Marie M Gleason, M.D.  

The Children’s Hospital of Philadelphia
877-77 HEART (877-774-3278)
Philadelphia, PA
My Posts
May 15, 2014 in the Pediatric Heart Expert Forum - 5
Usually the progression to aortic valve leakage is very slow in this situation. Once a trivial amount of valve leakage develops then surgery could be undertaken. Aortic valve leakage of a trivial degree usually does not progress. However, if you feel very uncomfortable about this aspect of the condition, then it might push you to agree to surgical repair a...
May 07, 2014 in the Pediatric Heart Expert Forum - 5
The dilation of the aorta is not enough of an indication to proceed with surgery if there is no aortic valve leakage. Careful follow up should allow you to pick up even minor changes in aortic valve function. Unfortunately it sounds like you need the tie-breaker 3rd opinion.
May 01, 2014 in the Pediatric Heart Expert Forum - 5
Thank you for your posting. When the right coronary cusp of the aortic valve prolapses into a VSD (it can either be a perimembranous or outlet type for this to happen), it is a concern, because the distortion of the aortic valve can lead to the development of valve leakage (because the leaflets do not close properly). In general, if this is being watched clo...
Apr 29, 2014 in the Pediatric Heart Expert Forum - 1
Due to your age you are out of the range for a pediatric cardiologist to make any comments. Additionally nobody can answer your question without information about what testing has been done to evaluate your symptoms. Perhaps you should see an adult cardiologist if you have chest pains.
Apr 28, 2014 in the Pediatric Heart Expert Forum - 1
A 4 mm ASD is not large and likely will close up or get smaller over time; it would not be a driving factor for surgical intervention at this point. I think you are saying that there are 2 VSD's- one 5 mm and one 4 mm in size, is that correct? (combined effect could be at least of moderate extra blood flow to the lungs which could elevated the lung art...
Apr 25, 2014 in the Pediatric Heart Expert Forum - 1
Heart murmurs are common in children, and most of them are innocent or benign in nature with no underlying heart probelms. They can be heard at many different phases of growth, especially between the ages of 2 and 6 years. If a doctor hears a new murmur, they often recommend a pediatric cardiology consultation to make sure the murmur does not fall into the ...
Apr 25, 2014 in the Pediatric Heart Expert Forum - 1
Blueness around the mouth and eyes is due to prominence of the collection of veins that are found around the mouth and eyes. Even though there mught be a bluish appearance, as long as the lips and tongue are a normal pink color, and someone has checked her oxygen saturation level along the line and it was normal, then there should not be a problem there. Ge...
Apr 24, 2014 in the Pediatric Heart Expert Forum - 3
Bicuspid aortic valves are associated with abnormal aortas, called an "aortopathy" in some patients. The ascending aorta can dilate to various degrees. This can occur with or without stenosis of the aortic valve. Fortunately the incidence of aortic dissection or tearing is lower in these patients than it is in patients with Marfan syndrome. Unfo...
Apr 22, 2014 in the Pediatric Heart Expert Forum - 1
Patients with some congenital heart defects do seem prone to GE reflux and that can complicate assessment of the effects of the VSD. However, if the baby is sweating with and without feeds, this is likely related to the large VSD. It is always our preference to try to give the child enough time to see if nature can make the VSD smaller, but if the child con...
Apr 21, 2014 in the Pediatric Heart Expert Forum - 5
Please understand that your questions cannot be answered while the child is still in the womb. Nobody can tell you what your child will need until after the baby is born and the size of the individual defects are accurately assessed. Surgeries for congenital heart defects are only undertaken if absolutely necessary. If the problem is mild or medium, it may ...