SUMmARY The morphological features of a series of 37 specimens of pulmonary atresia with intact ventricular septum were reviewed with particular emphasis on features which might influence the results of pulmonary valvotomy. The
SUMMARY Five patients with isolated clefts in the anterior leaflet of the mitral valve, unassociated with atrioventricular septal defects, are described. All had significant mitral regurgitation, with the cleft being the only abnormality in three. Two patients had an associated ventricular septal defect, one with a straddling right atrioventricular valve. Angiocardiography in four showed moderate regurgitation, but was not able to delineate the aetiology. Two dimensional echocardiography showed a constant defect in the anterior leaflet, pointing towards the left ventricular outflow tract. This differed from 30 cases with atrioventricular septal defects where the "cleft" pointed towards the interventricular septum and was situated between the anterior and posterior bridging leaflets. All cases with isolated clefts had surgical correction, with minimal residual regurgitation on follow-up examination in two cases. Our current policy in patients with uncomplicated isolated cleft involves non-invasive assessment of these children and surgical correction if the regurgitation is significant. Most
To evaluate the use of three‐dimensional (3D) echocardiography in the diagnosis of congenital heart defects, we studied 238 patients aged 3 days to 19 years (mean 4.3 years) with normal hearts (n= 13) or a variety of congenital heart defects (n = 225) Three different modalities of data acquisition suitable for reconstruction were applied For parallel scanning, the transducer is held in a 6‐cm long scan frame and then moved over the thorax, or in the subcostal position, by a stepper motor using 0.5‐mm steps with acquisition of perpendicular parallel images of the heart For rotational scanning, the transducer is rotated at sectors of 2° over a span of 180° For fan‐like scanning, the transducer is moved in an arc 45° each way from its vertical axis Movement of the transducer is computer‐controlled and performed with electrocardiography and respiratory gating Between 80 and 120 slices of the heart are thus obtained, which form the dataset This dataset can then be “sectioned” in any desired plane, thus permitting generation of views simulating intraoperative perspectives Ventricular septal defects and atrioventricular valves can be displayed as viewed via the atrium Muscular ventricular septal defects can be viewed as seen through a ventriculotomy Obstruction in the left ventricular outflow tract can be viewed as via an aortotomy, and so on We conclude that this new imaging modality has a vast potential and may facilitate planning of intracranial surgery.
A parachute deformity of the tricuspid valve occurred in a heart with atrioventricular concordance, double outlet right ventricle, and straddling mitral valve. Although to the best of our knowledge parachute deformity of the tricuspid valve has not previously been reported, in this case its presence was insignificant in relation to the other lesions.
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