest indices of contractility and left ventricular pump function were associated with myocytes less than 55% of normal. A linear correlation was found between the percentage area of fibrosis and the ratio of systolic pressure to end systolic volume in the left ventricle, arid between fibrosis and ejection fraction. Values for fibrosis exceeding 15% were associated with decreased functional indices. Disarray, therefore, seems to express a primary inability of myocardium to respond to anomalous overload with adequate hypertrophy and/or hyperplasia.

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