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Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual

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https://www.readbyqxmd.com/read/27060049/mechanical-pulmonary-valve-replacement
#1
REVIEW
John M Stulak, Bassem N Mora, Sameh M Said, Hartzell V Schaff, Joseph A Dearani
Although most valve operations performed annually address lesions of the aortic or mitral valves, the frequency of pulmonary valve replacement (PVR) is increasing because most patients with congenital heart disease are surviving into the adult years. The vast majority of patients, especially children that require PVR, obtain a tissue valve because of the relative good durability and the lack of a need for anticoagulation. Because the need for repeat operation is inevitable for most patients, and the population of adults with congenital heart disease continues to grow, there are increasing situations in which a mechanical pulmonary prosthesis may be appropriate...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060048/preservation-of-the-pulmonary-valve-during-early-repair-of-tetralogy-of-fallot-surgical-techniques
#2
REVIEW
Vladimiro L Vida, Alvise Guariento, Fabio Zucchetta, Massimo Padalino, Biagio Castaldi, Ornella Milanesi, Giovanni Stellin
During the last decade interest in preserving pulmonary valve (PV) function has stimulated a few surgeons to apply valve-sparing techniques in repairing tetralogy of Fallot (TOF), with the aim of preserving long-term right ventricular function. Since June 2007, we embarked upon a program for preserving PV function in selected patients during TOF repair. More recently, the introduction of more complex PV plasty techniques allowed us to further extend the applicability of PV preservation techniques. We believe that preservation of PV function during early repair of TOF, by combining different intraoperative surgical maneuvers, can be extended to almost all patients with classic TOF...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060047/transcatheter-hybrid-aortic-valves-in-the-young
#3
REVIEW
Mirko Doss, Thomas Walther
Transcatheter aortic valve implantation (T-AVI) has been established as an alternative to conventional aortic valve replacement. The number of procedures is steadily rising and has reached comparable implant rates to conventional aortic valve replacement. The success of T-AVI is easily explained by their true minimally invasive nature, ease of use, and excellent hemodynamics. Whilst their use was initially limited to high-risk patients, current trends show that more and more intermediate-risk patients are now treated with theses prostheses...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060046/are-bioprosthetic-valves-appropriate-for-aortic-valve-replacement-in-young-patients
#4
REVIEW
Aditya K Kaza, Frank A Pigula
Selection of a prosthetic aortic valve for use in the young patient is complicated by a variety of important considerations. Age, growth potential, activity and life style expectations, child bearing, and social factors, in addition to anatomic considerations, are all important to the recommendation of a prosthetic valve choice. We review the clinical experience and expectations of currently available prosthetic aortic valves available for the young patient, and describe the advantages and disadvantages for each...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060045/long-term-clinical-and-imaging-follow-up-after-reinforced-pulmonary-autograft-ross-procedure
#5
REVIEW
Thierry Carrel, Alexander Kadner
The Ross operation remains a controversially discussed procedure when performed in the full root technique because concern exists regarding late dilatation of the pulmonary autograft and regurgitation of the neo-aortic valve. In 2008, we published our short-term experience when using external reinforcement of the autograft, which was inserted into a prosthetic Dacron graft. This detail was thought to prevent neoaortic root dilatation. Since 2006, 22 adult patients have undergone a Ross procedure using this technique...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060044/when-and-how-to-enlarge-the-small-aortic-root
#6
REVIEW
Phan-Kiet Tran, Victor Tsang
Successful enlargement of the small aortic root in children has remained a management challenge, particularly in the neonates and small infants. Achieving this aim requires thorough understanding of the anatomic features of the left ventricular outflow tract, careful patient selection, and skilful execution of complex surgery. This article reviews the anatomical principles upon which the surgical techniques rely, the decision-making, the timing of surgery, the surgical options, and the outcomes.
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060043/is-four-stage-management-the-future-of-univentricular-hearts-destination-therapy-in-the-young
#7
REVIEW
Robert D B Jaquiss, Hamza Aziz
For the child born with a functionally univentricular heart, multi-stage surgical palliation culminating in the Fontan operation is now well established as the standard of care. Though this is an effective approach, there are several inherent disadvantages to the Fontan circulation: subnormal resting cardiac output, impaired exercise capacity, increased risk of thromboembolism, and increased risk of arrhythmia. Perhaps most importantly, the long-term deleterious effects of substantial systemic venous hypertension, which is necessary to "drive" blood through the pulmonary vascular bed, include progressive dysfunction of other organ systems, particularly renal, lymphatic, gastrointestinal, and hepatic systems...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060042/heart-transplantation-in-children-after-a-fontan-procedure-better-than-people-think
#8
REVIEW
Kirk R Kanter
Previous studies have reported that children with a prior Fontan procedure have decreased survival after heart transplantation. We examined 273 primary pediatric heart transplants. Since 1988, 33 (12.1%) of 273 children <18 years old undergoing primary heart transplantation had a Fontan procedure 3.7 ± 4.3 years before transplantation. Compared with 240 (87.9%) non-Fontan primary transplants, the Fontan patients were older (8.8 ± 5.2 vs 6.6 ± 5.9 years; P = .023), but were similar in presensitization and pre-transplant clinical status...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060041/the-relentless-effects-of-the-fontan-paradox
#9
REVIEW
Jack Rychik
The Fontan operation is the anticipated palliative strategy for children born with single-ventricle type of congenital heart disease. As a result of important circulatory limitations, a series of end-organ complications are now increasingly recognized. Elevated central venous pressure and impaired cardiac output are the hallmarks of cavo-pulmonary flow, which result in a cascade of pathophysiological consequences. The Fontan circulation likely impacts all organ systems in an indolent and relentless manner, with progressive decline in functionality likely to occur in many...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060040/anomalous-aortic-origin-of-a-coronary-artery-is-not-always-a-surgical-disease
#10
REVIEW
Ralph S Mosca, Colin K L Phoon
Anomalous aortic origin of the coronary artery (AAOCA) from the opposite sinus of Valsalva with an interarterial course has become a high-profile lesion as a result of its association with sudden cardiac death in otherwise young and healthy individuals. Despite our incomplete knowledge of its pathophysiology and natural history, surgical intervention is often recommended. Evidence now shows AAOCA to be relatively common, with lower than previously suspected rates of sudden cardiac death. Analysis of this information reveals that AAOCA is not always a surgical disease...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060039/anomalous-aortic-origin-of-a-coronary-artery-is-always-a-surgical-disease
#11
REVIEW
Pascal R Vouhé
Anomalous aortic origin of a coronary artery is a congenital anomaly in which a major coronary artery arises from the wrong sinus of Valsalva (left coronary from right sinus or right coronary from left sinus) and courses between the great arteries before reaching its normal epicardial course. Although the risk of sudden death is clearly established, the indications for surgery remain controversial. The risk of sudden death is increased in symptomatic patients, in anomalous left coronary artery, as well as in the presence of some risk factors (intense physical activity, young age [<35 years], aggravating anatomical features [intramural interarterial course, slit-like ostium, acute angle of take-off])...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060038/larger-centers-produce-better-outcomes-in-pediatric-cardiac-surgery-regionalization-is-a-superior-model-the-con-prospective
#12
REVIEW
Mark H D Danton
Regionalization, in the context of congenital heart surgery, describes a process where smaller units close and patients are redistributed to larger centers. Proponents argue this will produce superior patient outcome based primarily on a volume-outcome effect. The potential disadvantage is that, as distance to center increases, access to service is compromised. In this article the volume-outcome effect is appraised and the effect of risk-stratification and threshold volumes explored. Access to service, and how certain congenital lesions and demographics might be disadvantaged, is reviewed...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060037/larger-centers-may-produce-better-outcomes-is-regionalization-in-congenital-heart-surgery-a-superior-model
#13
REVIEW
Sarah Burki, Charles D Fraser
Efforts to correlate outcomes of children undergoing heart surgery with center volume and characteristics are not novel. In the current era, outcomes are defined as, and in many cases limited to, mortality rates. Over the past two decades, several investigators have explored various aspects of the volume-mortality relationship. The association between center volume and mortality, although not uniform, is highly implicated by the current literature. Notwithstanding, varied population densities in the United States makes regionalization of specialized services, such as pediatric cardiac surgery, undeniably challenging...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060036/neonatal-aortic-stenosis-is-a-surgical-disease-an-interventional-cardiologist-view
#14
REVIEW
Lee Benson
The application of balloon valvotomy as primary treatment for neonatal congenital aortic stenosis is contentious. In this debate, we discuss data comparing outcomes of a percutaneous and surgical strategy between two tertiary centers that have adopted opposite therapeutic strategies. The outcomes with surgical and balloon therapies appear comparable. These contemporaneous data validate the empiric switch to primary balloon valvotomy in the modern era.
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060035/neonatal-aortic-stenosis-is-a-surgical-disease
#15
REVIEW
Viktor Hraška
Neonates with critical aortic stenosis represent a challenging group of patients with severe obstruction at a valvar level and with symptoms of heart failure. If biventricular repair is chosen, open valvotomy (OV) has been firmly established as the most effective initial treatment. In comparison with blind ballooning, OV, with exact splitting of fused commissures and shaving of obstructing nodules, can produce a better valve with a maximum valve orifice, without causing regurgitation. Thus, predictable and consistent early and longer-lasting results in any type of valve morphology are provided...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27060034/introduction
#16
Robert D B Jaquiss
No abstract text is available yet for this article.
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/25939845/three-dimensional-echocardiography-for-the-assessment-of-atrioventricular-valves-in-congenital-heart-disease-past-present-and-future
#17
REVIEW
Timothy Colen, Jeffrey F Smallhorn
Echocardiography has developed as an imaging technology over 60 years to become the mainstay for investigating heart disease, providing invaluable structural and functional information. In the last 20 years, 3-dimensional echocardiography (3DE) has emerged as an adjunct to 2-dimensional echocardiography in adult and congenital heart disease. Early work with 3-dimensional imaging of the mitral valve describing normal annular shape and function significantly changed the understanding of mitral valve dynamics...
2015: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/25939844/tracheobronchial-issues-in-congenital-heart-disease
#18
REVIEW
Catherine K Hart, Michael J Rutter
In children with congenital heart disease, tracheobronchial compromise is uncommon but potentially life-threatening. Airway lesions in these patients may be congenital or acquired, and may be stenotic, compressive, or malacic in nature. We present an overview of the etiologies of tracheobronchial lesions typically seen in children with congenital heart disease and review management options for these lesions.
2015: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/25939843/improving-pacemaker-therapy-in-congenital-heart-disease-contractility-and-resynchronization
#19
REVIEW
Peter P Karpawich
Designed as effective therapy for patients with symptomatic bradycardia, implantable cardiac pacemakers initially served to improve symptoms and survival. With initial applications to the elderly and those with severe myocardial disease, extended longevity was not a major concern. However, with design technology advances in leads and generators since the 1980s, pacemaker therapy is now readily applicable to all age patients, including children with congenital heart defects. As a result, emphasis and clinical interests have advanced beyond simply quantity to quality of life...
2015: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/25939842/checklists-and-safety-in-pediatric-cardiac-surgery
#20
REVIEW
Chris Konfirst, Stephanie Preston, Thomas Yeh
In rebuilding Tulane's pediatric heart center after Hurricane Katrina, the use of checklists proved to be essential, not only in rebuilding inventory and systems, but the culture of continued debriefing around their use was seminal in establishing a culture of safety and trust between caregivers; safety that ultimately benefitted our patients.
2015: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
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