No abstract available.
Aneurysm* ; Child* ; Diagnosis* ; Echocardiography* ; Humans

The pressure and resistance of the pulmonary artery are the most important factors when evaluating the congenital heart disease. They are easily measured by the cardiac catheterization, but this procedure is a invasive technique, and difficult to perform repeatedly. There were some reports to estimate the pulmory artery pressure by using non-invasive techniques, such as the echocardiography. The accuracy and the application of the estimate derived from this technique is still a matter of controversy. We estimate the right ventricular pressure by the real time two dimensional echocardiography. The way to measure accuracy for this technique is by of camparing the estimate the right ventricular pressure derived by the echocardiograpy against the right ventricular pressure measured by the cardiac catheterization. The diameter of the left ventricle in the plane of the papillary muscles in measured by short axis view from parasternal positions at the end-systolic phase. The diameter between the interventricular sulcus[B] and the longest vertical from to the interventricular septum[C] are measured. The relationship between the ration, C/B by the two-dimensional echocardiography and the RVP/LVP by the cardiac catheterization is relatively well correlated(r=-0.88). Thus we may conclude that measuring the right ventricular pressure by using the two-dimensional echocardiography is relatively accurate and should be used for evaluating the congenital heart disease.
Arteries ; Axis, Cervical Vertebra ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart Defects, Congenital* ; Heart Ventricles ; Papillary Muscles ; Pulmonary Artery ; Ventricular Pressure*

In the treatment of congenital heart in Korea, a big progress has made so far, and successful results have been achieved. However, there were few reports pertaining to the age and cause of death in congenital heart disease patients. Now, the author made observation on the mortality, the age and the mode of death in 3817 patients of congenital heart disease who had been admitted to Severance Hospital during the period of 15 years, from Jan 1972 to Dec 1986. The overall hospital mortality of the congenital heart disease was 6.1% ; 10.1% in the unoperated cases and 4.5% in the patients who underwent surgery. The hospital mortality of indivisual congenital heart disease was, in the order of increasing frequency, 1.0% for ventricular septal defect, and for the complicated heart disease, such as transposition of great vessels(12.5%), and total anomalous pulmonary venous return(15.8%) the death rate was higher in general. The mortality was highest under 1 year of age, especially during the neonatal period, i.e. under 1 month of age. The mode of death in the unoperated cases were congestive heart failure, infection, and hypoxia, in the order of frequency, comprising 84.5%, and in the patients who underwent surgery were congestive heart faliure or low cardiac output syndrome and htpoxia, 62.3%. Among the patients who died in the neonatal period, 76.9% died without accurate diagnosis, and 38.5% were under 5 days of age. Hypoxia(27%), congestive heart faliure(19.4%), and sepsis(11.6%) were the main mode of death. The analysis of the dead patients with congenital heart disease revealed the following results.The mortality was high in the complicated heart disease ; the major mode of death in surgical patients were congestive heart faliure or low cardiac output syndrome ; and the mortality was high in patients under one year of age, especially in the neonates, and most of then lacked accurate diagnosis.Therefore, more accurate properative diagnosis of complicated heart disease and better surgical techniques, development of diagnostic tools in neonatal period, and the need for early surgery and emergency medical management are uregently demanded.
Anoxia ; Cardiac Output, Low ; Cause of Death ; Child* ; Diagnosis ; Emergencies ; Estrogens, Conjugated (USP) ; Heart ; Heart Defects, Congenital* ; Heart Diseases ; Heart Failure ; Heart Septal Defects, Ventricular ; Hospital Mortality ; Humans ; Infant, Newborn ; Korea ; Mortality

No abstract available.
Diagnosis* ; Heart Failure* ; Heart Septal Defects, Ventricular ; Heart*

No abstract available.

No abstract available.
Empyema* ; Gastroenteritis* ; Salmonella* ; Urinary Bladder*

No abstract available.

No abstract available.
Catheters* ; Heart Defects, Congenital*

To evaluate the diagnostic accuracy of two-dimensional echocardiogrphy(2-D echo) in ventricular septal defect, location and size of the defects, estimated right ventricular systolic pressure and associated cardiac anomaly were compared to the operative findings in 139 children operated for correction of ventricular septal defect at Severance Hospital from Jan. 1983 to June 1987. In addition, postoperative complications and mortality cases were anlysed. The following results were obtained; 1) Perimembranous defects were 82 cases(66.1%), subarterial infundibular defects 33 cases(26.6%), and muscular defect was found in only 1 case(0.8%). The accuracy of 2-D echo in localizing the defects was 84.2%. 2) In 79.2% of the patients, the defects were moderate to large in size, and actual size measured at operation was larger than that obtained by echocardography in general. 3) The estimated right ventricular systolic pressure was correlated(r=0.650) with that measured at the operating field. 4) Combined cardiac anomalies were patent ductus arteriosus(22 cases), atrial septal defect(3 cases), valvular pulmonic stenosis(2 cases) and interventricular septal aneurysm(2 cases). The sensitivity of 2-D echo in detecting these anomalies was 65.5% and the specificity was 96.4%. 5) Among 32 patients who had postoperative complications, in two thirds, there were pulmonary complication including lung atelectasis(16 cases), pleural effusion(5 cases)and pneumonia(5 cases). 6) Operative mortality was 2.9%(4 cases). The causes of death were low cardiac output state due to left ventricular myocardial failure in 3 patients and respiratory failure from asphyxia in one case. In conclusion, with close cooperation with cardiac surgeons, there will be few problems in diagnosing and operating patients with ventricular septal defect on the basis of two-dimensional echocardiographic findings without invasive procedures, such as cardiac catheterization, even with pulmonary hypertension, unless Eisenmenger syndrome is complicated.
Asphyxia ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output, Low ; Catheterization* ; Catheters* ; Cause of Death ; Child* ; Echocardiography* ; Eisenmenger Complex ; Heart Failure ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Lung ; Mortality ; Postoperative Complications ; Respiratory Insufficiency ; Sensitivity and Specificity

A total of 120 infants, children, and teenagers, who were admitted to the Department of Pediatrics, Severance Hospital from April 1989 to August 1989, were examined by cross-sectional echocardiography. Right and left atrial and ventricular dimensions and areas were measured in the parasternal, apical, and subcostal views. Dimensions of the inferior caval vein, the pulmonary and the aorta were obtained in the parasternal, suprasternal, and subcostal views. The results were as follows : 1) Statistical analysis showed no difference between boys and girls. 2) For all parameters, a positive linear correlation was found with age, height, weight, and body surface area. The best correlation was with body surface area. 3) The correlation was further improved if the logarithmic values of the measurements and body surface area were considered. 4) Measurements by cross-sectional echocardiography are clinically useful, especially in the study of the right-sided cardiac structures that are difficult to evaluate with M-mode echocardiography, but the problems of reproducibility have to be taken into account.
Adolescent ; Aorta ; Body Surface Area ; Child* ; Echocardiography* ; Female ; Humans ; Infant* ; Pediatrics ; Reference Values ; Veins