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palliative heart surgery

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https://www.readbyqxmd.com/read/29329432/cardiac-surgical-strategy-for-extremely-low-birthweight-infants-with-pulmonary-overcirculation
#1
Takashi Kido, Kyoichi Nishigaki, Yoichi Kawahira, Koji Kagisaki, Kazuki Tanimoto, Eiji Ehara, Yosuke Murakami
OBJECTIVES: This study aimed to review the clinical outcomes of staged cardiac surgery in extremely low-birthweight infants with congenital heart disease and pulmonary overcirculation. METHODS: Six extremely low-birthweight infants with congenital heart disease and pulmonary overcirculation underwent staged cardiac surgery between 2005 and 2017. The median birthweight was 895 g (range 620-990 g), and the median gestational age was 28 weeks (range 23-31 weeks)...
January 9, 2018: Interactive Cardiovascular and Thoracic Surgery
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
#2
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/29300861/asanguineous-priming-of-miniaturized-paediatric-cardiopulmonary-bypass-circuits-for-congenital-heart-surgery-independent-predictors-associated-with-transfusion-requirements-and-effects-on-postoperative-morbidity
#3
Wolfgang Boettcher, Matthias Redlin, Frank Dehmel, Katharina Graefe, Mi-Young Cho, Helmut Habazettl, Marian Kukucka
OBJECTIVES: In paediatric cardiac surgery, body weight-adjusted miniaturized cardiopulmonary bypass (CPB) circuits within a comprehensive blood-sparing approach can reduce transfusion requirements. Haemodilution resulting from mixing the patient's blood with a CPB crystalloid solution may be reduced to the extent that asanguineous priming becomes possible. Therefore, we adopted asanguineous priming in our clinical routine. Our goal was to report the effects of asanguineous priming on transfusion requirements, clinical features associated with transfusion and effects on in-hospital morbidity...
January 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29290485/tricuspid-valve-adaptation-during-the-first-interstage-period-in-hypoplastic-left-heart-syndrome
#4
Timothy Colen, Shelby Kutty, Richard B Thompson, Edythe Tham, Andrew S Mackie, Ling Li, Dongngan T Truong, Michiko Maruyama, Jeffrey F Smallhorn, Nee Scze Khoo
BACKGROUND: Tricuspid regurgitation (TR) is an important risk factor for morbidity and mortality in hypoplastic left heart syndrome (HLHS), yet the evolution of tricuspid valve (TV) dysfunction in HLHS is poorly understood. This study sought to examine changes in TV function in HLHS between the first two stages of surgical palliation and to determine the mechanism of TR at the time of stage two surgery-bidirectional cavopulmonary anastomosis (BCPA). METHODS: We prospectively investigated 44 infants at two time points-prior to Norwood-Sano (T1 - median age 5...
December 29, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29273480/high-ionized-calcium-concentration-is-associated-with-prolonged-length-of-stay-in-the-intensive-care-unit-for-postoperative-pediatric-cardiac-patients
#5
Satoshi Kimura, Tatsuo Iwasaki, Katsunori Oe, Kazuyoshi Shimizu, Tomohiko Suemori, Tomoyuki Kanazawa, Naohiro Shioji, Yasutoshi Kuroe, Yuto Matsuoka, Hiroshi Morimatsu
OBJECTIVE: There has been controversy regarding the beneficial effects of calcium on myocardial contractility and the harmful effects on myocardial cells, especially in children. The aim of this study was to investigate an association between ionized calcium concentration (iCa) and outcomes for pediatric patients after cardiac surgery. DESIGN: A retrospective, single-center study from May 2013 to December 2014. SETTING: Referral high-volume pediatric cardiac center in a tertiary teaching hospital...
November 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29273201/hybrid-palliation-outcomes-after-the-comprehensive-stage-2-procedure
#6
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/29248924/is-there-more-to-zika-complex-cardiac-disease-in-a-case-of-congenital-zika-syndrome
#7
Asimenia Angelidou, Zoe Michael, Arda Hotz, Kevin Friedman, Sitaram Emani, Kerri LaRovere, Helen Christou
The epidemic of Zika virus (ZIKV) has resulted in a surge of newborns with microcephaly and brain abnormalities. In this report, we describe the first case, to our knowledge, of congenital Zika syndrome with concomitant critical congenital heart disease. The mother had a confirmed ZIKV infection in the first trimester of pregnancy. Fetal ultrasonography at 31 weeks of gestation revealed cerebral cortical calcifications and hypoplastic left heart syndrome. The severity of brain involvement was assessed by postnatal magnetic resonance imaging and echocardiogram, and palliative surgery was performed...
December 16, 2017: Neonatology
https://www.readbyqxmd.com/read/29241451/energetic-performance-analysis-of-staged-palliative-surgery-in-tricuspid-atresia-using-vector-flow-mapping
#8
Mao Kinoshita, Koichi Akiyama, Keiichi Itatani, Ayahiro Yamashita, Maki Ishii, Atsushi Kainuma, Yoshinobu Maeda, Takako Miyazaki, Masaaki Yamagishi, Teiji Sawa
BACKGROUND: Staged palliative surgery markedly shifts the balance of volume load on a single ventricle and pulmonary vascular bed. Blalock-Taussig shunt necessitates a single ventricle eject blood to both the systemic and pulmonary circulation. On the contrary, bidirectional cavopulmonary shunt release the single ventricle from pulmonary circulation. CASE PRESENTATION: We report a case of tricuspid atresia patient who underwent first palliative surgery and second palliative surgery...
December 14, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29229621/stem-cell-therapy-for-congenital-heart-disease-a-systematic-review
#9
REVIEW
Diamantis I Tsilimigras, Evangelos K Oikonomou, Demetrios Moris, Dimitrios Schizas, Konstantinos P Economopoulos, Konstantinos S Mylonas
BACKGROUND: Congenital heart disease (CHD) constitutes the most prevalent and heterogeneous group of congenital anomalies. Although surgery remains the gold standard treatment modality, stem cell therapy has been gaining ground as a complimentary or alternative treatment option in certain types of CHD. The aim of this study was to present the existing published evidence and ongoing research efforts on the implementation of stem cell-based therapeutic strategies in CHD. METHODS: A systematic review was conducted by searching Medline, ClinicalTrials...
December 12, 2017: Circulation
https://www.readbyqxmd.com/read/29212547/restrictive-surgical-approach-to-palliate-angina-in-a-patient-with-coronary-three-vessel-disease-and-biventricular-metastatic-hepatocellular-carcinoma
#10
Angela Kornberger, Tillmann Emrich, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Metastatic cardiac tumors may cause different symptoms including angina, symptoms of heart failure and/or arrhythmia. In patients with concomitant coronary artery disease, it may be difficult to distinguish between angina caused by metastases to the heart, for example, by stealing perfusion from the coronary arteries, and angina caused by coronary stenosis. Identifying the origin of the symptoms is, however, essential for designing appropriate surgical strategies. CASE PRESENTATION: A 69-year-old male with multifocal recurrence of a hepatocellular carcinoma (HCC) presented with increasing ventricular arrhythmia and angina several weeks after posterior myocardial infarction and PCI of the RCA culprit lesion during which two further lesions present in the distal RCX and a posterolateral branch, and a chronically occluded LAD had not been addressed...
December 7, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29199861/stenting-the-complex-patent-ductus-arteriosus-in-tetralogy-of-fallot-with-pulmonary-atresia-challenges-and-outcomes
#11
Rizwan Rehman, Mood Che Marhisham, Mazeni Alwi
Patent ductus arteriosus (PDA) stenting has gained acceptance for palliation in cyanotic congenital heart disease. The PDA in tetralogy of Fallot with pulmonary atresia (ToF-PA) arises, in the left aortic arch, from underneath the arch and connects to the proximal left pulmonary artery, often resulting in stenosis. The PDA is usually elongated and tortuous, making stent implantation challenging. Shorter duration of palliation, aggravation of branch pulmonary artery stenosis resulting in poor growth and difficulty at surgery makes ductal stenting controversial...
December 4, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29196588/understanding-stage-ii-bidirectional-cavopulmonary-shunts
#12
Cecilia St George-Hyslop, Jennifer Thomas, Linda G Fazari
Despite improvements in surgical technique and medical management, single-ventricle lesions remain one of the most challenging congenital heart anomalies to treat, and mortality rates are high. Most infants who have single-ventricle palliation undergo a sequence of surgeries to optimize pulmonary and systemic blood flow. The first surgery to separate pulmonary and systemic blood flow is the bidirectional cavopulmonary shunt. This article describes single-ventricle lesions and gives a basic overview of outcomes and strategies to improve interstage mortality...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29183331/four-successful-pregnancies-in-a-patient-with-fontan-palliation-and-congenital-heart-disease-a-case-report
#13
Khalid S Al Najashi, Syed Mehdi, Shazia Mohsin, Merna Atiyah, Hafez A Abdullah, Jassim Abdulhameed, Ahmed M Al Zahrani
BACKGROUND: Fontan is a palliative procedure in patients with single ventricle. Single ventricle supports systemic cardiac output and pulmonary blood flow is passively directed to the right pulmonary artery. Women with Fontan palliation are reported to have increased maternal risk during pregnancy. There are few reports of successful pregnancies in such cases. However data on these pregnancies is lacking, we consider this to be the first reported from kingdom of Saudi Arabia. CASE PRESENTATION: We present a 35-year-old woman from the Kingdom of Saudi Arabia who had Fontan surgery and who had four successful pregnancies and multiple miscarriages...
November 28, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29124558/development-of-a-simple-device-enabling-percutaneous-flow-regulation-for-a-small-vascular-graft-for-a-blalock-taussig-shunt-capable-of-flow-regulation-complete-translation-of-a-review-article-originally-published-in-pediatric-cardiology-and-cardiac-surgery
#14
Yoshikazu Motohashi, Ryo Shimada, Tomoyasu Sasaki, Takahiro Katsumata, Kazunori Dan, Yasuhiro Tsutsui, Shintaro Nemoto
OBJECTIVES: The Blalock-Taussig shunt (BTS) operation is a cornerstone as initial palliative surgery for congenital heart disease with severely reduced pulmonary blood flow (PBF). The ideal PBF provided by BTS is crucial for an uneventful postoperative course, since excess PBF results in acute distress of the systemic circulation and insufficient PBF requires another BTS surgery. Therefore, the goal of this study was to develop a simple device to control the shunt graft flow percutaneously using a constrictor balloon connected to a subcutaneous port...
November 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29119450/surgical-treatment-for-adult-congenital-heart-disease-consideration-for-indications-and-procedures
#15
REVIEW
Kozo Matsuo, Masashi Kabasawa, Soichi Asano, Shigeru Tateno, Yasutaka Kawasoe, Yoshitomo Okajima, Naoki Hayashida, Hirokazu Murayama
The number of the adult patients with congenital heart diseases (ACHD) continues to grow owing to improvement of surgical results and medical management. Corrective surgery for complex CHD does not always mean complete cure. It is not rare that the patients will visit the cardiology institutes because of secondary lesions due to residua or sequela in adults. Some patients with CHD remain unrepairable with different degree of heart failure and pulmonary arterial hypertension. Association of arrhythmias is common in ACHD patients and sometimes critical...
November 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29063727/nurse-driven-analgesia-and-sedation-in-pediatric-patients-with-univentricular-hearts-requiring-extracorporeal-life-support-after-first-stage-palliation-surgery-a-pilot-study
#16
Jörg Michel, Michael Hofbeck, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Walter Jost, Christian Schlensak, Matthias Kumpf, Gunnar Blumenstock, Felix Neunhoeffer
BACKGROUND: Few data are available regarding requirements of sedation and analgesia in children during extracorporeal life support. AIMS: The aim of this study was to evaluate if children with functionally univentricular hearts on extracorporeal life support after first-stage palliation surgery have higher requirement of analgesics and sedatives compared with children without extracorporeal life support using a goal-directed nurse-driven analgesia and sedation protocol...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28981194/elevated-preoperative-von-willebrand-factor-is-associated-with-perioperative-thrombosis-in-infants-and-neonates-with-congenital-heart-disease
#17
Ryan Hunt, Corey M Hoffman, Sirisha Emani, Cameron C Trenor, Sitaram M Emani, David Faraoni, Chava Kimchi-Sarfaty, Juan C Ibla
BACKGROUND: The surgical repair of congenital heart lesions is frequently complicated by perioperative thrombosis of unclear etiology. An imbalance between von Willebrand Factor (VWF) and ADAMTS-13 is an emerging variable in thrombosis. OBJECTIVES: To describe perioperative changes to VWF, ADAMTS-13 and NETosis and evaluate clinical and biochemical associations with postoperative thrombosis. METHODS: Neonates and infants undergoing palliation or definitive repair of congenital heart disease (CHD) were recruited (n =133)...
October 5, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28964410/association-of-shunt-type-with-arrhythmias-after-norwood-procedure
#18
Eric J Hall, Andrew H Smith, Frank A Fish, David P Bichell, Bret A Mettler, Kimberly Crum, Prince J Kannankeril, Andrew E Radbill
BACKGROUND: Transplant-free survival for single right ventricle (RV) lesions remains less than 70% at 3 years. Arrhythmia burden, influence of shunt type at Norwood procedure (RV-to-pulmonary artery shunt [RVPAS] versus Blalock-Taussig shunt [BTS]), and implications for mortality risk are not well defined. METHODS: The authors performed a single-center retrospective analysis of patients with single RV lesions enrolled in a prospective study of arrhythmias after congenital heart surgery...
September 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28936753/long-term-results-of-bilateral-pulmonary-artery-banding-versus-primary-norwood-procedure
#19
Yasutaka Hirata, Hiroaki Miyata, Norimichi Hirahara, Arata Murakami, Hideaki Kado, Kisaburo Sakamoto, Shunji Sano, Shinichi Takamoto
Bilateral pulmonary artery banding (PAB) has emerged to be an attractive option as an initial procedure for the treatment of hypoplastic left heart syndrome (HLHS), and some centers report excellent survival. However, its usage is variable among institutions and its true efficacy is unknown due to reporting biases. We aimed to describe the results of bilateral PAB use, preoperative risk factors, and long-term outcomes compared with primary Norwood procedure, using a national database. Infants who underwent bilateral PAB or Norwood procedure as an initial palliation for HLHS between January 2008 and December 2012 listed in the Japan Congenital Cardiovascular Surgery Database (JCCVSD) were included...
September 21, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28936438/unusual-case-of-spindle-cell-sarcoma-metastases-to-right-ventricle-a-case-report-and-a-literature-review
#20
Rezarta Frakulli, Silvia Cammelli, Fabrizio Salvi, Damiano Balestrini, Antonella Baldissera, Claudio Degli Esposti, Ombretta Martelli, Massimo Abate, Anna Piaoli, Stefano Ferrari, Alessio G Morganti, Giovanni Piero Frezza
Cardiac metastases from sarcoma are uncommon. Due to their rarity there is not a standard of care. However, complete cardiac metastases resection is the best option but most of patients has widespread disease. In these patients palliative radiotherapy (RT) might improve symptoms and prevent further cardiac function decline. Here we present the case of a symptomatic 30-year-old woman with spindle cell sarcoma metastasis of right ventriculum and widespread disease. The patient received radiotherapy to the heart with palliative intent...
September 2017: Annals of Translational Medicine
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