Ductus arteriosus aneurysm presenting as pulmonary artery obstruction: Diagnosis and management

The occurrence of pulmonary artery obstruction in an 8 day old infant as a complication of an aneurysm of a nonpatent ductus arteriosus is reported, together with the echocardiographic and angiographic findings. To relieve the obstruction, the aneurysm and an intrapulmonary thrombus were successfully removed with the use of cardiopulmonary bypass when the infant was 3 months old

The Fontan operation in infants less than 2 years of age

AbstractYoung age remains a reported risk factor for a successful Fontan operation despite improved survival rates. Since March 1978, the Fontan operation has been performed in 47 patients. To avoid a primary or secondary polliative shunt, an early Fontan procedure (Group 1: mean age 1.5 ± 0.5 years, range 0.6 to 2) has been performed in 17 children with the outcome similar to that of the remaining 30 older patients (Group 2: mean age 7.5 ± 5 years, range 2.4 to 23 years). Preoperatively both groups had acceptable hemodynamic status for a successful Fontan result.Operative variables including cardiopulmonary bypass time, aortic cross-clamp time and core temperature were similar between groups and did not affect mortality. The postoperative mortality rate including early surgical (0% vs. 13%, respectively), late (18% vs. 12%) and total (18% vs. 23%) was similar between Groups 1 and 2 (p > 0.05). Immediate postoperative arrhythmias were more frequent in Group 1 (71% vs. 25%, p < 0.01) with no related mortality, while late arrhythmias occurred with equal frequency (29% vs. 39%, p > 0.05). Group 1 infants required a longer hospital stay (22 ± 9 vs. 14 ± 5 days, p < 0.01).Thus, young age is not a risk factor for successful outcome of the Fontan operation in patients with acceptable preoperative hemodynamic status. An early Fontan operation may also avoid prolonged palliative procedures and their potential deleterious effects

L 2 -topological invariants of 3-manifolds

We give results on the L 2 -Betti numbers and Novikov-Shubin invariants of compact manifolds, especially 3-manifolds. We first study the Betti numbers and Novikov-Shubin invariants of a chain complex of Hilbert modules over a finite von Neumann algebra. We establish inequalities among the Novikov-Shubin invariants of the terms in a short exact sequence of chain complexes. Our algebraic results, along with some analytic results on geometric 3-manifolds, are used to compute the L 2 -Betti numbers of compact 3-manifolds which satisfy a weak form of the geometrization conjecture, and to compute or estimate their Novikov-Shubin invariants.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46581/1/222_2005_Article_BF01241121.pd