George H. Khoury

Hemorrhagic renal necrosis in infancy: Relationship to radiopaque compounds

Three infants with hemorrhagic renal necrosis are reported; each of them prior to death had received intravenous administration of radiopaque compounds varying in dosage from 1 ml. to 3 ml. per kilogram of body weight

The hypoplastic right heart complex: Clinical, hemodynamic, pathologic and surgical considerations

Abstract The term hypoplastic right heart complex is proposed to define a diversity of anomalies of the right ventricle and the tricuspid and pulmonary valves. Based on the angiocardio-graphic and pathologic findings in 10 patients, the cases were divided into four types: Type I, moderate-sized right ventricular cavity (functioning right ventricle), moderate tricuspid stenosis, well formed pulmonary valve but with orifice either stenotic or atretic (4 cases). Type II, small right ventricle (nonfunctioning), rudimentary tricuspid valve and atretic pulmonary valve (3 cases). Type III, same as type I but in association with ventricular septal defect (2 cases). Type IV, isolated hypoplasia of the right ventricle (1 case). The patients ranged in age from a few days to 10 months. Cyanosis, with or without congestive heart failure, was present in all. The electrocardiogram was not characteristic. Hemodynamic studies were available in 5 patients. The right ventricular pressure was higher than systemic pressure in type I, slightly elevated in type II and normal in type IV. A large diastolic gradient was measured across the tricuspid valve in types I and II. In type III no studies were available. The angiocardiogram was of prime value in differentiating among the four types. Successful surgical management depends on an accurate delineation of the various malformed structures.

Management ofsupraventricular tachycardia by atrial stimulation

Summary The use of intracardiac pacing for conversionof a supraventricular tachycardia resistant to usual and accepted drug therapy is reported.

Arrhythmias in the pediatric age group.

Some arrhythmias occurring in infants and children are benign and do not require therapy. Examples are sinus arrhythmia, premature ectopic beats, and some instances of parasystole. In babies two weeks to six months old, supraventricular tachycardia is the most common serious arrhythmia. Various irregularities of the heart rate are frequently seen after open heart surgery.

Taussig-Bing malformation with coarctation of the aorta.

* From the Departments of Pediatrics and Pathology, West Virginia University School of Medicine, Morgantown, W. Va. † Associate Professor of Pediatrics. ‡ Associate Professor of Pathology. The Taussig-Bing malformation’ , is a double outlet right ventricle with large subpulmonary ventricular septal defect. Coarctation of the aorta as an associated lesion has not been previously emphasized, particularly in relation to its incidence and its effect on morbidity. Our aim in this communication is to describe the clinical, hemodynamic, pathologic and surgical aspects of two patients who presented with coarctation of the aorta in association with double outlet right ventricle and to point out the complexity of surgical repair in these patients.

Clinical applications of vectorcardiography, with special reference to use in children.

The spatial vectorcardiogram is of clinical value in interpreting complex 12-lead scalar electrocardiograms in diagnosis of ventricular hypertrophy and abnormal conduction disturbances. The VCG is ...

Recognizing Congenital Heart Diseases

Mortality among infants with congenital heart disease is high, especially in the first month of life, and some of these disorders may be fatal suddenly. Diagnosis is based on clinical signs, which vary with the age of the patient and the severity of the lesion. This discussion presents clues to recognizing the three main clinical signs—heart failure, cyanosis, and heart murmur.