Michael Cooper

UCSF University of California, San Francisco | UCSF · Department of Pediatrics

The cardiovascular-radical outcome method is a proactive process of patient care that uses standard critical pathway methodology to reduce negative variation while encouraging positive variation to accelerate recovery. Its effectiveness in patients with complex congenital heart disease is explored. Two hundred fourteen consecutive patients with con...

To assess the indications, use, and yield of fetal echocardiography. We reviewed our 8-year experience with fetal echocardiography at a large health maintenance organization in northern California to assess the yield of abnormal findings for each indication and the accuracy of prenatal cardiac diagnosis. The study included 915 fetuses undergoing fe...

In a critically ill neonate, pulsed and color-flow Doppler echocardiography was able to document normal pulmonary venous return after an intravenous dose of tolazoline hydrochloride. Differential diagnosis was between persistent pulmonary hypertension of the newborn and obstructed total anomalous pulmonary venous return. Once normal pulmonary venou...

Critical pathway methodology has been demonstrated to provide producible reduction in average length of stay (ALOS) in adults in certain diagnostic-related groups and operations such as coronary artery bypass grafting. The efficacy of this approach in congenital heart surgery was explored. Two hundred eighty-six consecutive patients from a health m...

• Maternal hyperglycemia may result in fetal hyperinsulinemia and asymmetric septal hypertrophy, macrosomia, and hypoglycemia in infants of diabetic mothers. We monitored glycosylated hemoglobin levels in 61 pregnant • betic women each trimester as an index of maternal glycemic control and did serial fetal echocardiograms starting at 18 weeks of ge...

Maternal hyperglycemia may result in fetal hyperinsulinemia and asymmetric septal hypertrophy, macrosomia, and hypoglycemia in infants of diabetic mothers. We monitored glycosylated hemoglobin levels in 61 pregnant diabetic women each trimester as an index of maternal glycemic control and did serial fetal echocardiograms starting at 18 weeks of ges...

Changes in the Doppler indexes, acceleration time (AcT), right ventricular ejection time (RVET), AcT/RVET ratio and pulmonary artery peak velocity were measured as were changes in pulmonary artery pressure and pulmonary vascular resistance in 21 children with pulmonary hypertension due to a large interventricular communication. In 11 children pulmo...

Five children, aged 0.2 to 6.7 years, with pulmonary artery origin of the left coronary artery proved by angiography underwent echocardiographic examination from 1985 through 1986. Prospective identification of this condition was achieved by two-dimensional echocardiography alone in two patients. Using a parasagittal plane from the second or third...

We have demonstrated an anomalous left coronary artery originating from the main pulmonary artery by saline contrast echocardiography. The anomalous vessel was easily identified using contrast injections into the ascending aorta at catheterization and into a radial artery cannula following catheterization. Contrast echocardiography may be useful in...

A coronary-cameral fistula was inspected clinically by two-dimensional and pulsed Doppler ultrasound. At cardiac catheterization a fistulous connection between the left coronary artery and the right ventricle was observed. Contrast echocardiography using agitated saline solution injected into the aortic catheter clearly showed the passage of microc...

Verapamil is effective in the treatment of hypertrophic cardiomyopathy (HC).1-4 Continuous-wave Doppler ultrasound is useful in the noninvasive assessment of high-velocity intracardiac blood flow.5 We evaluated the hemodynamic response in a child with HC through intravenously administered verapamil during cardiac catheterization with simultaneous c...

Right ventricular (RV) wall thickness was measured from M-mode echocardiograms at end-diastole from both the parasternal and subcostal approaches in 50 children of various body surface areas (0.24 to 1.68 m2). The measurements were obtained from M-mode recordings generated from sector scans to ensure precise location and position. Twenty-three chil...

We studied neonates with the infradiaphragmatic form of total anomalous pulmonary venous drainage by a combination of cross-sectional echocardiography and pulsed Doppler ultrasound. The diagnosis by ultrasound was made prospectively in all six patients. Three large vascular channels could be observed passing through the diaphragm from the subcostal...

Mitral valve prolapse (MVP) consists of prolapse or billowing of the mitral leaflet(s) into the left atrium during ventricular systole associated with a mid-to-late systolic click and/or a late systolic murmur. Thoracic skeletal abnormalities, progressive mitral regurgitation, ventricular arrhythmia, and sudden death have been associated with an au...

• Mitral valve prolapse (MVP) consists of prolapse or billowing of the mitral leaflet(s) into the left atrium during ventricular systole associated with a mid-to-late systolic click and/or a late systolic murmur. Thoracic skeletal abnormalities, progressive mitral regurgitation, ventricular arrhythmia, and sudden death have been associated with an...

Chronic sympathetic nervous system overactivity has been implicated as a factor capable of elevating and maintaining high serum cholesterol levels independent of dietary measures. We conducted a controlled trial to determine the effect of a relaxation technique. Transcendental Meditation, on serum cholesterol levels in hypercholesterolemic subjects...

A rare form of paroxysmal supraventricular tachycardia (SVT), associated with swallowing solid food, is described. Repeated triggering of the arrhythmia during esophagoscopy was produced by mechanical stimulation of the anterior esophageal wall, 30 cm from the incisors. Treatment with verapamil abolished this tachycardia. Esophagoscopic examination...

The antiarrhythmic efficacy of mexiletine hydrochloride was studied in ten selected patients with stable resistant ventricular ectopic activity in whom lidocaine, procainamide, and other antiarrhythmic agents were of no avail. Continuous Holter ECG tapes were analyzed before, during, and after mexiletine. Orally administered mexiletine was found to...

The antiarrhythmic efficacy of mexiletine hydrochloride was studied in ten selected patients with stable resistant ventricular ectopic activity in whom lidocaine, procainamide, and other antiarrhythmic agents were of no avail. Continuous Holter ECG tapes were analyzed before, during, and after mexiletine. Orally administered mexiletine was found to...

A bradycardic and mildly hypotensive acute myocardial infarction patient developed sinus tachycardia, ventricular tachycardia, flutter, and fibrillation following intravenous atropine. Previous case reports are reviewed and the literature regarding the advisability of this mode of therapy is discussed. In the light of conflicting opinion as to the...