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  • 1
    Electronic Resource
    Electronic Resource
    T Wave Alternans Threshold Late After Repair of Tetralogy of Fallot (2002)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 13 (2002), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: TWA Threshold After TOF Repair. Introduction: Sustained microvolt-level T wave alternans (TWA) is a marker of increased risk for malignant ventricular arrhythmia. There is a significant risk of arrhythmia and sudden death after repair of congenital heart disease. The aim of this study was to determine the prevalence and characteristics of TWA after repair of tetralogy of Fallot (TOF). Methods and Results: TWA was evaluated during bicycle exercise in 49 subjects who had consecutively undergone transatrial-transpulmonary repair. Median values for age, age at repair, and follow-up duration were 14.9 years (11.5–20.8), 1.6 years (0.2–4.9), and 11.6 years (9.4–17.2), respectively. All patients were in New York Heart Association functional class I and were asymptomatic. Median QRS duration was 120 msec (80–150). Sustained TWA was detected in 7 (23%) of 31 subjects with adequate tests. In these 7 subjects, median onset heart rate (HR) was 120 (98–155). Median HR threshold as a percentage of predicted maximum HR (220 – age) was 58%(48–77). Sustained TWA prevalence was not significantly different compared with normal subjects (7/31 vs 9/83; P = 0.1). Onset HR in the TOF group was significantly lower [mean (SD) of 122 (20) vs 139 (12), P 〈 0.05]. In the TOF group with sustained TWA, the TWA occurred in 4 of 7 at 〈 60% predicted maximum HR versus 1 of 9 normal subjects (P 〈 0.05); 3 of 7 had onset HR 〈 120 versus 0 of 9 normal subjects (P 〈 0.03). There was no significant difference in age, gender, transannular patch use, restrictive right ventricular physiology, QRS duration, QTc, QT/QRS dispersion, or nonsustained ventricular tachycardia in subjects with or those without sustained TWA. Conclusion: The onset HR for sustained TWA is significantly lower after repair of TOF. Further study is required to determine whether this represents an increased risk for arrhythmia in this patient group.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2002.00657.x
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  • 2
    Electronic Resource
    Electronic Resource
    Long-Term Follow-Up After Two Coronary Repair of Anomalous Left Coronary Artery From the Pulmonary Artery (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 8 (1993), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract A retrospective analysis of ten patients with anomalous left coronary artery arising from the pulmonary artery operated between 1979 and 1990 was undertaken. All presented with evidence of left ventricular dysfunction and “ischemic” mitral regurgitation. Surgical repair consisted of an aortopulmonary tunnel (Takeuchi) procedure in eight and direct left coronary artery reimplantation in two. Two patients required postoperative support with a left ventricular assist device. There were no operative or late deaths (CL 0% to 17%) for a follow-up of over 670 patient months. All patients are in New York Heart Association Class I or II, though two patients are still receiving anticongestive medications. One patient has required further surgery for pulmonary artery stenosis, and another has had a mitral valve replacement because of severe mitral regurgitation. One additional patient has moderate-to-severe residual mitral regurgitation and two have a trivial left coronary to main pulmonary artery fistula. All have a patent, nonstenotic left coronary artery and much improved left ventricular function and perfusion as assessed by echocardiography, thallium scan, gated blood pool scan, and angiography. There have been no documented arrhythmias, clinically or on Hotter monitoring. The ECGs have shown resolution or improvement of the initial changes of ischemia/infarction in all patients. Chest X-rays have shown normalization of cardiothoracic ratio in eight of ten patients. Excellent early and late results can be achieved following timely surgical repair. Marked improvement in left ventricular function has been observed in patients with poor preoperative left ventricular function, even in the presence of extensive ischemia/infarction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1993.tb00380.x
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  • 3
    Electronic Resource
    Electronic Resource
    T Wave Alternans Threshold in Normal Children (2001)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 12 (2001), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: T Wave Alternans in Children. Introduction: Sustained microvolt-level T wave alternans (TWA) during exercise is a predictor of ventricular arrhythmia propensity in adult populations. TWA occurs in normal adults, but it is rare at 〈 70% of predicted maximum heart rate. An onset heart rate ≤ 110 is believed to be significant. The aim of this study was to examine the feasibility of performing the test in children and to determine the normal heart rate threshold for sustained TWA in children. Methods and Results: Alternans was evaluated during bicycle exercise in 100 normal volunteers aged 8 to 17 years. Adequate resting data were obtained in 76 of 100 children and was negative in all. Exercise data from 16 of 100 was excluded due to excessive noise. Median maximum heart rate was 192 (range 140 to 214). Sustained alternans was absent in 75 (89%) of 84. In the nine children with sustained alternans, median onset heart rate was 138 (range 120 to 158), and 7 of 9 had an onset heart rate ≤ 135. Median heart rate threshold as a percentage of predicted maximum heart rate (220 – age) was 67% (range 58% to 76%). Only 1 subject (1.2%) had an onset heart rate 〈 60% of predicted maximum. There was no significant difference between age, gender, endurance, maximum heart rate, QRS duration, QT interval, or QTc in those with and those without sustained TWA. Conclusion: Noninvasive assessment of TWA is feasible at ≤ 8 years of age. Sustained TWA was present in 11% of normal children, but was absent at heart rates below 120 and rare (1.2%) below 60% of predicted maximum heart rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2001.00424.x
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  • 4
    Electronic Resource
    Electronic Resource
    Pulmonary Artery Size After Bidirectional Cavopulmonary Connection (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 10 (1995), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pulmonary arterial size was measured during cineangiography in 23 patients, 1.9 months before, and 14 months after bidirectional cavopulmonary connection (BCPC). Measurements were standardized for body surface area using the method of Nakata and co-workers (pulmonary artery index). There was a significant reduction in pulmonary artery index after BCPC. These data suggest that pulmonary arterial growth is impaired after the creation of a BCPC. This may be related to an absolute reduction in pulmonary arterial flow, and/or the loss of systolic expansion of the pulmonary artery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1995.tb00585.x
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  • 5
    Electronic Resource
    Electronic Resource
    Tricuspid atresia and univentricular heart (1980)
    Springer
    Pediatric cardiology 1 (1980), S. 165-166 
    Details
    ISSN: 1432-1971
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02083150
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  • 6
    Electronic Resource
    Electronic Resource
    Is “tricuspid atresia” a univentricular heart? (1979)
    Springer
    Pediatric cardiology 1 (1979), S. 51-56 
    Details
    ISSN: 1432-1971
    Keywords: Tricuspid atresia ; Univentricular heart ; Heart malformations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It is evident that the term “tricuspid atresia” is imprecise and can be used to describe hearts with widely varying morphology. It might be preferable if the term were reserved for one or other of these variants, probably that which is the most commonly encountered. In this anomaly there is total absence of the connection between the right atrium and the ventricular mass, and the ventricular morphology is that of a univentricular heart. Only if a detailed segmental analysis of the heart is performed can the distinction be made between this and other malformations in which the tricuspid valve is imperforate and in which any ventricular morphology can be encountered. Tricuspid atresia is usually, but not always, univentricular.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02307343
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  • 7
    Electronic Resource
    Electronic Resource
    Univentricular atrioventricular connection: The single ventricle trap unsprung (1983)
    Springer
    Pediatric cardiology 4 (1983), S. 273-280 
    Details
    ISSN: 1432-1971
    Keywords: Univentricular heart ; Atrioventricular connection ; Single ventricle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02278873
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  • 8
    Electronic Resource
    Electronic Resource
    Sequential segmental analysis of congenital heart disease (1984)
    Springer
    Pediatric cardiology 5 (1984), S. 281-287 
    Details
    ISSN: 1432-1971
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02424973
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  • 9
    Electronic Resource
    Electronic Resource
    Normal variations in the relationship of the tricuspid valve to the membranous septum in the human heart (1990)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 226 (1990), S. 258-263 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The anatomy of the antero-septal commissure of the tricuspid valve and its relationship to the membranous part of the septum are described in 72 normal hearts from subjects ranging in age from 25 weeks gestation to 13 months. Three major patterns were found. According to whether the contiguous leaflets were fused at the commissure, joined at the circumference of the orifice, or left a gap at the commissural site, the varieties are described as undivided, annular, or gap commissure, respectively. Commissures of annular type showed further morphological varieties, as did the patterns of division of the membranous septum into its atrioventricular and interventricular components. Dominance of the atrioventricular component and/or absence of the interventricular membranous septum were encountered in 38 cases out of 72 (52%). This finding demonstrates that dominance of the atrioventricular membranous septum during fetal life and infancy is not universal. The variability noted in the morphology and position of the antero-septal commissure was not associated with other positional variations of the tricuspid valve.
    Additional Material: 5 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092260215
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