Abstract：
:Pulmonary hypertension associated with pediatric congenital heart defects is a major cause of postoperative morbidity and death. Sildenafil has been combined with inhaled nitric oxide to treat pulmonary hypertension. We retrospectively studied the pre- and postoperative effects of oral sildenafil as monotherapy in children with pulmonary hypertension who underwent surgery to correct congenital cardiac defects. From September 2005 through November 2009, 38 children with moderate-to-severe pulmonary arterial hypertension (pulmonary arterial/aortic pressure ratio, >0.7) underwent cardiac surgery at our institution. Fifteen patients were given sildenafil (0.35 mg/kg, every 4 hr) orally or through nasogastric tubes 1 week before and 1 week after surgery. Twenty-three patients of comparable medical status were given sildenafil only upon the institution of cardiopulmonary bypass and for 1 week after surgery. Postoperatively, the 15 patients who were given preoperative sildenafil had significantly lower mean pulmonary arterial pressures (25.6 ± 3.1 vs. 30.4 ± 5.7 mmHg; P = 0.005) and pulmonary arterial/aortic pressure ratios (0.35 ± 0.05 vs. 0.42 ± 0.07; P = 0.002) than did the other 23 patients. The preoperative therapy also shortened cardiopulmonary bypass time, mechanical ventilation time, and lengths of intensive care unit and hospital stays. No sildenafil-related hypertensive crises or sequelae occurred. As monotherapy, oral sildenafil in low doses appears to control pulmonary hypertension safely and effectively in children undergoing operations to correct congenital heart defects, particularly when it is given both preoperatively and postoperatively. Further study is warranted.
journal_name
Tex Heart Inst Jjournal_title
Texas Heart Institute journalauthors
Palma G,Giordano R,Russolillo V,Cioffi S,Palumbo S,Mucerino M,Poli V,Vosa Csubject
Has Abstractpub_date
2011-01-01 00:00:00pages
238-42issue
3eissn
0730-2347issn
1526-6702journal_volume
38pub_type
杂志文章abstract：:Lesions of the ascending aorta associated with aortic valve disease are usually treated by implanting a prosthetic valved conduit (Bentall procedure). In this report, we present our experience in which a valved homograft conduit was used for the procedure. Six patients underwent a Bentall procedure with the use of a c...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：:Alternans of the ST segment is sometimes observed in experimental studies but is rarely seen in the clinical setting. Described is a case of exercise-induced ST segment elevation alternans that was successfully treated with transluminal coronary artery angioplasty. Theories regarding the cause and mechanism of this ph...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1983-06-01 00:00:00
abstract：:The indications for transcatheter aortic valve implantation have been increasing with the development of new-generation valves and delivery systems. Our patient, an 81-year-old man with aortic stenosis, had an existing coronary artery bypass graft and bilateral aortoiliac bypass grafts. We used the transfemoral approa...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:Percutaneous closure of patent arterial ducts with the Amplatzer Ductal Occluder has become an effective and widely accepted alternative to surgical management. Although rarely, the occluder can be dislodged after an initially successful deployment, and with catastrophic consequences. We describe such a case in a 12-m...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：10.14503/THIJ-12-2927
更新日期：2014-02-01 00:00:00
abstract：:A successful cardiac transplant starts with the selection of an appropriate donor. Once consent to organ donation has been obtained, the donor should be managed aggressively in order to maintain optimal organ function. In the case of multi-organ donation, the heart is the first organ to be prepared, as well as the fir...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：:Pulsatile ventricular assist devices have successfully provided circulatory support for many patients throughout the past quarter century; however, persistent complications have hindered expanded clinical application of this technology. Although the use of smaller, continuous-flow ventricular assist device pumps has r...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:We operated on a 14-year-old boy who had an echocardiographic diagnosis of ventricular septal defect. At surgery we found, in addition, an anomalous and obstructive intraventricular muscle bundle. Detection of a continuous thrill over the right pulmonary veins, prior to cardiopulmonary bypass, led to exploration of th...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:We prospectively compared closure and complication rates in 91 children with secundum atrial septal defects: 44 (mean age, 8.1 +/- 4.7 years) were treated surgically and 47 (mean age, 10.1 +/- 4.9 years) were treated by percutaneous Amplatzer septal occluder Complications were classified as mild, moderate, or severe. ...
journal_title：Texas Heart Institute journal
pub_type： 临床试验,杂志文章
doi：
更新日期：2004-01-01 00:00:00
abstract：:Cardiac amyloidosis is an infiltrative cardiomyopathy with a grave prognosis. Its clinical manifestations include restrictive cardiomyopathy, diastolic heart failure, conduction defects, and arrhythmias. Isolated cardiac involvement and significant conduction disturbances are reported very infrequently. We report a ra...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：:Aortoiliac occlusive disease is a frequently encountered occlusive arterial disease. Different surgical approaches to the infrarenal abdominal aorta have been reported. We retrospectively studied the postoperative outcomes of patients who were treated for aortoiliac occlusive disease via a retroperitoneal versus a tra...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：:We present a case in which endovascular stenting was used for recurrent proximal para-anastomotic stenosis 11 years after aorto-bi-iliac bypass grafting for severe aorto-iliac occlusive disease. A 55-year-old woman presented with worsening bilateral hip and buttock claudication. At presentation, her resting ankle-brac...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2002-01-01 00:00:00
abstract：:We report the case of a patient with Alagille syndrome and severe pulmonary valve and bilateral pulmonary artery branch stenosis. In this patient, transcatheter balloon pulmonary valvuloplasty combined with bilateral pulmonary artery angioplasty and stent placement provided excellent immediate results and long-term im...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:In Part 1 of this review, we discussed how plaque rupture is the most common underlying cause of most cases of unstable angina/non-ST-segment-elevation myocardial infarction (UA/NSTEMI) and how early risk stratification is vital for the timely diagnosis and treatment of acute coronary syndromes (ACS). Now, in Part 2, ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2010-01-01 00:00:00
abstract：:This report describes an unusual case of subaortic stenosis in which hypertrophic obstructive cardiomyopathy was found in combination with both anomalous insertion of papillary muscle directly into the anterior mitral leaflet and "sawfish" systolic narrowing of the left anterior descending coronary artery. Definitive ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：:We report a modified technique for advancing a catheter or sheath into the right common carotid artery when the aortic arch anatomy is unfavorable.A standard 0.035-inch guidewire is passed into the right subclavian artery, and a diagnostic catheter is threaded over it, deep into the right axillary and brachial artery....
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2008-01-01 00:00:00
abstract：:Carcinoid tumors are rare neuroendocrine malignancies that typically originate from the gastrointestinal tract. Patients who are diagnosed with carcinoid heart disease generally have poor prognoses because of advanced metastases during staging and few therapeutic options. We present the case of a 61-year-old woman wit...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-13-3314
更新日期：2014-10-01 00:00:00
abstract：:From January of 1984 through December of 1990, we implanted 739 Pop De Popa wild boar aortic valves in 626 patients, in all cardiac valvular positions. Of these patients, 562 received only the Pop De Popa xenobioprostheses, which numbered 620 valves. Only patients with contraindications for bioprosthetic valves (such ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:We present herein the case of a 48-year-old patient who had undergone repair of total anomalous pulmonary venous return at the age of 14 months, in March 1960, at Texas Children's Hospital. When this patient voluntarily underwent re-examination in 2007, echocardiography revealed the late results of surgery that had be...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2008-01-01 00:00:00
abstract：:We report on a case of premature atherosclerosis in a patient with short stature, dysmorphic features, mild diabetes mellitus, hypertriglyceridemia, Mönckeberg's sclerosis, and the general appearance of premature aging, compatible with the diagnosis of Werner's Syndrome. The patient was referred to us after suffering ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1984-03-01 00:00:00
abstract：:Left ventricular hypertrophy in aortic stenosis is considered a compensatory response for the maintenance of systolic function but a risk factor for cardiac morbidity and death. We investigated the degree of left ventricular mass regression after implantation of the sutureless Medtronic 3f Enable Aortic Bioprosthesis....
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-13-3943
更新日期：2015-04-01 00:00:00
abstract：:Inferior vena cava filters are commonly used to prevent pulmonary embolism in patients who manifest deep vein thrombosis and recurrent pulmonary embolism despite anticoagulation, or in patients with contraindications to anticoagulation. We report the case of a 69-year-old man with a structurally normal heart who exper...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：:Legionella infection can manifest itself in many clinical forms, most commonly as pneumonia, but rarely in the form of myocardial involvement. Legionella with myocardial involvement independent of pneumonia is almost never seen in the adult population and therefore is cited only a handful of times in the medical liter...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:To evaluate the possibility of providing, in vitro, an endothelial lining for artificial hearts, we cultivated adult autologous endothelial cells on two polyurethane and two silicone rubber surfaces. Over the ensuing 11-day period, we investigated the resulting cell proliferation and morphology by means of scanning el...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：:Non-healing mid-sternotomy wounds are a persistently difficult problem. The numerous methods that have been employed to manage these wounds are costly in terms of patient discomfort and length of hospital stay. We present a method to manage a complicated sternotomy that uses an omental flap with an immediate, split-th...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1989-01-01 00:00:00
abstract：:Unruptured aneurysms of the left sinus of Valsalva are extremely rare, and their clinical features are not well-documented in the literature. We describe an unusual case in which an unruptured aneurysm of the left sinus of Valsalva associated with previously undiagnosed Marfan syndrome caused extrinsic compression of ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:The year 2016 was the 180th anniversary of Wilhelm Ebstein's birth and the 150th anniversary of his description of the congenital tricuspid valve malformation that came to be known as Ebstein anomaly. We present a brief history of the life and work of Dr. Wilhelm Ebstein. Despite his distinguished career, he is seemin...
journal_title：Texas Heart Institute journal
pub_type： 传,历史文章,杂志文章,评审
doi：10.14503/THIJ-16-6063
更新日期：2017-06-01 00:00:00
abstract：:A 56-year-old woman had unstable angina pectoris 3 months after aortic and mitral valve replacement for rheumatic heart disease. Repeat coronary arteriography revealed critical proximal left anterior descending and circumflex artery stenoses in previously normal coronary arteries. This case emphasizes the need for tho...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1986-09-01 00:00:00
abstract：:The detection and correction of ventricular fibrillation at the earliest time after its onset is essential to ensure long-term survival. During successive cardiac arrests the rhythms occurring were sensed by using disposable pre-gelled ECG defibrillator pads placed in the anterior-anterior position. Simultaneously wit...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1986-12-01 00:00:00
abstract：:Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium. W...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4296
更新日期：2015-06-01 00:00:00
abstract：:Aortoventricular fistula, a rare congenital or acquired defect of the aortic wall, is characterized by an abnormal connection between the aorta and one of the ventricles. Symptom severity correlates with the diameter of the fistula and with the acute or chronic timing of presentation. The diagnosis is usually made by ...
journal_title：Texas Heart Institute journal
pub_type：
doi：10.14503/THIJ-17-6332
更新日期：2019-04-01 00:00:00
