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https://www.readbyqxmd.com/read/29341986/pulmonary-dead-space-fraction-and-extubation-success-in-children-after-cardiac-surgery
#1
Renee L Devor, Paul Kang, Chasity Wellnitz, John J Nigro, Daniel A Velez, Brigham C Willis
OBJECTIVES: 1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. DESIGN: A retrospective chart review. SETTING: Cardiac ICU in a quaternary care free-standing children's hospital...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29327893/heart-failure-in-grown-up-congenital-heart-disease
#2
Alessia Faccini, Angelo Micheletti, Diana G Negura, Luca Giugno, Gianfranco Butera, Mario Carminati, Alessandro Giamberti, Massimo Chessa
The increasing survival in the adulthood of patients with congenital heart disease (CHD) has changed the epidemiology of adult CHD (ACHD) patients and has led to an increment in hospitalization rates due to heart failure (HF). ACHD patients hospitalized for HF have a five-fold higher risk of death HF than those compensated. HF occurs predominantly in patients with tetralogy of Fallot, single ventricles, and after the Mustard operation for transposition of the great arteries. Diagnostic strategies applied in acquired HF patients are usually used to evaluate ACHD patients, but sometimes this can postpone the identification of HF that can become manifest with unusual and peculiar signs or symptoms...
January 10, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29327147/post-operative-catheterization-interventions-at-the-site-of-surgery-an-application-of-the-crisp-scoring-system
#3
Katie Mowers, Toby Rockefeller, David Balzer, Ramzi Nicolas, Shabana Shahanavaz
Catheter-based interventions in the early post-operative period are performed with caution due to concerns for increased procedural risk, particularly across fresh suture lines. The recently published CRISP scoring system provides prospective risk stratification based on pre-procedural criterion. In an effort to refine the assessment of risk in patients undergoing post-operative catheter-based interventions, the predicted risk of an adverse event based on CRISP scores was compared to actual adverse event rates...
January 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29316996/a-randomised-trial-of-early-palliative-care-for-maternal-stress-in-infants-prenatally-diagnosed-with-single-ventricle-heart-disease
#4
Hayley S Hancock, Ken Pituch, Karen Uzark, Priya Bhat, Carly Fifer, Maria Silveira, Sunkyung Yu, Suzanne Welch, Janet Donohue, Ray Lowery, Ranjit Aiyagari
Children with single-ventricle disease experience high mortality and complex care. In other life-limiting childhood illnesses, paediatric palliative care may mitigate maternal stress. We hypothesised that early palliative care in the single-ventricle population may have the same benefit for mothers. In this pilot randomised trial of early palliative care, mothers of infants with prenatal single-ventricle diagnoses completed surveys measuring depression, anxiety, coping, and quality of life at a prenatal visit and neonatal discharge...
January 10, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29315714/brain-abnormalities-in-cognition-anxiety-and-depression-regulatory-regions-in-adolescents-with-single-ventricle-heart-disease
#5
Nancy A Pike, Bhaswati Roy, Ritika Gupta, Sadhana Singh, Mary A Woo, Nancy J Halnon, Alan B Lewis, Rajesh Kumar
BACKGROUND: Single ventricle heart disease (SVHD) adolescents show cognitive impairments and anxiety and depressive symptoms, indicating the possibility of brain injury in regions that control these functions. However, brain tissue integrity in cognition, anxiety, and depression regulatory sites in SVHD remains unclear. We examined brain tissue changes in SVHD compared to controls using T2-relaxometry procedures, which measure free water content and show tissue injury. METHODS: Proton-density and T2-weighted images, using a 3...
January 6, 2018: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/29315433/indications-for-and-results-of-axillary-arterio-venous-fistula-in-patients-with-a-functionally-single-ventricle-after-cavopulmonary-anastomosis
#6
Ivan A Yurlov, Vladimir P Podzolkov, Dmitry V Kovalev, Mikhail M Zelenikin, Victor B Samsonov, Nikolay S Chikin, Lyudmila A Yurpol'skaya, Tatyana V Mataeva
OBJECTIVES: This study aimed to investigate the indications for and the results of axillary arterio-venous fistula in patients with a functionally single ventricle at mid-term follow-up after bidirectional cavopulmonary connection. METHODS: From 2012 to 2017, 20 patients aged 21 ± 8.7 years underwent axillary arterio-venous fistula after bidirectional cavopulmonary connection in our institution. The interval between bidirectional cavopulmonary connection and axillary arterio-venous fistula was 13...
January 5, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29310555/mechanical-circulatory-support-for-the-failing-fontan-conversion-to-assisted-single-ventricle-circulation-preliminary-observations
#7
Syed M Peer, Kristopher B Deatrick, Thomas J Johnson, Jonathan W Haft, Francis D Pagani, Richard G Ohye, Edward L Bove, Alvaro Rojas-Peña, Ming-Sing Si
BACKGROUND: Mechanical circulatory support (MCS) of a failing Fontan circulation remains challenging. We hypothesized that MCS can be provided by converting the Fontan circulation into a mechanically assisted single ventricle parallel circulation (MASVC). METHODS: A porcine model of functionally univentricular circulation was created under cardiopulmonary bypass (CPB) by performing an atrial septectomy, tricuspid valvectomy, and interrupting antegrade pulmonary blood flow...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29305367/embolic-stroke-in-a-postpartum-patient-with-fontan-physiology
#8
Katherine VanHise, Linda Li, Emily Smith, Niamh Condon
In cardiac physiology, single ventricle typically refers to the presence of a dominant systemic ventricle along with a hypoplastic ventricle. The Fontan operation is used to repair the single ventricle by directing deoxygenated systemic venous flow to the pulmonary arterial circulation. Normal pregnancy physiology, particularly increased intravascular volume, increased heart rate, increased cardiac output, hypercoagulability and decreased systemic vascular resistance, can exacerbate cardiac disease in patients with Fontan circulation, leading to pregnancy complications...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29299618/heart-transplantation-in-children-with-turner-syndrome-analysis-of-a-linked-dataset
#9
Joshua D Chew, Jonathan H Soslow, Cary Thurm, Matt Hall, Debra A Dodd, Brian Feingold, Jill Simmons, Justin Godown
Turner syndrome (TS) patients with hypoplastic left heart syndrome (HLHS) have poor single ventricle palliation outcomes; therefore, consideration of other potential management strategies is important. Little is known about heart transplantation (HTx) in this group, as standard HTx databases do not allow for identification of TS. This study describes experiences and outcomes of HTx in TS using a unique linkage between the Scientific Registry of Transplant Recipients and the Pediatric Health Information System databases...
January 3, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29298325/conditional-ablation-of-the-rfx4-isoform-1-transcription-factor-allele-dosage-effects-on-brain-phenotype
#10
Ping Xu, James P Morrison, Julie F Foley, Deborah J Stumpo, Toni Ward, Darryl C Zeldin, Perry J Blackshear
Regulatory factor X4 (RFX4) isoform 1 is a recently discovered isoform of the winged helix transcription factor RFX4, which can bind to X-box consensus sequences that are enriched in the promoters of cilia-related genes. Early insertional mutagenesis studies in mice first identified this isoform, and demonstrated that it was crucial for mouse brain development. RFX4 isoform 1 is the only RFX4 isoform significantly expressed in the mouse fetal and adult brain. In this study, we evaluated conditional knock-out (KO) mice in which one or two floxed alleles of Rfx4 were deleted early in development through the use of a Sox2-Cre transgene...
2018: PloS One
https://www.readbyqxmd.com/read/29287141/isolated-coarctation-of-the-aorta-in-the-fetus-a-diagnostic-challenge
#11
Joshua A Kailin, Alexia B Santos, Betul Yilmaz Furtun, S Kristen Sexson Tejtel, Regina Lantin-Hermoso
Isolated coarctation of the aorta (CoA) is estimated by the Centers for Disease Control and Prevention to account for 4%-6% of all congenital heart disease (CHD) in the United States, with a reported prevalence of ~4 per 10 000 live births. Prenatal recognition of coarctation is important as it may improve neonatal survival and reduce morbidity. However, despite advances in imaging and the trend toward detailed aortic arch assessment as part of a comprehensive fetal echocardiogram, isolated CoA may still elude prenatal detection, with potentially lethal consequences if the diagnosis is not suspected and the patent ductus arteriosus (PDA) closes spontaneously in postnatal life...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29287139/fetal-interventions-for-structural-heart-disease
#12
David N Schidlow, Lindsay Freud, Kevin Friedman, Wayne Tworetzky
Fetal cardiac intervention (FCI) offers the potential to alter in utero anatomy and physiology. For aortic stenosis with evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum with evolving hypoplastic right heart syndrome, FCI may result in maintenance of a biventricular circulation, thus avoiding single-ventricle palliation and its attendant complications. In the case of hypoplastic left heart syndrome with intact atrial septum, FCI may ameliorate in utero pathophysiology and portend a more favorable postnatal prognosis...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29286269/landmark-lecture-perloff-lecture-tribute-to-professor-joseph-kayle-perloff-and-lessons-learned-from-him-aortopathy-in-adults-with-chd
#13
Koichiro Niwa
Marfan syndrome, bicuspid aortic valve, and/or coarctation of the aorta are associated with medial abnormalities of the ascending aortic or para-coarctation aorta. Medial abnormalities in the ascending aorta are prevalent in other type of patients with a variety of CHDs such as single ventricle, persistent truncus arteriosus, transposition of the great arteries, hypoplastic left heart syndrome, and tetralogy of Fallot, encompassing a wide age range and may predispose to dilatation, aneurysm, and rapture necessitating aortic valve and root surgery...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29282492/the-use-of-fecal-calprotectin-levels-in-the-fontan-population
#14
Carlos Miranda, Anas Taqatqa, Adrian Chapa-Rodriguez, Jacob P Holton, Sawsan M Awad
The Fontan procedure was first performed in the seventies as a palliation for patients with single ventricle physiology. A feared complication after a Fontan procedure is the development of protein losing enteropathy (PLE). Systemic inflammation has a negative effect on the intestinal barrier integrity, which has supported the use of steroids in this setting. To the best of our knowledge there are no studies linking intestinal inflammation in patients with PLE after Fontan. The objective of this study was to identify the presence of intestinal inflammation measured by FC in patients with PLE after a Fontan procedure...
December 28, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29278641/reduction-of-brain-volumes-after-neonatal-cardiopulmonary-bypass-surgery-in-single-ventricle-congenital-heart-disease-prior-to-fontan-completion
#15
Kristina N Mayer, Walter Knirsch, Beatrice Latal, Ianina Scheer, Kristina Wetterling, Andreas Hahn, Hakan Akintürk, Dietmar Schranz, Ingrid Beck, Ruth ÓGorman Tuura, Bettina Reich
BACKGROUND: Little is known about the relationship between brain volumes and neurodevelopmental outcome at two years of age in children with single ventricle congenital heart disease (CHD). We hypothesized that reduced brain volumes may be associated with adverse neurodevelopmental outcome. METHODS: Volumetric segmentation of cerebral MRI scans was done in 44 patients without genetic comorbidities and in eight controls. Neurodevelopmental outcome was assessed with the Bayley-III scales...
August 21, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29277952/a-tale-of-two-cases-of-pulmonary-arteriovenous-malformation-how-they-fared-after-cardiac-transplantation
#16
Bethany L Wisotzkey, Dari L Magyar, Thomas K Jones, Robert J Boucek, Lester C Permut, Mariska S Kemna, Yuk M Law
BACKGROUND: In single ventricle patients, aorticopulmonary collaterals (APCs) and pulmonary arteriovenous malformations (PAVMs) following superior cavopulmonary shunt (CPS) can complicate orthotopic heart transplant (OHT) by cyanosis and hemoptysis. Though PAVMs can regress with restoration of hepatic venous flow to the pulmonary circulation, the effects of hypoxemia on the "unconditioned" allograft are not known. CASES: Two patients with significant PAVMs after CPS were cyanotic following OHT...
December 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29275964/fontan-palliation-for-single-ventricle-physiology-perioperative-management-for-noncardiac-surgery-and-analysis-of-outcomes
#17
REVIEW
Jimmy Windsor, Matthew M Townsley, David Briston, Pedro A Villablanca, Jorge R Alegria, Harish Ramakrishna
No abstract text is available yet for this article.
December 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29273201/hybrid-palliation-outcomes-after-the-comprehensive-stage-2-procedure
#18
Clifford L Cua, Patrick I McConnell, James M Meza, Kevin D Hill, Shuaiqi Zhang, Diane Hersey, Tara Karamlou, Jeffrey P Jacobs, Marshall L Jacobs, Mark Galantowicz
BACKGROUND: Comprehensive Stage 2 procedure (CS2) follows initial Hybrid Stage 1 palliation for patients with single ventricle physiology. Goal of this study was to describe CS2 outcomes and describe differences between survivors of CS2 (s-CS2) versus non-survivors (nons-CS2). METHODS: All patients in the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) who underwent CS2 as index operation from 2010-2016 were included. Pre-operative, operative, and post-operative data were analyzed, stratified by operative mortality (in-hospital, or within 30 days of surgery), with univariate comparisons using a chi-square / Fisher exact test or Wilcoxon rank sum test...
December 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29261645/fetal-somatic-growth-trajectory-differs-by-type-of-congenital-heart-disease
#19
Kriti Puri, Carri R Warshak, Mounira A Habli, Amy Yuan, Rashmi D Sahay, Eileen C King, Allison Divanovic, James F Cnota
BackgroundThe growth trajectories of common measurements, including estimated fetal weight (EFW), head circumference (HC), and abdominal circumference (AC), in fetuses with congenital heart disease (CHD) have not been described for different cardiac lesions. We hypothesized that (i) fetuses with CHD have differential growth in utero, and (ii) different categories of CHD demonstrate different in utero growth curves.MethodsWe performed a retrospective observational cohort study of pregnancies with known fetal CHD seen from January 2000 to June 2013...
December 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29250225/atrial-fibrillation-in-patients-with-congenital-heart-disease
#20
REVIEW
Tabitha G Moe, Victor A Abrich, Edward K Rhee
Advances in surgical techniques have led to the survival of most patients with congenital heart disease (CHD) up to their adulthood. During their lifetime, many of them develop atrial tachyarrhythmias due to atrial dilatation and scarring from surgical procedures. More complex defects and palliative repairs are linked to a higher incidence and earlier occurrence of arrhythmias. Atrial fibrillation (AF) is common in patients who have atrial septal defects repaired after age 55 and in patients with tetralogy of Fallot repaired after age 45...
June 2017: Journal of Atrial Fibrillation
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