Robert A. Boxer

Nuclear magnetic resonance imaging in evaluation and follow-up of children treated for coarctation of the aorta

Electrocardiographic-gated nuclear magnetic resonance imaging was used to evaluate 10 patients, aged 2.5 to 18 years, with coarctation of the aorta. Six patients had balloon dilation angioplasty, one had surgical repair and three are awaiting treatment. Imaging studies were performed before and after therapy in three patients. In all pretreatment studies, the sagittal and 60 degrees left anterior oblique imaging planes adequately revealed the anatomy of the coarctation. Post-treatment imaging studies demonstrated effective relief of the coarctation in all cases. In three of the six patients who had balloon angioplasty, there was a variable degree of dilation of the aorta at the site of the previous coarctation. Nuclear magnetic resonance imaging is an effective noninvasive imaging method for visualizing coarctation of the aorta and for follow-up after treatment.

Life-threatening organophosphate-induced delayed polyneuropathy in a child after accidental chlorpyrifos ingestion

Life-threatening organophosphate-induced delayed polyneuropathy with transient bilateral vocal cord paralysis occurred in a 3-year-old child. Recovery was slow after prolonged ventilatory support. Patients who recover from serious organophosphate intoxications should be closely monitored for the development of organophosphate-induced delayed polyneuropathy.

Usefulness of triiodothyronine (T3) treatment after surgery for complex congenital heart disease in infants and children

This is a study of the use of T3 infusion in the postoperative period in 6 pediatric patients who underwent complex cardiac surgical procedures under cardiopulmonary bypass. Normalization of serum T3 levels was reflected in a marked decrease in requirement of inotropic support, conversion to normal sinus rhythm, and progressively improving clinical course.

Noninvasive diagnosis of congenital left coronary artery to right ventricle fistula by nuclear magnetic resonance imaging

SummaryIn two children with left coronary artery to right ventricle fistula, nuclear magnetic resonance imaging provided high-quality images of the course of the dilated coronary artery and its termination in the right ventricular apex. The advantages of this noninvasive multiplanar imaging technique for visualization of coronary fistulae and dilated coronary arteries are described. This report represents the first description of coronary artery fistula by nuclear magnetic resonance imaging.

Diagnosis and postoperative evaluation of supravalvular aortic stenosis by magnetic resonance imaging

Abstract Electrocardiogram-gated magnetic resonance imaging (MRI) is a new noninvasive technique that has been used to evaluate many forms of congenital heart disease.1 In this report, the pre- and postoperative cardiac MRI findings in a patient with severe supravalvular ortic stenosis are presented and correlated with angiographic studies.

Cardiac Tamponade in an Adolescent Female: an Unusual Manifestation of Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) af fects approximately 0.6 children per 100, 000.1 The disease is extremely rare in children under 5 years of age and is diagnosed predominantly in adolescent females.2 Children tend to present with more severe multisystem involvement than adults.2,3 Pericarditis occurs in approximately 25 % of patients with SLE in all age groups. 2 Progression to tamponade is extremely uncommon in the pediatric population.2,4 In the current report, an adolescent girl is diagnosed with SLE after presenting with signs and symptoms consistent with cardiac tamponade. A review of other pediatric patients with a similar presentation is also included. 5,6