No abstract

No abstract

Seven patients with atypical coarctation of the aorta were treated with a long thoracoabdominal bypass graft. One of them had a right renal bypass at the same time. One patient who had undergone a patch angioplasty 4 years previously died of bleeding at the time of surgery. Five out of 6 patients who survived the operation have remained normotensive and free of symptoms for up to 12 years, with an average follow-up period of 4 years. One patient died 31/2 years postoperatively from rupture of a pseudoaneurysm. Our experience indicates that atypical coarctation of the elongated type can be treated satisfactorily by the long thoracoabdominal bypass graft. If associated lesions of renal stenosis are present, renal revascularization is also necessary to overcome hypertension.Atypical coarctation of the aorta, particularly of the diffuse and elongated type, involving both the thoracic and the abdominal aorta is an uncommon vascular lesion. The most common causes of death in atypical coarctation with or without renal stenosis, are heart failure and cerebral hemorrhage secondary to hypertension in the upper half of the body. A long thoracoabdominal bypass graft is usually em-

No abstract

A seven-year-old girl with a permanent epicardial programmable pulse generator developed inappropriate slowing of the pacing rate due to oversensing a combination of T wave and afterpotential voltage. This phenomenon occurred only in the first three days after implantation and was demonstrable only at long programmed pulse widths. Our observations suggest that the current of injury in the early post-operative period may generate a relatively high T wave voltage capable of combining with a large afterpotential to produce a signal exceeding the sensitivity of a demand pulse generator.