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https://www.readbyqxmd.com/read/28899955/natural-history-and-clinical-predictors-of-atrial-tachycardia-in-adults-with-congenital-heart-disease
#1
Pablo Ávila, José María Oliver, Pastora Gallego, Ana González-García, María José Rodríguez-Puras, Esther Cambronero, José Ruiz-Cantador, Ana Campos, Rafael Peinado, Raquel Prieto, Fernando Sarnago, Raquel Yotti, Francisco Fernández-Avilés
BACKGROUND: Atrial tachycardias (ATs) are a significant source of morbidity in adults with congenital heart disease (CHD). This study evaluates the incidence and clinical predictors of AT in a cohort of patients with CHD. METHODS AND RESULTS: We included 3311 adults (median age at entry 22.6 years, 50.6% males) with CHD (49% simple, 39% moderate, and 12% complex) prospectively followed up in a tertiary center for 37 607 person-years. Predictors of AT were identified by multivariable Cox regression analysis accounting for left truncation...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28898966/employment-characteristics-of-a-complex-adult-congenital-heart-disease-cohort
#2
L Pickup, T Gaffey, P Clift, S Bowater, S Thorne, L Hudsmith
Background: Due to advances in surgical techniques and subsequent management, there have been remarkable improvements in the survival of patients with congenital heart disease. In particular, larger numbers of patients with complex disease are now living into adulthood and are entering the workforce. Aims: To establish the types of employment complex adult congenital heart disease (ACHD) patients are engaged in, based on the largest cohort of patients with a single-ventricle circulation in the UK...
August 1, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28895188/an-alternative-technique-of-atrial-septectomy-during-bidirectional-superior-cavopulmonary-anastomosis
#3
Sachin Talwar, Yatin Arora, Sukhjeet Singh, Balram Airan
An atrial septectomy is often required to create or enlarge a pre-existing restrictive atrial septal defect in patients with univentricular hearts undergoing the bidirectional superior cavopulmonary anastomosis. We describe an alternative surgical technique through the transected cardiac end of the superior vena cava without a right atriotomy successfully performed in 26 patients.
September 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28889816/first-stage-palliation-strategy-for-univentricular-heart-disease-may-impact-risk-for-acute-kidney-injury
#4
Bryan H Goldstein, Stuart L Goldstein, Prasad Devarajan, Farhan Zafar, David M Kwiatkowski, Bradley S Marino, David L S Morales, Catherine D Krawczeski, David S Cooper
OBJECTIVE: Norwood palliation for patients with single ventricle heart disease is associated with a significant risk for acute kidney injury, which portends a worse prognosis. We sought to investigate the impact of hybrid stage I palliation (Hybrid) on acute kidney injury risk. DESIGN: This study is a single-centre prospective case-control study of seven consecutive neonates with single ventricle undergoing Hybrid palliation. Levels of serum creatinine and four novel urinary biomarkers, namely neutrophil gelatinase-associated lipocalin, interleukin-18, liver fatty acid-binding protein, and kidney injury molecule-1, were obtained before and after palliation...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28886927/suitability-of-cardiac-resynchronisation-therapy-in-patients-with-fontan-circulation-and-congenitally-corrected-transposition-of-the-great-arteries
#5
P Demetriades, A Bell, C Gubran, H Marshall, J de Bono, L Hudsmith
BACKGROUND: Cardiac resynchronisation therapy (CRT) is a well-recognised treatment in systolic heart failure. There is limited evidence in congenital patients with univentricular hearts or systemic right ventricles. In 2014 PACES/HRS published a consensus statement recommending CRT if ventricular ejection fraction (EF)≤35%, QRS duration≥150ms (with RBBB in systemic RV), NYHA II-IV and ventricular dilatation. The incidence of patients meeting these criteria in whom CRT is possible is not known...
September 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28883840/modalities-of-ventricular-pacing-for-cardiac-resynchronization-therapy-in-patients-with-heart-failure-a-meta-analysis-and-systematic-review
#6
REVIEW
Ailan Chen, Xinyu Chen, Yuechun Shen, Wanglin Li
INTRODUCTION: This meta-analysis evaluated 14 studies which compared clinical and functional outcomes after different cardiac resynchronization therapy (CRT) modalities. MATERIAL AND METHODS: Relevant studies were selected from the Medline, PubMed, Cochrane, and Google Scholar databases until June 27(th), 2016. We analyzed and compared the clinical outcomes (peak O2 consumption and LVEF) and functional outcomes (6-min walk distance and quality of life (SF-36)) of HF patients who received different CRT modalities with outcomes in patients who received conventional univentricular therapy...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28879464/prevalence-of-subclinical-enteric-alpha-1-antitrypsin-loss-in-children-with-univentricular-circulation-following-total-cavopulmonary-connection
#7
Colm R Breatnach, Aoife Cleary, Terence Prendiville, Kathleen Crumlish, Helene Murchan, Colin J McMahon
Protein-Losing Enteropathy post Fontan palliation is associated with significant morbidity and mortality. To date, very little research has been carried out to improve early identification of enteric protein loss in these patients. We hypothesise that subclinical enteric protein loss may occur in patients post Fontan surgery. A cross-sectional study was performed on 43 patients post Fontan surgery. We collected specimens of stool and blood from patients with no symptoms of protein-losing enteropathy post Fontan...
September 6, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28859128/plasma-microvesicle-analysis-identifies-microrna-129-5p-as-a-biomarker-of-heart-failure-in-univentricular-heart-disease
#8
Sweta Ramachandran, Alexander Lowenthal, Carissa Ritner, Shiri Lowenthal, Harold S Bernstein
Biomarkers of heart failure in adults have been extensively studied. However, biomarkers to monitor the progression of heart failure in children with univentricular physiology are less well understood. We proposed that as mediators of diverse pathophysiology, miRNAs contained within circulating microvesicles could serve as biomarkers for the presence and progression of heart failure in univentricular patients. To test this, we studied the association of heart failure with elevations in specific miRNAs isolated from circulating microvesicles in a cohort of children with univentricular heart disease and heart failure...
2017: PloS One
https://www.readbyqxmd.com/read/28845873/-late-complications-of-fontan-operation
#9
Alessandro Frigiola, Mauro Lo Rito
Complex univentricular heart defects are treated with the Fontan operation that consists in the diversion of the systemic venous return to the pulmonary arteries. Currently, the operation is achieved through a staged approach and with the use of prosthetic extracardiac conduits to connect the inferior vena cava to the pulmonary arteries. The improvement of early and late survival allowed these patients to reach adulthood, although long-term complications remain a relevant problem. Most of the complications are caused by chronic systemic venous hypertension due to the lack of a pumping sub-pulmonary ventricle...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28814710/left-univentricular-pacing-by-rate-adaptive-atrioventricular-delay-in-treatment-of-chronic-heart-failure
#10
Lulu Zhao, Ling Zhao, Lijin Pu, Baotong Hua, Yu Wang, Shumin Li, Qing Li, Tao Guo
BACKGROUND Cardiac resynchronization therapy (CRT) is efficacious in the treatment of chronic heart failure (CHF); however, because it is non-physiological, some patients are unresponsive. The present study used rate-adaptive atrioventricular delay (RAAVD) to track the physiological atrioventricular delay and investigated the effects of left univentricular pacing on CRT. MATERIAL AND METHODS Patients with CHF fulfilling the indication of CRT Class I were categorized into a left univentricular pacing by RAAVD group and a standard biventricular pacing group...
August 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28805038/novel-approaches-to-direct-atrial-access-after-extracardiac-fontan-palliation
#11
EDITORIAL
Victor Sam Lucas
Catheter access to the "native" atria is limited after extra-cardiac Fontan palliation of univentricular cardiac defects Catheter access to the atria is necessary to percutaneously treat acquired abnormalities after extra-cardiac Fontan palliation Direct trans-thoracic atrial access and extra-cardiac conduit puncture is technically straightforward and allows for novel catheter interventions.
August 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28783102/the-pulmonary-circulation-in-the-single-ventricle-patient
#12
REVIEW
Amanda Hauck, Nicolas Porta, Steven Lestrud, Stuart Berger
In recent decades, survival of children with complex congenital heart disease has improved considerably. Specifically, children with a variety of congenital heart defects resulting in 'single ventricle' physiology can now undergo palliative surgery that allows survival beyond the neonatal period, and in many cases into adulthood, despite having a single functional ventricular pumping chamber supplying both the pulmonary and systemic circulation. Our growing understanding of the functionally univentricular heart has resulted in freedom from Fontan failure of >50% at 25 years post-Fontan...
August 7, 2017: Children
https://www.readbyqxmd.com/read/28765742/clinical-characteristics-and-independent-factors-related-to-long-term-outcomes-in-patients-with-left-isomerism
#13
Sun Hyang Lee, Bo Sang Kwon, Gi Beom Kim, Eun Jung Bae, Chung Il Noh, Hong Gook Lim, Woong Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: We studied the results of patient management for left isomerism (LI) and sought to determine factors that may influence survival and prognosis. SUBJECTS AND METHODS: We reviewed the medical records of 76 patients who were compatible with LI criteria between 1982 and 2014. RESULTS: Of the total study population, 29 patients (38.1%) had functional univentricular heart disease, 43 patients (56.5%) had cardiac anomalies suitable for biventricular hearts, and four patients (5...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28743383/successful-atrioventricular-valve-repair-improves-long-term-outcomes-in-children-with-unbalanced-atrioventricular-septal-defect
#14
Edward Buratto, Xin Tao Ye, Christian P Brizard, Johann Brink, Yves d'Udekem, Igor E Konstantinov
BACKGROUND: Atrioventricular valve regurgitation is a significant cause of morbidity and mortality in patients with unbalanced atrioventricular septal defect. However, knowledge of the outcomes of atrioventricular valve repair in children with unbalanced atrioventricular septal defect and univentricular physiology is limited. METHODS: We conducted a retrospective review of all patients with unbalanced atrioventricular septal defect treated with single-ventricle palliation who underwent atrioventricular valve surgery at The Royal Children's Hospital...
June 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28734439/coronary-sinus-orifice-atresia-after-the-fontan-completion-unique-repair-technique
#15
Shinya Yokoyama, Takeo Yonekura, Noboru Nishiwaki, Shigeki Taniguchi
We report a successful unroofing of the coronary sinus via a unique technique. Our patient was diagnosed with single ventricle morphology. Pulmonary artery banding and bidirectional cavopulmonary shunt were performed at 1 and 6 months old, respectively. Ordinary univentricular repair strategy was performed; extracardiac total cavopulmonary connection was achieved at 18 months old. Catheterization performed 1 year after the Fontan procedure revealed the coronary sinus orifice atresia, diffuse coronary artery stenosis, and sinusoid formation of the coronary system...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28734437/two-pumps-for-single-ventricle-mechanical-support-for-establishment-of-biventricular-circulation
#16
Stanislav Ovroutski, Oliver Miera, Thomas Krabatsch, Felix Berger, Joachim Photiadis, Evgenii Potapov
A 31-year-old patient with a univentricular heart and double-inlet left ventricle, moderate pulmonary stenosis, and severe mitral valve regurgitation experienced irreversible heart failure after mitral valve replacement. "Biventricular" mechanical circulatory support was initiated. The systemic circulation was supported using the HeartWare ventricular assist device (HVAD) (HeartWare, Framingham, MA) pump in the usual manner. The second pump was inserted into the right atrium and connected to the pulmonary artery after closure of the pulmonary valve and atrial separation...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28730300/health-related-quality-of-life-in-paediatric-patients-with-congenital-heart-defects-association-with-the-type-of-heart-defect-and-the-surgical-technique
#17
A Heusch, H J Kahl, K O Hensel, G Calaminus
The aim of the study was to investigate the impact of a number of surgical interventions for a various congenital cardiac defects (CHDs) on self-reported HRQoL. METHODS: Patients who had received corrective surgery of several congenital heart defects (surgical VSD closure, Fallot, TGA after atrial or arterial switch or Fontan-type circulation for univentricular AV-connection) were interviewed in the office of their home peadiatric cardiologist. HRQoL in children along 7 dimensions was assessed using a standardised questionnaire (PEDQoL); information on the medical case history of each respondent was also collected...
July 20, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28727893/outcome-after-prenatal-and-postnatal-diagnosis-of-complex-congenital-heart-defects-and-the-influence-of-genetic-anomalies
#18
Katya De Groote, Ellen Vanhie, Ellen Roets, Paul Ramaekers, Hans De Wilde, Joseph Panzer, Kristof Vandekerckhove, Thierry Bove, Katrien François, Koen Van Herck, Daniël De Wolf
OBJECTIVE: Determine prenatal detection rate, mortality and association with genetic abnormalities in patients with severe CHD. METHOD: Single center retrospective study in patients with severe CHD diagnosed pre or postnatally (2006 to 2014). RESULTS: 567 patients were included, 176 (31%) after prenatal diagnosis, with large differences in prenatal detection rate among CHD types. Coarctation (24%), tetralogy of Fallot (21%) and univentricular heart (19%) were the most prevalent CHD...
July 20, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28720202/a-novel-surgical-approach-to-mechanical-circulatory-support-in-univentricular-infants
#19
Avihu Z Gazit, Orlando Petrucci, Peter Manning, Mark Shepard, Sirine Baltagi, Kathleen Simpson, Chesney Castleberry, Charles Canter, Pirooz Eghtesady
BACKGROUND: Historically, the options for mechanical circulatory support in infants, particularly those with single-ventricle physiology, have been limited and outcomes have generally been poor. We report a new approach implemented for long-term support in a series of such patients. METHODS: This study is a single-center case series of 7 patients with single-ventricle physiology after stage 1 palliation supported with mechanical circulatory support using a novel technique, between May 2014 and September 2015...
July 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28719142/changing-prevalence-of-severe-congenital-heart-disease-results-from-the-national-register-for-congenital-heart-defects-in-germany
#20
Constanze Pfitzer, Paul C Helm, Hannah Ferentzi, Lisa-Maria Rosenthal, Ulrike M M Bauer, Felix Berger, Katharina R L Schmitt
OBJECTIVE: To assess the prevalence of congenital heart disease (CHD) in Germany in relation to phenotypes, severity and gender. DESIGN: Cross-sectional registry study. SETTING: We analyzed data from patients with CHD born between 1996 and 2015. PATIENTS: A total of 26 630 patients, registered with the NRCHD, were born between 1996 and 2015. 10 927 patients were excluded from the current analysis due to prior registration with the NRCHD under the German PAN Prevalence Study, which showed a potential bias in the inclusion of this patient population (proportion of mild cardiac lesions was comparatively high due to improved diagnostic capability for earlier identifying minor lesions)...
July 18, 2017: Congenital Heart Disease
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