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  • ANGIOGRAPHY  (3)
  • Indomethacin
  • Complications
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Years
  • 1
    Keywords: Germany ; CT ; FOLLOW-UP ; imaging ; VISUALIZATION ; DISEASE ; NEW-YORK ; RISK ; NUCLEAR-MEDICINE ; PATIENT ; primary ; QUALITY ; MRI ; PERFORMANCE ; LESIONS ; COMPUTED-TOMOGRAPHY ; MAGNETIC-RESONANCE ANGIOGRAPHY ; CT ANGIOGRAPHY ; pathology ; ANGIOGRAPHY ; CHILDREN ; nuclear medicine ; radiology ; CHILDHOOD ; STENOSIS ; RADIATION-EXPOSURE ; methods ; NUCLEAR ; IMAGE QUALITY ; multidetector CT ; USA ; correlation ; YOUNG-ADULTS ; ADOLESCENTS ; ANEURYSMS ; ARTERY STENOSES ; comparison ; Kawasaki syndrome ; MRA
    Abstract: Background After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically. Objective To compare the diagnostic quality of MDCT-A and MRI with that of CCC for coronary imaging in a group of patients with coronary artery pathology after childhood KS. Materials and methods A total of 16 patients (aged 5-27 years) underwent CCC and 16-row MDCT-A and 14 patients MRI (1.5 T). Results There was 100% agreement between MDCT-A and CCC in the detection of coronary aneurysms and stenoses. MDCT-A was superior for the visualization of calcified lesions. MRI and CCC showed 93% agreement for the detection of aneurysms. Visualization of coronary artery stenoses was difficult using MRI-one stenosis was missed. Conclusion MDCT-A has excellent correlation with CCC regarding all changes affecting the coronary arteries in the follow-up of childhood KS. In comparison to MDCT-A and CCC, MRI is less precise in the detection of stenotic lesions. Due to its high image quality and ease of performance MDCT-A should be the primary diagnostic modality in patients following childhood KS
    Type of Publication: Journal article published
    PubMed ID: 17768616
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  • 2
    Keywords: Germany ; CT ; DIAGNOSIS ; DISEASE ; computed tomography ; PATIENT ; COMPLEX ; MR ; MAGNETIC-RESONANCE ; tomography ; COMPUTED-TOMOGRAPHY ; MR-ANGIOGRAPHY ; ANOMALIES ; CT ANGIOGRAPHY ; ABNORMALITIES ; ANGIOGRAPHY ; congenital heart disease ; MR angiography ; PULMONARY ; CARDIOVASCULAR-DISEASE ; COMPRESSION ; THORACIC AORTA ; vascular rings ; slings
    Abstract: Ultrafast CT and MR angiography are noninvasive, accurate and robust techniques for preoperative diagnosis and planning of congenital heart disease and vascular abnormalities in pediatric patients. While they seem to be equivalent to conventional catheter angiocardiography for detecting vascular abnormalities, they are more accurate for the diagnosis of potentially life-threatening complications, such as tracheal, bronchial or esophageal compression. The value of ultrafast CT and MR angiography is demonstrated in 22 pediatric patients with vascular rings, slings and other vascular abnormalities
    Type of Publication: Journal article published
    PubMed ID: 15024587
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  • 3
    Keywords: Germany ; CT ; DIAGNOSIS ; VENTILATION ; ACCURACY ; radiation ; TIME ; PATIENT ; COMPLEX ; COMPLEXES ; EXPERIENCE ; AGE ; MOTION ; MAGNETIC-RESONANCE ANGIOGRAPHY ; ANGIOGRAPHY ; CHILDREN ; COMPLICATIONS ; HEART-DISEASE ; PULMONARY ; COLLIMATION ; IMAGE QUALITY ; complication ; surgical planning ; YOUNG-CHILDREN
    Abstract: Purpose: To assess the value of multidetector CT (MDCT) for evaluation of vascular anomalies (VA) and associated complications in newborns and infants. Materials and Methods: Seventy-five children (mean age: 9 +/- 6 months, range: 2 weeks to 24 months) with VA were examined using MDCT (4-, 8- or 16-row; collimation 0.5 - 1.25 mm; scan time 7 - 30s), which was performed under controlled ventilation or free breathing. Image quality was rated using a 5-point scale. Image findings were correlated to echocardiography, conventional catheter angiography (CCA), bronchoscopy, and intraoperative findings. Results: High quality MDCT data were almost free of cardiac and respiratory motion. In all cases, VA morphology and topography in relation to adjacent structures, e. g. tracheal and esophageal compression caused by an aortic ring, could be assessed exactly and allowed the final diagnosis. Even aberrant vessels, such as aorto-pulmonary collaterals (MAPCA) with a diameter of less than 1 mm, could be identified and excellently visualized. Eighty percent (60/75) of all patients had benefited from the MDCT: in 31 patients CCA was neither necessary to perform surgical planning nor to exclude a VA; in an additional 29 patients radiation doses and sedation time due to interventional procedures could be reduced markedly. Conclusions: MDCT can now be regarded as the modality of choice as a minimally invasive, robust, and accurate technique for the diagnosis of complex VA, their potentially life-threatening complications and preoperative planning even in newborns and infants. Its accuracy for detecting VA appears equivalent to CCA while it is more accurate in delineating potential life-threatening complications
    Type of Publication: Journal article published
    PubMed ID: 16170705
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  • 4
    ISSN: 1435-2451
    Keywords: Patent ductus arteriosus ; Respiratory distress syndrome ; Indomethacin ; Ductus arteriosus persistens ; Atemnotsyndrom ; Indometacin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Ligatur des offenen Ductus arteriosus ist auch bei kleinsten Frühgeborenen ein risikoarmer Eingriff und stellt immer eine vitale Indikation dar. Neben der Operation ist in indizierten Fällen auch der Verschluß mit Prostaglandin-Inaktivatoren möglich. Von 1976–1985 wurden 215 Frühgeborene behandelt. Bei 52 Säuglingen kam es zum Spontanverschluß. Bei 68 war Indomethacin erfolgreich. Bei 42 führte Indometacin nicht zum Verschluß, so daß eine Operation erforderlich wurde. 53 Säuglinge wurden wegen Kontraindikationen für Indometacin primär operiert. Die Gesamtletalität betrug 20%, wobei die kombinierte Gruppe die höchste Letalität aufwies.
    Notes: Summary Ligation of patent ductus arteriosus can be safely performed even in the smallest prematures and may be life-saving. Medical treatment with prostaglandin-inhibitors may be substituted in selected cases. From 1976–1985 a total of 215 prematures was treated. 52 of those experienced spontaneous closure. In 68 infants closure occurred following indomethacin-treatment. 48 had operation after failure of medical therapy and 53 with contraindications to indomethacin were primarily operated. The overall mortality reached 20% and was highest among those with combined medical and surgical treatment.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1076
    Keywords: Indomethacin ; Drug level monitoring ; Very low birth weight infants ; Ductus arteriosus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract First results are described of individually tailored indomethacin dose rates employing on-line drug level monitoring for pharmacologically induced ductal constriction in very low birth weight infants with symptomatic patent ductus arteriosus (sPDA). In addition prolonged indomethacin therapy was introduced. From our data it appears that the effective threshold indomethacin level for the induction of ductus constriction has to be about 1000 ng/ml 10 h postdosing, while ductus closure can be maintained with a dose rate that exceeds a plasma level of 500 ng/ml for at least 1 week. These maintenance levels were also effective in completely suppressing the urinary metabolite excretion rates of PGI2 and PGE2, which are potential mediators of ductal relaxation. On-line indomethacin level monitoring appears to be practically essential for prolonged indomethacin therapy to overcome the marked variation of indomethacin disposition in preterm infants with sPDA.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1076
    Keywords: Supraventricular tachycardia ; Cardioversion ; Chest thump ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on two cases of mechanical termination of supraventricular tachycardia by chest thump which were followed by serious complications. In a 3-year-old boy with an otherwise normal heart, incessant supraventricular tachycardia was converted to sinus rhythm by a single precordial thump. This, however was followed by thrombo-embolic infarction of the left-sided middle cerebral artery. In another case of a 9-year-old girl, recurrent episodes of supraventricular tachycardia were associated with Ebstein anomaly of the tricuspid valve. Chest thump was successful in terminating supraventricular tachycardia but induced a short run of ventricular tachycardia which terminated itself and was then followed by sinus rhythm. It is concluded that even a slight precordial thump implies undetermined risks in the acute management of supraventricular tachycardia in children and should therefore be abandoned in favour of other methods.
    Type of Medium: Electronic Resource
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