Among fetuses with AVSD, those with trisomy 21 are detected earlier in pregnancy, have less distorted cardiac anatomy, higher rates of biventricular repair and better survival rates. Due to the limited sample size in euploid fetuses, it remains unclear whether this apparent protection afforded to Down syndrome accounts also for cohorts with isolated and balanced AVSD.
* Aus Gründen der besseren Lesbarkeit verwenden wir zumeist nur den Begriff "Brustkrebspatientinnen". Damit sind auch die männlichen Patienten gemeint, die an der Befragung teilgenommen haben. Ist umgekehrt von "Patienten" die Rede, so sind auch immer die Patientinnen eingeschlossen.
A 45 year old male suffered from typical exercise-induced dyspnoea and angina. Crohn's disease treated with glucocorticoids was present for 18 years. Coronary angiography revealed small left anterior descending and right coronary arteries without reference to coronary artery disease, while the main stem and circumflex artery were severely dilated due to a fistula (diameter 5.5 mm) into the coronary sinus with a left/right shunt amounting to 35%. Haemodynamics, significant risk of endocarditis with chronic inflammatory bowel disease and obligatory glucocorticoid treatment were indications for fistula closure. As an alternative to surgical correction, the coronary fistula was totally occluded by antegrade micro-coil embolization. The present report offers a review on differential therapeutic considerations and specific treatment options including novel interventional modalities for coronary fistulas.
In the context of a specialised university hospital with all treatment options for critically ill newborns and with the establishment of a specialised training programme, neonatal ECMO for pulmonary failure can achieve equally good results in comparison to those of national and international ECMO centres.
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