Milton Weinberg

Stenotic Lesions of the Pulmonary Arteries Clinical and Hemodynamic Findings in 84 Cases

Abstract The clinical and hemodynamic data of 32 cases with unilateral pulmonary artery stenosis and 52 cases with bilateral pulmonary artery stenosis are reported. Twenty-five of the former group and 32 of the latter were associated with other cardiac defects. The diagnosis was substantiated by cardiac catheterization or angiocardiography, or both. The diagnosis may be suspected because of the typical distribution of the murmur, which is well heard in the axillae and back. This is particularly true of the group with bilateral stenosis unassociated with other lesions, which constitutes a relatively clearcut entity with characteristic auscultatory findings, pulmonary trunk pressure curves and angiocardiographic appearances. The developmental origins of this group of lesions and the treatment are briefly discussed.

Surgical injury to the conduction system in ventricular septal defect

Abstract The conduction systems of 9 hearts with ventricular septal defect coming to autopsy after open heart surgery were studied by serial section. In 2 cases severe A-V block was present; in 2, complete right bundle branch block; and in the remainder there was no clinical evidence of A-V block after surgery. The severe A-V block in both cases could be ascribed to injury of the penetrating portion of the A-V bundle. An alternate explanation in 1 case was the injury to the branching bundle and the posterior radiation of the left bundle branch. The right bundle branch block in 2 cases for which a postoperative electrocardiogram was available was associated with severe injury to the right bundle. In double outlet right ventricle with an anterior ventricular septal defect, the branching portion of the A-V bundle may lie considerably to the left of the summit of the ventricular septum as in some cases of tetralogy. In a case of double outlet right ventricle with a massive posterior ventricular septal defect, the conduction system resembled that of common A-V orifice or single ventricle.

Emergency approach to the subclavian and innominate vessels.

he operative approach to an acutely injured subclavian vesselprotected by clavicle, sternum, the costal cartilages, and ribs T -is by no means an easy one in the presence of active bleeding. We wish to describe a new emergency approach to these vessels which provides rapid exposure for control of bleeding and excellent visualization for arterial and venous reconstruction.

Pulmonary stenosis with mitral and tricuspid incompetence

Abstract A case of pulmonary stenosis associated with mitral incompetence and tricuspid incompetence in a 13 year old boy is reported. The diagnosis was made by cardiac catheterization and selective angiocardiography, and confirmed at surgery. This combination of lesions, we believe, is being reported for the first time.