Weights of heart ventricles in children with hydrocephalus treated with ventriculo-caval shunts.

Emery, John L.; Mahgrefte, B

doi:10.1136/hrt.31.5.613

Cited by 6 publications

(2 citation statements)

References 6 publications

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“…The question of careful follow-up of patients with VA shunts to detect PHT early is complicated. Frequently at postmortem there is a lack of anatomical evidence of right-ventricular hypertrophy (Crome andErdohazi 1966, Emery andMahgrefte 1969) among shunted children, even when emboli are present in the lungs; thus clinical screening for rightventricular hypertrophy will not help to detect cases at risk. Furthermore, if PHT supervenes only when more than 60 per cent of the pulmonary vascular bed has been obstructed (Rao et al 1970), such case-finding will have already failed to prevent serious damage (one of the two asymptomatic cases picked up by Sperling (1964) died).…”

Section: Discussionmentioning

confidence: 99%

Cor Pulmonale as a Complication of Ventriculo‐atrial Shunts Reviewed

Sleigh¹,

Dawson

Penny

1993

Develop Med Child Neuro

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SUMMARY The authors present the case of a nine‐year‐old patient with spina bifida and hydrocephalus treated with a ventriculo‐atrial shunt who developed fatal pulmonary hypertension 5 1/2 years after his last valve revision; he had been well and active up to one month before his death. Details of the dramatic cardiovascular findings are given. The problems of treatment, once symptoms occur, and the difficulty of pre‐symptomatic detection are discussed. RÉSUMÉ Coeur pulmonaire compliquant une dérivation ventriculoatriale Les auteurs rapportent le cas d'un patient de neuf ans présentant un spina bifida et une hydrocéphalie traitée par une dérivation ventriculoatriale qui développa une hypertension pulmonaire mortelle cinq ans et demi après la dermière révision de valve; il fut extrěment bien et actif jusqu'au mois précédent le décès. Les détails des données cardio‐vasculaires dramatiques sont précisés. Les problèmes de traitement, une fois les symptomes apparus et la difficultée de la détection pré‐symptomatique sont discutés. ZUSAMMENFASSUNG 'Cor pulmonale' als Komplikotion bei einem ventrikulo‐avialen shunt Die Autoren stellen den Fall eines neun‐jährigen Patienten mit Spina bifida und Hydrozephalus und ventrikulo‐atrialem Shunt vor, der 5 ½ Jahre nach der letzten Ventilrevision eine zum Tode fiihrende pulmonale Hypertension entwickelte; er war bis zu einem Monat vor seinem Tod sehr gesund und aktiv. Es werden Einzelheiten der dramatischen kardio‐vaskulären Befunde aufgeführt. Die Probleme der Behandlung—wenn Symptome auftreten—und die Schwierigkeiten einer prä‐symptomatischen Diagnose werden diskutiert. RESUMEN 'Cor pulmonale ' como complicación de derivaciones ventriculo‐otriales. Revisión Los autores presentant el caso de una paciente de nueve años con espína bifida e hidrocefalia, tratada con una derivación ventriculo‐atrial que padeció una hipertension pulmonar fatal 5 anAos y medio después de la última revision de su válvula. Estaba extremadamente bien y activa hasta un mes antes de su muerte. Se dan detalles de los marcados hallazgos cardiovasculares. Se discuten los problemas de tratamiento una vez aparecidos los sintomas y la dificultad de una detección.

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Section: Discussionmentioning

confidence: 99%

Cor Pulmonale as a Complication of Ventriculo‐atrial Shunts Reviewed

Sleigh¹,

Dawson

Penny

1993

Develop Med Child Neuro

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“…Other complications included infections (29%) and blockage of the shunt (55%). At necropsies of patients with ventriculoatrial shunts, cardiac and/or pulmonary thrombi were found in the vast majority of cases (Emery and Mahgrefte, 1969;Anderson, 1973). In many patients microembolisation is mild and intermittent, usually arising from the right atrium and so is difficult to recognise.…”

Section: Postmortem Findingsmentioning

confidence: 99%