COARCTATION OF THE AORTA IN INFANTS

PEDIATRICS ◽  
1960 ◽  
Vol 26 (1) ◽  
pp. 109-121
Author(s):  
Irving H. Glass ◽  
William T. Mustard ◽  
John D. Keith
Keyword(s):  
Blood Pressure ◽  
Septal Defect ◽  
Operative Mortality ◽  
Ductus Arteriosus ◽  
Coarctation Of The Aorta ◽  
First Year ◽  
Great Vessels ◽  
Sick Children ◽  
First Year Of Life ◽  
Symptoms And Signs

A review of 108 cases of coarctation of the aorta diagnosed under 1 year of age, and admitted to The Hospital for Sick Children, Toronto, over a 12-year period, is presented. Preductal coarctation accounted for 90% of the fatalities under 1 year. Patency of the ductus arteriosus occurned in 98% of cases in the first 6 months of life. Forty-nine per cent of cases of coarctation of the aorta under 1 year of age have major cardiac anomalies other than patent ductus: ventricular septal defect, 33%; transposition of great vessels, 10%; and atrial septal defect, 6%. Problems in diagnosis occurred when blood pressure readings were equivocal. Operative mortality for coarctation of the aorta in the first year of life was 41%, while after 1 month of age it was only 29%. Mortality in patients not operated on during the first year of life was 50%, while for those less than 1 month of age with symptoms and signs of decompensation and not operated on, the mortality was 87%. In dealing with coarctation of the aorta in the first year of life the following are recommended: 1) When blood pressure readings in the arms and legs are equivocal, the readings should be repeated frequently until the diagnosis is clarified; 2) aortogram should be performed on patients difficult to diagnose; 3) babies presenting with symptoms in the first month of life should be operated on promptly unless they show a dramatic response in a 12-hour trial of treatment with digitalis; 4) babies after 1 month of age who respond to digitalis may be kept on this medication until adequate adjustment in circulatory hemodynamics has taken place and surgery can be performed at the optimum age.

Increased Prevalence of Ventricular Septal Defect: Epidemic or Improved Diagnosis

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. 200-203
Author(s):  
Gerard R. Martin ◽  
Lowell W. Perry ◽  
Charlotte Ferencz
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Coarctation Of The Aorta ◽  
Cardiovascular Malformations ◽  
Ventricular Septal Defects ◽  
Live Births ◽  
Septal Defects ◽  
Clinical Diagnoses ◽  
Control Study

The Baltimore-Washington Infant Study is an ongoing case-control study of congenital cardiovascular malformations in infants in whom the clinical diagnoses have been confirmed by echocardiography, catheterization, surgery, or autopsy. An increase in the prevalence of ventricular septal defects was detected in 1,494 infants with congenital cardiovascular malformations between 1981 and 1984. The prevalence of congenital cardiovascular malformations increased from 3.6 to 4.5 per 1,000 live births (P<.025) and the prevalence of ventricular septal defect increased from 1.0 to 1.6 per 1,000 live births (P< .001). The increase in ventricular septal defects accounted for the total increase in congenital cardiovascular malformations. The prevalence of isolated ventricular septal defect increased from 0.67 to 1.17 per 1,000 live births (P<.001). The prevalence of ventricular septal defect with associated coarctation of the aorta, patent ductus arteriosus, atrial septal defect, and pulmonic stenosis did not change. The prevalence of ventricular septal defect diagnosed by catheterization, surgery, and autopsy did not change; however, defects diagnosed by echocardiography increased from 0.30 to 0.70 per 1,000 live births (P<.001). It is concluded that the reported increase in prevalence of ventricular septal defect is due to improved detection of small, isolated ventricular septal defects and that there is no evidence of an "epidemic."

scholarly journals Atrial Septal Defect - A New Perspective on the Cardiac Dyspnea

2018 ◽  
Vol 15 (2) ◽  
pp. 53-57
Author(s):  
Larisa Renata Roșan ◽  
Vlad Alin Pantea ◽  
Otilia Anca Ţica ◽  
Ovidiu Ţica ◽  
Mădălina Ioana Moisi ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
First Year ◽  
Cardiac Diseases ◽  
Embryological Development ◽  
Heart Malformation ◽  
New Perspective ◽  
First Year Of Life ◽  
Previous Medical History

AbstractThe congenital cardiac diseases predominately affect the children, as well as the young adults, and they are the consequence of an abnormal embryological development.Atrial septal defect (DSA) is a congenital heart malformation, which can close in the first year of life, being shown by the presence of a communication between the left atrium and right atrium with the left-to-right shunt, and it subsequently produces some complications.We report the case of a 31 years-old-female without previous medical history, who was diagnosed with atrial septal defect.

Surgical Treatment of Coarctation of the Aorta in the First Year of Life. Immediate and Late Results in 35 Patients

1982 ◽  
Vol 30 (02) ◽  
pp. 75-78 ◽  
Author(s):  
M. Barbero-Marcial ◽  
G. Verginelli ◽  
J. Sirera ◽  
M. Ebaid ◽  
E. Zerbini
Keyword(s):  
Surgical Treatment ◽  
Coarctation Of The Aorta ◽  
Late Results ◽  
First Year ◽  
First Year Of Life

Neurogenic intermittent claudication associated with aortic steal from the anterior spinal artery complicating coarctation of the aorta

1972 ◽  
Vol 37 (1) ◽  
pp. 89-94 ◽  
Author(s):  
Brian E. Kendall ◽  
John Andrew
Keyword(s):  
Intermittent Claudication ◽  
Coarctation Of The Aorta ◽  
Aqueductal Stenosis ◽  
Anterior Spinal Artery ◽  
First Year ◽  
Neurogenic Intermittent Claudication ◽  
Content Type ◽  
Collateral Channel ◽  
Collateral Vessels ◽  
First Year Of Life

✓ A boy born with coarctation of the aorta developed postmeningitic hydrocephalus associated with aqueductal stenosis in the first year of life; a ventriculoatrial shunt was performed. When 11 years old, following an operation on the coarctation, he developed neurogenic intermittent claudication superimposed on a preexisting spastic weakness of his legs. Investigations disclosed the intraspinal collateral vessels to be stealing blood through the anterior spinal artery to the aorta below the incompletely relieved coarctation. Revision of the coarctation repair and diversion within the thorax of the main collateral channel from the anterior spinal artery to the distal aorta relieved the intermittent claudication.

scholarly journals Relation between Birth Weight, Growth, and Subclinical Atherosclerosis in Adulthood

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Helena Valente ◽  
Filumena Maria da Silva Gomes ◽  
Isabela Judith Martins Benseñor ◽  
Alexandra Valéria Maria Brentani ◽  
Ana Maria de Ulhôa Escobar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Subclinical Atherosclerosis ◽  
Hdl Cholesterol ◽  
Intima Media Thickness ◽  
First Year ◽  
Increased Risk ◽  
Low Hdl ◽  
Right Lobe ◽  
First Year Of Life

Background and Objectives.Adverse conditions in the prenatal environment and in the first years of life are independently associated with increased risk for cardiovascular disease. This paper aims to study the relation between birthweight, growth in the first year of life, and subclinical atherosclerosis in adults.Methods.88 adults aged between 20 and 31 were submitted to sociodemographic qualities, anthropometric data, blood pressure measurements, metabolic profile, and evaluation of subclinical atherosclerosis.Results.Birthweight <2,500 grams (g) was negatively correlated with (a) increased waist-to-hip ratio (WHR), according to regression coefficient (RC) equal to −0.323, 95% CI [−0.571, −0.075]P<0.05; (b) diastolic blood pressure (RC = −4.744, 95% CI [−9.017, −0.470]P<0.05); (c) low HDL-cholesterol (RC = −0.272, 95% CI [−0.516, −0.029]P<0.05); (d) frequency of intima-media thickness (IMT) of left carotid >75th percentile (RC = −0.242, 95% CI [−0.476, −0.008]P<0.05). Birthweight >3,500 g was associated with (a) BMI >25.0 kg/m2, (RC = 0.317, 95% CI [0.782, 0.557]P<0.05); (b) increased waist circumference (RC = 0.284, 95% CI [0.054, 0.513]P<0.05); (c) elevated WHR (RC = 0.280, 95% CI [0.054, 0.505]P<0.05); (d) minimum subcutaneous adipose tissue (SAT) (RC = 4.354, 95% CI [0.821, 7.888]P<0.05); (e) maximum SAT (RC = 7.095, 95% CI [0.608, 13.583]P<0.05); (f) right lobe of the liver side (RC = 6.896, 95% CI [1.946, 11.847]P<0.001); (g) frequency’s right lobe of the liver >75th percentile (RC = 0.361, 95% CI [0.169, 0.552]P<0.001). Weight gain in the first year of life was inversely correlated with (a) mean IMT of left carotid (RC = −0.046, 95% CI [−0.086, −0.006]P<0.05; (b) frequency IMT of left carotid >75th percentile (RC = −0.253, 95% CI [−0.487, −0.018]P<0.05); (c) mean IMT (RC = −0.038, 95% CI [0.073, −0.002]P<0.05); (d) the frequency of the mean IMT >75th percentile (RC = −0.241, 95% CI [−0.442, −0.041]P<0.05).Conclusions.Adults birthweight <2,500 g and >3,500 g and with insufficient weight gain in the first year of life have showed different metabolic phenotypes, but all of them were related to subclinical atherosclerosis.

scholarly journals Major heart defects: the diagnostic evaluations of first-year-olds

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Pavlicek ◽  
Eva Klaskova ◽  
Sabina Kapralova ◽  
Alzbeta Moravova Palatova ◽  
Alicja Piegzova ◽  
...  
Keyword(s):  
Septal Defect ◽  
Clinical Symptoms ◽  
Heart Defects ◽  
Genetic Disorder ◽  
Coarctation Of The Aorta ◽  
Normal Karyotype ◽  
Maternity Hospital ◽  
Individual Risk ◽  
First Year ◽  
Heart Murmur

Abstract Background Severe or critical congenital heart defects (CHDs) constitute one third of the heart defect cases detected only after birth. These prenatally unrecognised defects usually manifest as cyanotic or acyanotic lesions and are diagnosed postnatally at various times. The aim of the study was to identify their clinical symptoms and determine individual risk periods for CHD manifestation. Methods Data were assessed retrospectively based on a cohort of patients born between 2009 and 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was classified into: early neonatal (0–7 days), late neonatal (8–28 days), early infancy (1–6 months), or late infancy (6–12 months). The first symptom for which the child was referred to a paediatric cardiologist was defined as a symptom of CHD. Results There were 598 major CHDs diagnosed in the studied region, 91% of which were isolated anomalies. A concomitant genetic disorder was diagnosed in 6% of the cases, while 3% presented extracardiac pathology with a normal karyotype. In total, 47% (282/598) of all CHDs were not identified prenatally. Of these, 74% (210/282) were diagnosed as early neonates, 16% (44/282) as late neonates, and 10% (28/282) as infants. The most common symptoms leading to the diagnosis of CHD were heart murmur (51%, 145/282) and cyanosis (26%, 73/282). Diagnosis after discharge from the hospital occurred in 12% (72/598) of all major CHDs. Ventricular septal defect and coarctation of the aorta constituted the majority of delayed diagnoses. Conclusions In conclusion, murmur and cyanosis are the most common manifestations of prenatally undetected CHDs. Although most children with major CHDs are diagnosed as neonates, some patients are still discharged from the maternity hospital with an unidentified defect.

THE NATURAL HISTORY OF CERTAIN CONGENITAL CARDIOVASCULAR MALFORMATIONS

PEDIATRICS ◽  
1964 ◽  
Vol 33 (6) ◽  
pp. 993-995
Author(s):  
Alexander S. Nadas
Keyword(s):  
Natural History ◽  
Septal Defect ◽  
Medical Center ◽  
Ductus Arteriosus ◽  
Surgical Techniques ◽  
Coarctation Of The Aorta ◽  
Signs And Symptoms ◽  
Secundum Atrial Septal Defect ◽  
History Of ◽  
To Come

INFORMATION on the "natural history" of congenital cardiac malformations is difficult to obtain and may have very little meaning for the statistician. One is aware that the facts obtained may yield a profile only of those patients with heart malformations who have signs and symptoms significant enough to bring them to a cardiac center. The others, either not sick enough to come to a center, or too sick and even dying before they can be brought to the specialist, or living too far from the medical center, therefore, will not be included in any survey. The only way the entire congenital heart disease population may be caught in the net of the investigator is by following up carefully a large group of newborns. Though information gathered may not be statistically significant it is none the less important as a frame of reference in making recommendations to patients and their families. Also it is of necessary historical import that we document the course of patients with malformations as yet unaltered by the hand of the surgeons. The effect of surgery on patients with certain malformations is far reaching and changes the course of their natural history. Another reason why we should try to find out what happens without operation to certain patients is that there will be a tremendous advance in cardiovascular surgical techniques for many lesions yet in the future. Nobody questions the fact that cardiac surgery, in many, if not most, areas will be better tomorrow than it is today. The notable exceptions to improvement of surgical techniques include repair of patent ductus arteriosus, coarctation of the aorta, secundum atrial septal defect, and pulmonic stenosis.

Sign in / Sign up

Export Citation Format

Share Document