简介
Summary:
Publisher Summary 1
Discusses congenital cardiac disorders from the perspective of the abnormal hemodynamics of circulation, reviewing current concepts as well as controversial issues such as the advisability of procedures for alleviating cardiac lesions in utero. The physiology of normal fetal circulation is presented and the effects of congenital cardiac lesions are discussed with particular reference for the interactions between the lesions and fetal cardiovascular development. Useful for pediatric cardiologists, neonatologists, and pediatric intensive care physicians. This second edition reflects advances in the field since the publication of the first edition in 1974. Rudolph is affiliated with the Cardiovascular Research Institute at the University of California-San Francisco. Annotation c. Book News, Inc., Portland, OR (booknews.com)
Publisher Summary 2
Congenital Diseases of the Heart: Clinical-Physiological Considerations, Fully Revised and Updated Second Edition represents the accumulated experiences of the author. Dr. Abraham M. Rudolph is recognized internationally as a leading contributor in the field of Pediatric Cardiology. Since the publication of the book's first edition in 1974, remarkable achievements in diagnostic and therapeutic techniques have been attained, making possible and necessary this thorough update of the work.A uniquely important contribution of this new edition is the discussion of the hemodynamic and clinical features and their impact at various stages of development-from fetus to neonate to infant to child and adolescent. Due to the advent of prenatal ultrasound and Doppler flow studies, concepts of the influence of congenital cardiac lesions that were once based largely on conjecture can now be measured, compared, and quantified. The book discusses congenital cardiac disorders from the perspective of the abnormal hemodynamics of the circulation, reviewing current concepts as well as controversial issues (such as the advisability of procedures for alleviating cardiac lesions in utero). The physiology of the fetal normal circulation is presented and the effects of congenital cardiac lesions are discussed with particular reference to the interactions between the lesions and fetal cardiovascular development. A list of carefully selected references offers further guidance to relevant literature.Pediatric cardiologists, neonatologists, and pediatric intensive care physicians, as well as clinicians treating adult patients with congenital heart diseases, will find this updated classic to be useful, informative, and enlightening.
目录
General Considerations
The Fetal Circulation and Postnatal Adaptation p. 3
Postnatal Circulation p. 4
Circulation in the Fetal Lamb p. 5
Circulation in the Human Fetus p. 18
Perinatal and Postnatal Changes in the Circulation p. 20
Myocardial Growth p. 29
Factors Affecting Perinatal Cardiac Output p. 31
Circulatory Regulation in the Fetus p. 35
Fetal Circulatory Response to Reduced Oxygen Delivery p. 37
Cardiac Failure in the Fetus p. 38
Changes in Childhood and Adolescence p. 43
Functional Assessment p. 45
Intravascular Pressures p. 45
Cardiac Output and Intravascular Shunts p. 54
Indicator Dilution Techniques p. 69
Vascular Resistance p. 74
Calculation of Valve Area p. 80
Quantitative Ultrasound Techniques p. 83
Oxygen Uptake and Delivery p. 85
Oxygen in the Blood p. 85
Relationship between Oxygen Partial Pressure (Tension) and Oxygen Saturation of Hemoglobin--The Oxygen Dissociation Curve p. 87
Levels of Oxygen in Cardiac Chambers and Great Vessels p. 92
Oxygen Supply and Requirement p. 102
Prenatal and Postnatal Pulmonary Circulation p. 121
Fetal Pulmonary Circulation p. 121
Changes in Pulmonary Circulation after Birth p. 131
Effects of Hypoxia and Altitude on the Pulmonary Circulation p. 137
Effects of Congenital Heart Disease on the Pulmonary Circulation p. 143
Lesions Associated with Left-to-Right Shunts
The Ductus Arteriosus and Persistent Patency of the Ductus Arteriosus p. 155
The Ductus Arteriosus in the Fetus p. 155
Postnatal Closure of the Ductus Arteriosus p. 158
Regulation of the Ductus Arteriosus p. 159
The Ductus Arteriosus in Congenital Heart Disease p. 164
The Ductus Arteriosus at High Altitude and with Hypoxia p. 165
The Ductus Arteriosus in Premature Infants p. 165
Persistent Patency of the Ductus Arteriosus--The Abnormal Ductus p. 176
Differential Diagnosis p. 191
Principles of Management p. 192
Ventricular Septal Defect p. 197
Morphological Considerations p. 197
Hemodynamic Considerations p. 199
Clinical Features p. 220
Differential Diagnosis p. 232
Principles of Management p. 235
Atrial Septal Defect: Partial Anomalous Drainage of Pulmonary Veins p. 245
Morphological and Embryological Considerations p. 246
Hemodynamic Considerations p. 248
Clinical Features p. 260
Differential Diagnosis p. 272
Principles of Management p. 274
Atrioventricular Septal Defect p. 283
Morphological and Embryological Considerations p. 284
Hemodynamic Considerations p. 288
Clinical Features p. 300
Differential Diagnosis p. 312
Therapeutic Considerations p. 313
Obstructive Lesions
Aortic Stenosis and Hypoplastic Left Ventricle p. 321
Morphological Considerations p. 322
Embryological Considerations p. 325
Hemodynamic Considerations p. 326
Clinical Features p. 344
Differential Diagnosis p. 357
Principles of Management p. 358
Aortic Arch Obstruction p. 367
Morphological Considerations p. 367
Embryological Considerations p. 372
Hemodynamic Considerations p. 378
Clinical Features p. 393
Differential Diagnosis p. 405
Principles of Management p. 406
Aortic Atresia, Mitral Atresia p. 413
Morphological and Embryological Considerations p. 414
Hemodynamic Considerations p. 416
Clinical Features p. 427
Cardiac Catheterization and Angiocardiography p. 434
Differential Diagnosis p. 439
Principles of Treatment p. 441
Total Anomalous Pulmonary Venous Connection p. 449
Morphological Considerations p. 449
Embryological Considerations p. 452
Hemodynamic Considerations p. 453
Clinical Features p. 470
Differential Diagnosis p. 484
Principles of Treatment p. 487
Pulmonary Stenosis and Atresia with Ventricular Septal Defect (Tetralogy of Fallot) p. 489
Morphological and Embryological Considerations p. 489
Hemodynamic Considerations p. 495
Clinical Feature p. 512
Cardiac Catheterization and Angiocardiography p. 523
Differential Diagnosis p. 532
Complications p. 533
Principles of Treatment p. 534
Pulmonary Stenosis and Atresia with Intact Ventricular Septum p. 551
Morphological and Embryological Considerations p. 552
Hemodynamic Considerations p. 558
Clinical Features p. 578
Cardiac Catheterization and Angiocardiography p. 587
Differential Diagnosis p. 596
Principles of Management p. 601
Tricuspid Atresia and Hypoplastic Right Ventricle p. 617
Morphological and Embryological Considerations p. 617
Hemodynamic Considerations p. 620
Clinical Features p. 632
Differential Diagnosis p. 643
Principles of Treatment p. 645
Ebstein Malformation of the Tricuspid Valve p. 655
Morphological and Embryological Features p. 655
Hemodynamic Considerations p. 657
Clinical Manifestations p. 662
Differential Diagnosis p. 668
Therapeutic Considerations p. 669
Aortopulmonary Anomalies
Transposition of the Great Arteries (Aortopulmonary Transposition) p. 675
Morphological and Embryological Considerations p. 676
Hemodynamic Disturbances p. 679
Clinical Features p. 706
Differential Diagnosis p. 722
Therapeutic Considerations p. 727
Truncus Arteriosus Communis p. 737
Morphological and Embryological Considerations p. 737
Hemodynamic Considerations p. 741
Clinical Features p. 749
Differential Diagnosis p. 758
Principles of Management p. 759
Selected References p. 763
Index p. 791
The Fetal Circulation and Postnatal Adaptation p. 3
Postnatal Circulation p. 4
Circulation in the Fetal Lamb p. 5
Circulation in the Human Fetus p. 18
Perinatal and Postnatal Changes in the Circulation p. 20
Myocardial Growth p. 29
Factors Affecting Perinatal Cardiac Output p. 31
Circulatory Regulation in the Fetus p. 35
Fetal Circulatory Response to Reduced Oxygen Delivery p. 37
Cardiac Failure in the Fetus p. 38
Changes in Childhood and Adolescence p. 43
Functional Assessment p. 45
Intravascular Pressures p. 45
Cardiac Output and Intravascular Shunts p. 54
Indicator Dilution Techniques p. 69
Vascular Resistance p. 74
Calculation of Valve Area p. 80
Quantitative Ultrasound Techniques p. 83
Oxygen Uptake and Delivery p. 85
Oxygen in the Blood p. 85
Relationship between Oxygen Partial Pressure (Tension) and Oxygen Saturation of Hemoglobin--The Oxygen Dissociation Curve p. 87
Levels of Oxygen in Cardiac Chambers and Great Vessels p. 92
Oxygen Supply and Requirement p. 102
Prenatal and Postnatal Pulmonary Circulation p. 121
Fetal Pulmonary Circulation p. 121
Changes in Pulmonary Circulation after Birth p. 131
Effects of Hypoxia and Altitude on the Pulmonary Circulation p. 137
Effects of Congenital Heart Disease on the Pulmonary Circulation p. 143
Lesions Associated with Left-to-Right Shunts
The Ductus Arteriosus and Persistent Patency of the Ductus Arteriosus p. 155
The Ductus Arteriosus in the Fetus p. 155
Postnatal Closure of the Ductus Arteriosus p. 158
Regulation of the Ductus Arteriosus p. 159
The Ductus Arteriosus in Congenital Heart Disease p. 164
The Ductus Arteriosus at High Altitude and with Hypoxia p. 165
The Ductus Arteriosus in Premature Infants p. 165
Persistent Patency of the Ductus Arteriosus--The Abnormal Ductus p. 176
Differential Diagnosis p. 191
Principles of Management p. 192
Ventricular Septal Defect p. 197
Morphological Considerations p. 197
Hemodynamic Considerations p. 199
Clinical Features p. 220
Differential Diagnosis p. 232
Principles of Management p. 235
Atrial Septal Defect: Partial Anomalous Drainage of Pulmonary Veins p. 245
Morphological and Embryological Considerations p. 246
Hemodynamic Considerations p. 248
Clinical Features p. 260
Differential Diagnosis p. 272
Principles of Management p. 274
Atrioventricular Septal Defect p. 283
Morphological and Embryological Considerations p. 284
Hemodynamic Considerations p. 288
Clinical Features p. 300
Differential Diagnosis p. 312
Therapeutic Considerations p. 313
Obstructive Lesions
Aortic Stenosis and Hypoplastic Left Ventricle p. 321
Morphological Considerations p. 322
Embryological Considerations p. 325
Hemodynamic Considerations p. 326
Clinical Features p. 344
Differential Diagnosis p. 357
Principles of Management p. 358
Aortic Arch Obstruction p. 367
Morphological Considerations p. 367
Embryological Considerations p. 372
Hemodynamic Considerations p. 378
Clinical Features p. 393
Differential Diagnosis p. 405
Principles of Management p. 406
Aortic Atresia, Mitral Atresia p. 413
Morphological and Embryological Considerations p. 414
Hemodynamic Considerations p. 416
Clinical Features p. 427
Cardiac Catheterization and Angiocardiography p. 434
Differential Diagnosis p. 439
Principles of Treatment p. 441
Total Anomalous Pulmonary Venous Connection p. 449
Morphological Considerations p. 449
Embryological Considerations p. 452
Hemodynamic Considerations p. 453
Clinical Features p. 470
Differential Diagnosis p. 484
Principles of Treatment p. 487
Pulmonary Stenosis and Atresia with Ventricular Septal Defect (Tetralogy of Fallot) p. 489
Morphological and Embryological Considerations p. 489
Hemodynamic Considerations p. 495
Clinical Feature p. 512
Cardiac Catheterization and Angiocardiography p. 523
Differential Diagnosis p. 532
Complications p. 533
Principles of Treatment p. 534
Pulmonary Stenosis and Atresia with Intact Ventricular Septum p. 551
Morphological and Embryological Considerations p. 552
Hemodynamic Considerations p. 558
Clinical Features p. 578
Cardiac Catheterization and Angiocardiography p. 587
Differential Diagnosis p. 596
Principles of Management p. 601
Tricuspid Atresia and Hypoplastic Right Ventricle p. 617
Morphological and Embryological Considerations p. 617
Hemodynamic Considerations p. 620
Clinical Features p. 632
Differential Diagnosis p. 643
Principles of Treatment p. 645
Ebstein Malformation of the Tricuspid Valve p. 655
Morphological and Embryological Features p. 655
Hemodynamic Considerations p. 657
Clinical Manifestations p. 662
Differential Diagnosis p. 668
Therapeutic Considerations p. 669
Aortopulmonary Anomalies
Transposition of the Great Arteries (Aortopulmonary Transposition) p. 675
Morphological and Embryological Considerations p. 676
Hemodynamic Disturbances p. 679
Clinical Features p. 706
Differential Diagnosis p. 722
Therapeutic Considerations p. 727
Truncus Arteriosus Communis p. 737
Morphological and Embryological Considerations p. 737
Hemodynamic Considerations p. 741
Clinical Features p. 749
Differential Diagnosis p. 758
Principles of Management p. 759
Selected References p. 763
Index p. 791
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