Anomalous origin of the left coronary artery from the pulmonary trunk. Clinical features and midterm results after surgical treatment

OBJECTIVE: To report the authors' experience with the anomalous origin of the left coronary artery (AOLCA) from the pulmonary trunk, emphasizing preoperative data, surgical aspects and midterm results of the follow-up. METHODS: Retrospective analysis of 11 patients operated upon at the Royal Brompton Hospital from October, 84 to April, 97. RESULTS: Nine infants had heart failure (HF) and two other children presented with dyspnea and chest pain. All had ECG changes. The echocardiogram identified the anomalous origin of the coronary artery in 7 (64%) patients and hemodynamic studies were performed in 7 patients. All infants were operated upon between the 2nd and 10th month of life. Six patients were treated with aortic reimplantation of the left coronary artery, whereas five were operated upon according to the Takeuchi technique. All patients are alive, with clear improvement of the ECG changes and ventricular function, as evaluated by echocardiography. Two patients operated upon according to the Takeuchi technique required additional surgery due to severe supravalvular pulmonary stenosis. CONCLUSION: AOLCA is a rare disease. Most patients show early signs of severe HF associated with ECG findings. Surgical therapy must be instituted early in the disease, preferentially through aortic implantation of the anomalous coronary artery, with a high possibility of success. Shortly after surgery, clinical and ECG improvement, as well as normalization of left ventricular function, should be expected.

Frequência 180: estilismo sonoro nas narrativas audiovisuais

Relatório de estágio de mestrado em Ciências da Comunicação (área de especialização em Audiovisual e Multimédia)

Useful clinical features for the selection of ideal patients with strial fibrillation for mapping and catheter ablation

OBJECTIVE: To identify useful clinical characteristics for selecting patients eligible for mapping and ablation of atrial fibrillation. METHODS: We studied 9 patients with atrial fibrillation, without structural heart disease, associated with: 1) antiarrhythmic drugs, 2) symptoms of low cardiac output, and 3) intention to treat. Seven patients had paroxysmal atrial fibrillation and 2 had recurrent atrial fibrillation. RESULTS: In the 6 patients who underwent mapping (all had paroxysmal atrial fibrillation), catheter ablation was successfully carried out in superior pulmonary veins in 5 patients (the first 3 in the left superior pulmonary vein and the last 2 in the right superior pulmonary vein). One patient experienced a recurrence of atrial fibrillation after 10 days. We observed that patients who had short episodes of atrial fibrillation on 24-hour Holter monitoring before the procedure were those in whom mapping the focus of tachycardia was possible. Tachycardia was successfully suppressed in 4 of 6 patients. The cause of failure was due to the impossibility of maintaining sinus rhythm long enough for efficient mapping. CONCLUSION: Patients experiencing short episodes of atrial fibrillation during 24-hour Holter monitoring were the most eligible for mapping and ablation, with a final success rate of 66%, versus the global success rate of 44%. Patients with persistent atrial fibrillation were not good candidates for focal ablation.

The last of the Arctic voyages; being a narrative of the expedition in H. M. S. Assistance, under the command of Captian Sir Edward Belcher, C. B., in search of Sir John Franklin, during the years 1852-53-54. With notes on the natural history, by Sir John Richardson, Professor Owen, Thomas Bell, J. W. Salter and Lovell Reeve.

1

The last of the Arctic voyages; being a narrative of the expedition in H. M. S. Assistance, under the command of Captian Sir Edward Belcher, C. B., in search of Sir John Franklin, during the years 1852-53-54. With notes on the natural history, by Sir John Richardson, Professor Owen, Thomas Bell, J. W. Salter and Lovell Reeve.

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Narrative of the expedition of an American squadron to the China Seas and Japan : performed in the years 1852, 1853, and 1854, under the command of Commodore M.C. Perry, United States Navy, by order of the Government of the United States /

v. 3

Neural mechanisms of attentional selection in vision : locations, features, and objects

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2012

role of features and aspects in software development

Feature-Oriented Programming, Aspect-Oriented Programming, Software Product Lines, Stepwise Development

First-class features

Magdeburg, Univ., Fak. für Informatik, Diss., 2011