Kertész E

Modified Blalock-Taussig shunt using allograft saphenous vein: Six years' experience

BACKGROUND The occurrence of life-threatening late infectious complications after the use of expanded polytetrafluoroethylene conduits as modified Blalock-Taussig shunts prompted us to apply allograft saphenous veins instead. METHODS In 23 cyanotic patients (age, 1 week to 18 years) allograft saphenous veins were used for performing Blalock-Taussig shunts from July 1989 onward. Veins stored in Hanks solution were implanted in 8 patients and cryopreserved ones in 15. All patients were followed up regularly up to 15 months. RESULTS There were two early and two late deaths: none were related to shunt occlusion. Clinical, angiographic, and echocardiographic studies proved that, except for one early occlusion, all shunts were patent and functioning well after an average of 41 months. Donor cells disappeared 1 to 3 days after implantation, and several months after the operation both the wall and the luminal surface of the grafts were repopulated with cells possibly of recipient origin. No difference was found between veins stored in Hanks solution only and cryo-preserved grafts, concerning clinical outcome and histology. CONCLUSIONS Allograft saphenous veins function well as modified Blalock-Taussig shunts at least up to 6 years. Owing to the good results and lack of complications their clinical use is recommended.

Prostaglandin E1 treatment in patent ductus arteriosus dependent congenital heart defects.

Abstract Prostaglandin E1 (PGE1) treatment can be life saving in patients suffering from ductus dependent congenital heart defect. We analyzed the indications and side-effects of PGE1 therapy over a five-year period. The purpose of the study was also to examine whether a change in serum electrolyte levels could be detected. Forty-nine patients were treated with PGE1 during this period. PGE1 treatment was indicated by ductus dependent systemic circulation in 16 cases, ductus dependent pulmonary circulation in 17 cases, transposition of the great arteries in 13 cases and pulmonary hypertension (persistent fetal circulation) in three cases. As early side-effects of the treatment, fever occurred in 27/49 cases while apnoea was observed in 15 patients. In a one-week-old neonate with coarctation of the aorta grade III intraventricular hemorrhage developed. A mild decrease of sodium, potassium and chloride levels and a slight shift of pH levels toward metabolic alkalosis could be detected after one day and one week of PGE1 treatment. Because of these side-effects of PGE1 patients should be monitored in an intensive care unit. According to our observations electrolyte levels may exhibit a slight decrease; however, in the case of a short-term therapy extra salt supplementation is not necessary.

[More than 50 years' experience in the treatment of patients with congenital heart disease at a Hungarian university hospital].

Improvements in surgical techniques and technical advancements have made possible for several patients with congenital heart disease to grow up to adulthood. It has been decided to create a registry for their more precise treatment. This registry now includes 2770 patients with data on 3043 operations, with almost 30 different diagnoses. The purpose of this paper is to review the facts and the basics leading to the establishment of this registry.Absztrakt Koszonhetően az egyre tokeletesedő műteti technikaknak es a technikai fejlődesnek, ma mar sok, congenitalis szivbetegsegben szenvedő egyen eri meg a felnőttkort. Ezeknek a betegeknek a jobb ellatasa celjabol egy regiszter osszeallitasa mellett dontottek, amely jelenleg 2770 beteg 3043 műteti beavatkozasanak adatait tartalmazza, amelyeket kozel 30-fele diagnozis miatt vegeztek. Jelen tanulmany celja a regiszter-osszeallitas okainak es alapjainak bemutatasa. Orv. Hetil., 2015, 156(20), 794–800.

Több mint 50 év tapasztalat a congenitalis szívbetegek ellátásában egy magyar egyetemi központban. A CSONGRÁD Regiszter alapadatai

Improvements in surgical techniques and technical advancements have made possible for several patients with congenital heart disease to grow up to adulthood. It has been decided to create a registry for their more precise treatment. This registry now includes 2770 patients with data on 3043 operations, with almost 30 different diagnoses. The purpose of this paper is to review the facts and the basics leading to the establishment of this registry.Absztrakt Koszonhetően az egyre tokeletesedő műteti technikaknak es a technikai fejlődesnek, ma mar sok, congenitalis szivbetegsegben szenvedő egyen eri meg a felnőttkort. Ezeknek a betegeknek a jobb ellatasa celjabol egy regiszter osszeallitasa mellett dontottek, amely jelenleg 2770 beteg 3043 műteti beavatkozasanak adatait tartalmazza, amelyeket kozel 30-fele diagnozis miatt vegeztek. Jelen tanulmany celja a regiszter-osszeallitas okainak es alapjainak bemutatasa. Orv. Hetil., 2015, 156(20), 794–800.