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Pediatric cardiac surgery

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https://www.readbyqxmd.com/read/29779802/feasibility-of-initiating-early-enteral-nutrition-after-congenital-heart-surgery-in-neonates-and-infants
#1
Rajat Kalra, Rohit Vohra, Malti Negi, Reena Joshi, Neeraj Aggarwal, Mridul Aggarwal, Raja Joshi
OBJECTIVE: To assess the feasibility of initiating enteral nutrition support with first 24 h of congenital heart repairs in neonates and Infants and its impact on outcomes following surgery. DESIGN: It is a prospective randomized control single blind study. SETTING: It is a single centre prospective study carried out in a tertiary care centre at Pediatric cardiac intensive care unit. PATIENTS: All patients with the cyanotic congenital heart disease with increase pulmonary blood flow, weighing less than 5 kg and undergoing congenital heart repair during the study period were included in the study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29770300/tissue-engineered-vascular-grafts-for-pediatric-cardiac-surgery
#2
REVIEW
Toshihiro Shoji, Toshiharu Shinoka
New technologies and science have contributed to improved surgical outcomes in patients with congenital cardiovascular diseases. However, current materials display shortcomings, such as risk of infection and lack of growth capacity when applied to the pediatric patient population. Tissue engineering has the potential to address these limitations as the ideal tissue engineered vascular graft (TEVG) would be durable, biocompatible, nonthrombogenic, and ultimately remodel into native tissue. The traditional TEVG paradigm consists of a scaffold, cell source, and the integration of the scaffold and cells via seeding...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29770299/regenerative-medicine-therapy-for-single-ventricle-congenital-heart-disease
#3
REVIEW
Chetan Ambastha, Gregory J Bittle, David Morales, Nathaniel Parchment, Progyaparamita Saha, Rachana Mishra, Sudhish Sharma, Alexander Vasilenko, Muthukumar Gunasekaran, Manal T Al-Suqi, Deqiang Li, Peixin Yang, Sunjay Kaushal
One of the most complex forms of congenital heart disease (CHD) involving single ventricle physiology is hypoplastic left heart syndrome (HLHS), characterized by underdevelopment of the left ventricle (LV), mitral and aortic valves, and narrowing of the ascending aorta. The underdeveloped LV is incapable of providing long-term systemic flow, and if left untreated, the condition is fatal. Current treatment for this condition consists of three consecutive staged palliative operations: the first is conducted within the first few weeks of birth, the second between 4 to 6 months, and the third and final surgery within the first 4 years...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29770294/three-dimensional-modelling-and-three-dimensional-printing-in-pediatric-and-congenital-cardiac-surgery
#4
REVIEW
Laszlo Kiraly
Three-dimensional (3D) modelling and printing methods greatly support advances in individualized medicine and surgery. In pediatric and congenital cardiac surgery, personalized imaging and 3D modelling presents with a range of advantages, e.g., better understanding of complex anatomy, interactivity and hands-on approach, possibility for preoperative surgical planning and virtual surgery, ability to assess expected results, and improved communication within the multidisciplinary team and with patients. 3D virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29753821/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery
#5
Sirisha Emani, Lynn A Sleeper, David Faraoni, Michelle Mulone, Fatoumata Diallo, James A DiNardo, Juan Ibla, Sitaram M Emani
BACKGROUND: Perioperative bleeding is a common complication in pediatric patients undergoing cardiac surgery. Although thromboelastography (TEG) has been utilized in patients undergoing adult cardiac surgery, limited data are available in pediatric patients. We hypothesize that TEG parameters may be associated with surrogate endpoints for postoperative bleeding in pediatric patients undergoing complex cardiac surgery. METHODS: In a retrospective study, TEG was obtained after protamine administration and upon intensive care unit (ICU) admission in pediatric patients (≤ 18yrs) undergoing cardiac surgery requiring cardiopulmonary bypass...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29745734/primary-prevention-of-post-pericardiotomy-syndrome-using-corticosteroids-a-systematic-review
#6
Rachel Wamboldt, Gianluigi Bisleri, Benedict Glover, Sohaib Haseeb, Gary Tse, Tong Liu, Adrian Baranchuk
Post-pericardiotomy syndrome is a well-recognized inflammatory phenomenon that commonly occurs in patients following cardiac surgery. Due to the increased morbidity and resource utilization associated with this condition, research has recently focused on ways of preventing its prevention this condition; primarily using colchicine, NSAIDs and corticosteroids. Areas covered: This systematic review summarizes the three clinical studies that have used corticosteroids for PPS primary prevention in the perioperative period...
May 10, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#7
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29739232/comparison-of-the-coagulation-effect-achieved-by-octaplaslg-versus-fresh-frozen-plasma-in-pediatric-cardiac-surgical-patients
#8
Amanpreet S Kalsi, Omar Al-Azzawi, Ravi Gill
OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have beneficial effects when considering the transmission of enveloped viruses. Additionally, it has the potential for fewer adverse reactions, reduced disease transmission, and a more homogenous coagulation factor composition. However, its efficacy and safety have not yet been evaluated in the pediatric population...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29734243/incidence-and-risk-factors-for-perioperative-cardiovascular-and-respiratory-adverse-events-in-pediatric-patients-with-congenital-heart-disease-undergoing-noncardiac-procedures
#9
Sandra Lee, Elise Reddington, Sophia Koutsogiannaki, Michael R Hernandez, Kirsten C Odegard, James A DiNardo, Koichi Yuki
BACKGROUND: While mortality and adverse perioperative events after noncardiac surgery in children with a broad range of congenital cardiac lesions have been investigated using large multiinstitutional databases, to date single-center studies addressing adverse outcomes in children with congenital heart disease (CHD) undergoing noncardiac surgery have only included small numbers of patients with significant heart disease. The primary objective of this study was to determine the incidences of perioperative cardiovascular and respiratory events in a large cohort of patients from a single institution with a broad range of congenital cardiac lesions undergoing noncardiac procedures and to determine risk factors for these events...
April 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29732365/corticosteroids-in-pediatric-heart-surgery-myth-or-reality
#10
REVIEW
Daniel P Fudulu, Ben Gibbison, Thomas Upton, Serban C Stoica, Massimo Caputo, Stafford Lightman, Gianni D Angelini
Background: Corticosteroids have been administered prophylactically for more than 60 years in pediatric heart surgery, however, their use remains a matter of debate. There are three main indications for corticosteroid use in pediatric heart surgery with the use of cardiopulmonary bypass (CPB): (1) to blunt the systemic inflammatory response (SIRS) induced by the extracorporeal circuit; (2) to provide perioperative supplementation for presumed relative adrenal insufficiency; (3) for the presumed neuroprotective effect during deep hypothermic circulatory arrest operations...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29727421/near-infrared-spectroscopy-monitoring-after-pediatric-cardiac-surgery-time-for-an-intervention
#11
Michael C Spaeder
No abstract text is available yet for this article.
May 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29720109/altered-cerebral-glucose-metabolism-normalized-in-a-patient-with-a-pediatric-autoimmune-neuropsychiatric-disorder-after-streptococcal-infection-pandas-like-condition-following-treatment-with-plasmapheresis-a-case-report
#12
A H Nave, P Harmel, R Buchert, L Harms
BACKGROUND: Pediatric autoimmune neuropsychiatric disorder after streptococcal infection (PANDAS) is a specific autoimmune response to group-A streptococcal infections in children and adolescents with a sudden onset of obsessive-compulsive disorders or tic-like symptoms. Cerebral metabolic changes of patients have not yet been observed. CASE PRESENTATION: We present a case of an 18-year old male with a PANDAS-like condition after developing tic-like symptoms and involuntary movements three weeks after cardiac surgery...
May 2, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29709361/partial-thromboplastin-time-is-more-predictive-of-bleeding-than-anti-xa-levels-in-heparinized-pediatric-patients-after-cardiac-surgery
#13
Olubunmi O Oladunjoye, Lynn A Sleeper, Asha G Nair, Cameron C Trenor, Christina VanderPluym, John N Kheir, Sitaram M Emani
OBJECTIVES: Anticoagulation with unfractionated heparin (UFH) after pediatric cardiac surgery can be monitored using either activated partial thromboplastin time (aPTT) or anti-factor Xa activity (anti-Xa). However, correlation of bleeding with either of these laboratory values has not been established. We sought to determine the correlation between bleeding events and aPTT and anti-Xa in patients who undergo anticoagulation after congenital heart surgery. METHODS: We prospectively studied pediatric patients treated with UFH after cardiac surgery over an 11-month period...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29707528/changes-in-near-infrared-spectroscopy-after-congenital-cyanotic-heart-surgery
#14
Judith Ju-Ming Wong, Ching Kit Chen, Rajesh Babu Moorakonda, Olivia Wijeweera, Tracy Yi Shuen Tan, Masakazu Nakao, John Carson Allen, Tsee Foong Loh, Jan Hau Lee
Background: Since oxygen saturation from pulse oximetry (SpO2 ) and partial pressure of arterial oxygen (PaO2 ) are observed to improve immediately after surgical correction of cyanotic congenital heart disease (CHD), we postulate that cerebral (CrO2 ) and somatic (SrO2 ) oximetry also improves immediately post-correction. We aim to prospectively examine CrO2 and SrO2 , before, during, and after surgical correction as well as on hospital discharge in children with cyanotic CHD to determine if and when these variables increase...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29701191/-influential-factors-of-cerebral-oxygen-saturation-in-pediatric-cardiovascular-surgery
#15
Qian Li, Mao'en Zhu, Yanrong Zhang, Sisi Dai, Junjie Zhang, Qulian Guo, E Wang
To determine the intervention measures for the decrease of cerebral tissue oxygen saturation during anesthesia for the congenital heart disease in children.
 Methods: Twenty-eight children with cardiac surgery were enrolled. Anesthesia was deepened with propofol (3 mg/kg) intravenous injection. The data of cerebral tissue oxygen saturation(SctO2), mean arterial pressure (MAP), HR, bispectral index (BIS), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), hemoglobin (Hb) and middle cerebral artery (MCA) mean flow velocity (Vm) at different points were collected after intravenous injection of propofol at 3 mg/kg...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29698662/liberal-use-of-delayed-sternal-closure-in-children-is-not-associated-with-increased-morbidity
#16
S Ram Kumar, Nigel Scott, Winfield J Wells, Vaughn A Starnes
BACKGROUND: Delayed sternal closure (DSC) is often employed to optimize hemodynamics following pediatric cardiac surgery. Prior reports have suggested that DSC may be associated with increased morbidity. We sought to analyze the impact of a liberal policy of DSC on surgical outcomes at our center. METHODS: We retrospectively evaluated the clinical course of 1,000 consecutive patients between July 2005 and June 2015 whose sternum was electively left open following pediatric cardiac surgery...
April 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29692232/pediatric-cardiac-surgery-and-pain-management-after-40-years-in-the-desert-have-we-reached-the-promised-land
#17
Uri Pollak, Alain Serraf
Pain prevention in the pediatric population is mandatory and an integrative aspect of medical practice. Optimal pain management is the right of all patients and the responsibility of all health professionals. The key to adequate pain management is assessing its presence and severity, identifying those who require intervention, and appreciating treatment efficacy. The population of pediatric patients undergoing cardiac surgery is unique in both clinical severity and hemodynamic response to painful stimuli, thus making pain management even more challenging...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29692230/nutrition-considerations-in-the-pediatric-cardiac-intensive-care-unit-patient
#18
Lindsey Justice, Jason R Buckley, Alejandro Floh, Megan Horsley, Jeffrey Alten, Vijay Anand, Steven M Schwartz
Adequate caloric intake plays a vital role in the course of illness and the recovery of critically ill patients. Nutritional status and nutrient delivery during critical illness have been linked to clinical outcomes such as mortality, incidence of infection, and length of stay. However, feeding practices with critically ill pediatric patients after cardiac surgery are variable. The Pediatric Cardiac Intensive Care Society sought to provide an expert review on provision of nutrition to pediatric cardiac intensive care patients, including caloric requirements, practical considerations for providing nutrition, safety of enteral nutrition in controversial populations, feeding considerations with chylothorax, and the benefits of feeding beyond nutrition...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29692229/corticosteroids-and-other-anti-inflammatory-strategies-in-pediatric-heart-surgery-a-national-survey-of-practice
#19
Daniel P Fudulu, Alvin Schadenberg, Ben Gibbison, Ian Jenkins, Stafford Lightman, Gianni D Angelini, Serban Stoica
BACKGROUND: The role of steroids to mitigate the deleterious effects of pediatric cardiopulmonary bypass (CPB) remains a matter of debate; therefore, we aimed to assess preferences in administering corticosteroids (CSs) and the use of other anti-inflammatory strategies in pediatric cardiac surgery. METHODS: A 19-question survey was distributed to consultants in pediatric cardiac anesthesia from 12 centers across the United Kingdom and Ireland. RESULTS: Of the 37 respondents (37/60, 62%), 24 (65%) use CSs, while 13 (35%) do not use steroids at all...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#20
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
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