1) Pulmonary valve stenosis were relieved successfuley by ballon dilatation during cardiac catheterization on 72 children aged 8 months to 15 years. 2) 3 children with dysplastic valve were reluctant to balloon dilatation and needed surgical valvectomy. 3) A 15 year old girl, died suddenly 6 months after initial successful balloon valvuloplasty, probably caused by right ventricular dysfunction and arrhythmia. 4) In 17 case with residual transpulmonary pressure gradient exceeding 30mmHg after initial balloon valvuloplasty, we recatheterized one or two years later, and found spontaneous relief of pressure gradinent in most cases except two who needed another trial of balloon dilatation. 5) Infundibular and pulmonary annulus diameter ration during systolic phase on lateral cine angiography revealed significant aggrevation of infundibular stenosis immediately after balloon dilatation comparing to pre-dilation but significant relief of that 1-2 years later. 6) R votage in V1 precordial lead revealed rapid decrement in height for initial 6 months after balloon dilatation, and gradually decreased after then. 7) Although the long-term results are still unknown, the current data strongly support the statement that percutaneous transluminal balloon valvuloplasty is the treatment of choice for patients with non-dysplastic pulmonic valve stenosis.
Adolescent ; Angiography ; Arrhythmias, Cardiac ; Balloon Valvuloplasty* ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Constriction, Pathologic* ; Dilatation ; Female ; Humans ; Pulmonary Valve Stenosis ; Ventricular Dysfunction, Right

1) Among the 24 involved vessels, 5 renal arteries and one left suclavian artery were occluded totally and they were not candidate for angioplasty. 2) Four brachiocepholic branches, three renal artery, and two abdominal aorta were short segmental narrowing in nature and they were feasible for balloon balloon dilatation, 3) Eight sites of thoracic or abdominal aorta in 5 patients were involved in diffuse long segment and they were more resistant to balloon angioplasty comparing with short segmental lesions. 4) Three patients (4 arteries) needed angioplasty again because of the restenosis at the previous sites on the angiographic re-evaluation l or 2 year later. They all showed the persistent inflammatory process with elevated ESR (<20) and positive CRP. 5) The remaining three patients showed no evidence of restenosis with low ESR (<20) and negative CRP. 6) Four carotid artery involvements needed gradual dilatation with increasing the size of the balloon and there were no episodes of brain embolism.
Angioplasty* ; Angioplasty, Balloon ; Aorta, Abdominal ; Arteries ; Carotid Arteries ; Dilatation ; Humans ; Intracranial Embolism ; Renal Artery ; Takayasu Arteritis*

No abstract available.
Cardiology*

No abstract available.
Heart Murmurs*

Pulmonary atresia with major aorto-pulmonart collateral arteries(abbreviated as MAPCA in the following)as a route for pulmonary blood flow presents many problem in diagnosis and management and recently new approach to surgical management (unifocalization)was suggested and few reported it's application. Nineteen cases who had pulmonary with MAPCA, diagnosed at Seoul National University Children's Hospital from October 1987 to May 1989, were studied to lool at the relationship between MAPCA, central pulmonary artery and segmental pulmonary arteries. Also was observed the clinical course and operative management. The average number of MACPA in each patient was 4, two toward right lung and the other two toward left lung. MACPA arose most frequently from descending aorta and innominate artery contralateral to the side of aortic arch. Central pulmonary artery was identified in 86.7%. The number of bronchopulmonary segment connected to central pulmonary artery directly or indrectly was very variable so was the number of bronchopulmonary segment connected to MAPCA only. Three had a total correction and 14 had a various kinds of palliative operation once or twice. Seven had a called "unifocalization"(connection of MAPCA to central pulmonary artery) to correct arborization abnormality but the result was not satisfactory for technical reason.
Aorta, Thoracic ; Arteries* ; Brachiocephalic Trunk ; Diagnosis* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Seoul

BACKGROUND: To get the information about the clinical characteristics of the paroxysmal junctional tachycardia in children and to get the general principle in managing these children. METHOD: Analysis of the medical records of the 43 patients(male 30, female 13) with paroxysmal junctional tachycardia(JT) who had been followed-up in this hospital for a mean of 4.6 years(range 1 month up to 12 years) was done. RESULT: In 19 patients, JT started before 1 years of age : in 2, during gestational period, in 15, within 4 months of age, in 2, after 4 months of age. The next peak was 7 in the age of 5 years. The associated cardiac abnormalities were complex congenital defects in 2, tumor in 1, dilated and hypertrophic cardiomyopathy in 1 each. The significant hemodynamic disturbances during JT were noticed in 25. Among those whose surface electrocardiogram during JT were available, mean heart rate during JT was 232rpm(range 160-310) ; narrow QRS complex in 33 and wide in 1 ; P` wave in ST segment or T wave in 22. The delta waves were noticed after stopping JT and during followe up in 20. The types of delta waves were A in 7, B in 9, and indeterminate in 4. The different forms of delta waves unrelated to the degree of fusion were noticed in 6 ; disappearance or intermittent form of delta wave in 4. The efficacy of stopping JT was as follows : ATP 84.4%(38/45), diving reflex 50%(7/14), other vagal stimulation 71.4%(5/7), digoxin 72.7%(8/11), verapamil 54.5%(12/22), D/C cardioversion 62.5%(5/8), neosynephrine 100%(2/2). There were 2 deaths due to associated cardiac defects and 2 elective catheter ablations during the followe up period. The preventive medication with digoxin, beta blocker, and/or verapamil was succesful in 14, partially succesful in 11, failed in 14. The 7 persistent JT were treated with amiodarone in 3, with amiodarone and beta blocker in 1, with flecainide and digoxin in 1. In 1, surgical ablation of accessory pathway was done due to persistent JT. At present, JT do not recur or occur transiently without drugs in 29 ; with drugs, JT become controlled without recurrence in 4, with transient episodes in 4 and with intermittent episodes in 1. CONCLUSION: Althouh the JT in children is benign in most cases spite of the severity during the early period, JT is persistent in cases and needs potent drugs to control JT. Ablation of the foci may be necessary in these cases. Even in patients whose long-term results are benign, it is necessary to choose the optimal drugs to terminate and prevent the JT during the intervening period.
Adenosine Triphosphate ; Amiodarone ; Cardiomyopathy, Hypertrophic ; Catheters ; Child* ; Congenital Abnormalities ; Digoxin ; Diving ; Electric Countershock ; Electrocardiography ; Female ; Flecainide ; Heart Rate ; Hemodynamics ; Humans ; Medical Records ; Phenylephrine ; Recurrence ; Reflex ; Tachycardia* ; Verapamil

No abstract available.
Angiography* ; Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

No abstract available.
Heterotaxy Syndrome*

No abstract available.
Arrhythmias, Cardiac* ; Arteries* ; Child* ; Humans

No abstract available.
Signal Transduction*