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Procedures in Chd surg and postop care

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By Javier Castro Heart Failure And Heart Transplantation
Adeel Ashfaq, Mohammad S Soroya, Amit Iyengar, Myke Federman, Brian L Reemtsen
We aimed to evaluate the outcomes of systemic-to-pulmonary (SP) shunt procedures utilizing heparin-coated (HC) polytetrafluoroethylene (PTFE) vascular grafts compared to uncoated (non-HC) grafts, in order to observe any benefits in pediatric patients. Our institution switched from using non-HC grafts to HC grafts in March 2011. We conducted a retrospective review of consecutive pediatric patients receiving SP shunts from May 2008 to December 2015. Perioperative variables including baseline characteristics, morbidity, mortality, and blood product utilization were evaluated between the HC and non-HC groups...
March 2018: Pediatric Cardiology
Masanori Mizuno, Takaya Hoashi, Heima Sakaguchi, Koji Kagisaki, Masataka Kitano, Kenichi Kurosaki, Jun Yoshimatsu, Isao Shiraishi, Hajime Ichikawa
BACKGROUND: Outcomes of surgical intervention for severe tricuspid regurgitation related to Ebstein anomaly or tricuspid valve dysplasia in the neonatal period, particularly when associated with pulmonary atresia, are extremely poor. However, owing to emerging innovative surgical techniques, such as cone reconstruction, outcomes of tricuspid valve plasty in the neonatal period have gradually improved. METHODS: The study retrospectively reviewed the medical records of 12 neonates who were diagnosed with severe tricuspid regurgitation and pulmonary atresia related to Ebstein anomaly (n = 9) or isolated tricuspid valve dysplasia (n = 3) between 2000 and 2013...
May 2016: Annals of Thoracic Surgery
Cuijin Wang, Shubao Chen, Haibo Zhang, Jinfen Liu, Zhiwei Xu, Jinhao Zheng, Qin Yan, Huimin Huang, Meirong Huang
Objective  To discuss the anatomical morphologies of the coronary arteries and frequencies of unusual coronary arteries in complete transposition of the great arteries and double outlet right ventricle (DORV) associated with a subpulmonic ventricular septal defect (VSD). Methods  Between March 1999 and August 2012, 1,078 patients with complete transposition of the great arteries or DORV with subpulmonary VSD underwent arterial switch operations (ASOs) and were visually evaluated to classify their coronary artery morphology during open heart surgery...
January 2017: Thoracic and Cardiovascular Surgeon
David A Hehir, R Blaine Easley, Jonathan Byrnes
Outcomes following cardiac intensive care unit (CICU) admission are influenced by many factors including initial cardiac diagnosis, surgical complexity, and burden of critical illness. Additionally, the presence of noncardiac issues may have a significant impact on outcomes and the patient experience during and following an intensive care unit stay. This review focuses on three common noncardiac areas which impact outcomes and patient experience in and beyond the CICU: feeding and growth, pain and analgesia, and anticoagulation...
March 2016: World Journal for Pediatric & Congenital Heart Surgery
José Luis Torres-Cosme, Constanza Rolón-Porras, Mónica Aguinaga-Ríos, Pedro Manuel Acosta-Granado, Enrique Reyes-Muñoz, Teresa Murguía-Peniche
BACKGROUND AND OBJECTIVES: Temporal trends in mortality from congenital heart disease (CHD) vary among regions. It is therefore necessary to study this problem in each country. In Mexico, congenital anomalies were responsible for 24% of infant mortality in 2013 and CHD represented 55% of total deaths from congenital anomalies among children under 1 year of age. The objectives of this study were to analyze the trends in infant mortality from CHD in Mexico (1998 to 2013), its specific causes, age at death and associated socio-demographic factors...
2016: PloS One
Benjamin J S Al-Haddad, Jeremiah S Menk, Lazaros Kochilas, Jeffrey M Vinocur
Surgical treatment of congenital heart disease represents a major cause of pediatric hospitalization and healthcare resource use. Larger centers may provide more efficient care with resulting shorter length of postoperative hospitalization (LOH). Data from 46 centers over 25 years were used to evaluate whether surgical volume was an important determinant of LOH using a competing risk regression strategy that concurrently accounted for deaths, transfers, and discharges with some time interactions. Earlier discharge was more likely for infants and older children compared to neonates [subhazard ratios at postoperative day 6 of 1...
June 2016: Pediatric Cardiology
Hussam Suradi, Ziyad M Hijazi
Coarctation of the aorta (C) is the sixth most common lesion in congenital heart disease and represents a spectrum of aortic narrowing that varies from a discrete entity to tubular hypoplasia. This condition was once thought to be a relatively simple lesion that would be "cured" upon repair of the narrowing, however, despite relief of the anatomical obstruction the subsequent risk of early morbidity and death persists. This review outlines the optimal management strategy of this disease from neonatal to adult life and provides insights to approach this straightforward but challenging condition...
2015: Global Cardiology Science & Practice
Hamid Bigdelian, Mohsen Sedighi
BACKGROUND: Tetralogy of Fallot (TOF) is a well-recognized congenital heart disease. Despite improvements in the outcomes of surgical repair, the optimal timing of surgery and type of surgical management of patients with TOF remains controversial. The purpose of this study was to assess outcomes following the repair of TOF in infants depending on the surgical procedure used. METHODS: This study involved the retrospective review of 120 patients who underwent TOF repair between 2010 and 2013...
February 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Mahsun Yuerek, Joseph W Rossano, Christopher E Mascio, Robert E Shaddy
Low cardiac output syndrome (LCOS) is a well-described entity occurring in 25-65% of pediatric patients undergoing open-heart surgery. With judicious intensive care management of LCOS, most patients have an uncomplicated postoperative course, and within 24 h after cardiopulmonary bypass, the cardiac function returns back to baseline. Some patients have severe forms of LCOS not responsive to medical management alone, requiring temporary mechanical circulatory support to prevent end-organ injury and to decrease myocardial stress and oxygen demand...
2016: Expert Review of Cardiovascular Therapy
Hyun-Jin Jung, Ji Hyun Bang, Chun-Soo Park, Jeong-Jun Park, Yu-Mi Im, Tae-Jin Yun
Indications of sutureless repair (SR) for pulmonary vein anomalies have evolved from re-operational SR for pulmonary vein stenosis after the repair of total anomalous pulmonary venous drainage (TAPVD) to primary SR for TAPVD associated with right atrial isomerism or isolated TAPVD with small individual pulmonary veins (IPVs) and an unfavorable pulmonary vein anatomy. We sought to determine whether small IPVs outgrow somatic growth after primary SR. Between 2004 and 2013, 21 children underwent primary SR for TAPVD: 13 with a functionally single ventricle, 11 with right atrial isomerism, six with isolated TAPVD, and 13 with a pulmonary venous obstruction...
February 2016: Pediatric Cardiology
Jarle Jortveit, Leif Eskedal, Asle Hirth, Tatiana Fomina, Gaute Døhlen, Petter Hagemo, Grethe S Tell, Sigurd Birkeland, Nina Øyen, Henrik Holmstrøm
AIMS: Congenital heart defects (CHDs) are the most common birth defects and are an important cause of death in children. The fear of sudden unexpected death has led to restrictions of physical activity and competitive sports. The aim of the present study was to investigate the rate of sudden unexpected deaths unrelated to surgery in children 2-18 years old with CHDs and, secondarily, to determine whether these deaths were related to cardiac disease, comorbidity, or physical activity. METHODS AND RESULTS: To identify children with CHDs and to determine the number of deaths, data concerning all 9 43 871 live births in Norway in 1994-2009 were retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry for Congenital Heart Defects and the Norwegian Cause of Death Registry...
February 14, 2016: European Heart Journal
Michael F Canarie, Suzanne Barry, Christopher L Carroll, Amanda Hassinger, Sarah Kandil, Simon Li, Matthew Pinto, Stacey L Valentine, E Vincent S Faustino
OBJECTIVE: Delayed enteral nutrition, defined as enteral nutrition started 48 hours or more after admission to the PICU, is associated with an inability to achieve full enteral nutrition and worse outcomes in critically ill children. We reviewed nutritional practices in six medical-surgical PICUs and determined risk factors associated with delayed enteral nutrition in critically ill children. DESIGN: Retrospective cross-sectional study using medical records as source of data...
October 2015: Pediatric Critical Care Medicine
Zainab Samad, Linda K Shaw, Matthew Phelan, Mads Ersboll, Niels Risum, Hussein R Al-Khalidi, Donald D Glower, Carmelo A Milano, John H Alexander, Christopher M O'Connor, Andrew Wang, Eric J Velazquez
AIMS: The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes of patients with moderate or severe mitral regurgitation (MR) and LV systolic dysfunction. METHODS AND RESULTS: For the period 1995-2010, the Duke Echocardiography Laboratory and Duke Databank for Cardiovascular Diseases databases were merged to identify patients with moderate or severe functional MR and severe LV dysfunction (defined as LV ejection fraction ≤ 30% or LV end-systolic diameter > 55 mm)...
October 21, 2015: European Heart Journal
Nina Laudato, Pooja Gupta, Henry L Walters, Ralph E Delius, Christopher W Mastropietro
OBJECTIVE: Extubation failure after neonatal cardiac surgery has been associated with considerable postoperative morbidity, although data identifying risk factors for its occurrence are sparse. We aimed to determine risk factors for extubation failure in our neonatal cardiac surgical population. DESIGN: Retrospective chart review. SETTING: Urban tertiary care free-standing children's hospital. PATIENTS: Neonates (0-30 d) who underwent cardiac surgery at our institution between January 2009 and December 2012 was performed...
November 2015: Pediatric Critical Care Medicine
David Faraoni, Viviane G Nasr, James A DiNardo
This study sought to determine overall hospital cost in children with congenital heart disease (CHD) and to compare cost associated with cardiac surgical procedures, cardiac catheterizations, non-cardiac surgical procedures, and medical admissions. The 2012 Healthcare Cost and Utilization Project Kid's Inpatient Database was used to evaluate hospital cost in neonates and children with CHD undergoing cardiac surgery, cardiac catheterization, non-cardiac surgical procedures, and medical treatments. Multivariable logistic regression was applied to determine independent predictors for increased hospital cost...
January 2016: Pediatric Cardiology
Neeraj Awasthy, Yasser Bhat, S Radhakrishnan, Rajesh Sharma
Eosinophilia is a very unusual and rare cause of thrombosis of prosthetic mitral valve. We report a 10-year-old male child of recurrent stuck prosthetic mitral valve. The child underwent mitral valve replacement for severe mitral regurgitation secondary to Rheumatic heart disease. He had recurrent prosthetic mitral valve thrombosis, despite desired INR levels. There was associated eosinophilia. The child was treated on the lines of tropical eosinophilia with oral prednisolone and diethylcarbamazine, the eosinophil count dropped significantly with no subsequent episode of stuck mitral valve...
March 2015: Pediatric Cardiology
Koichi Sughimoto, Kazuki Okauchi, Diana Zannino, Christian P Brizard, Fuyou Liang, Michiko Sugawara, Hao Liu, Ken-Ichi Tsubota
The classical Fontan route, namely the atriopulmonary connection (APC), continues to be associated with a risk of thrombus formation in the atrium. A conversion to a total cavopulmonary connection (TCPC) from the APC can ameliorate hemodynamics for the failed Fontan; however, the impact of these surgical operations on thrombus formation remains elusive. This study elucidates the underlying mechanism of thrombus formation in the Fontan route by using a two-dimensional computer hemodynamic simulation based on a simple blood coagulation rule...
October 2015: Pediatric Cardiology
Ra-Id Abdulla
No abstract text is available yet for this article.
December 2014: Pediatric Cardiology
Tatiana Z A L Sampaio, Katie O'Hearn, Deepti Reddy, Kusum Menon
Fluid overload and prolonged mechanical ventilation lead to worse outcomes in critically ill children. However, the association between these variables in children following congenital heart surgery is unknown. The objectives of this study were to describe the association between fluid overload and duration of mechanical ventilation, oxygen requirement and radiologic findings of pulmonary and chest wall edema. This study is a retrospective chart review of patients who underwent congenital heart surgery between June 2010 and December 2013...
December 2015: Pediatric Cardiology
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